Reps. Doggett, Sen. Casey Author Bicameral Legislation to Ensure Special Enrollment Session for Marketplace Coverage During Public Health Emergencies Like COVID-19

WASHINGTON, March 24 -- Rep. Lloyd Doggett, D-Texas, issued the following news release:

On the tenth anniversary of the Affordable Care Act (ACA), and as the COVID-19 pandemic spreads across the United States, Rep. Doggett (D-TX), Chairman of the House Ways and Means Health Subcommittee, and Senator Bob Casey (D-PA) introduced legislation to require a special enrollment period any time there is a public health emergency declaration, such as COVID-19, and to require insurance plans to cover any treatments and services related to the disease that sparked the public health emergency declaration.

"The Affordable Care Act is an invaluable tool in combatting the coronavirus pandemic. Let's give more Americans an opportunity to access affordable health care, especially those who missed last year's Trump-narrowed and little federally-publicized enrollment period. And for those who have discovered that the junk, short-term insurance plan they purchased is really junk, this represents an opportunity to secure genuine health insurance," said Rep. Doggett. "With a public health emergency spreading like wildfire, we need to equip our uninsured and underinsured neighbors with the ability to protect and care for their families. Our entire communities are strengthened by expanding the ability of the health insurance market to respond."

On March 13, Rep. Doggett led over 100 colleagues in urging Secretary Azar to use his existing authority to establish a Special Enrollment Period for COVID-19. You can read the letter here, which has gone unanswered. "Many among the close to 30 million Americans living without insurance and estimated 44 million who are underinsured would benefit from such a declaration," the lawmakers wrote in that letter. "As outbreaks emerge and community spread continues in the United States, our most vulnerable neighbors are those who lack comprehensive health coverage. Without that coverage, they are unlikely to seek treatment for COVID-19, leaving all in our community at risk."

Here in Texas, 1.1 million uninsured people are currently eligible for no-premium marketplace plans; holding a special enrollment period during public health emergencies gives many of our most vulnerable the opportunity to get comprehensive coverage, making all of Texas safer. Likewise, requiring private insurance plans to cover treatment and services related to COVID-19 ensures consumers are guaranteed access to the care they need during the emergency.

This legislation would lower the barriers to care for patients and provide predictability and assurance for families, particularly in a public health emergency. This means allowing people to enroll in plans that provide comprehensive benefits, regardless of whether they are healthy or, in this case, diagnosed with COVID-19. With this bill, under the declaration of a Public Health Emergency by the Secretary of Health and Human Services, the Secretary would:

* Establish a special enrollment period of at least 30 days, open to anyone who wants to enroll and can be extended at the Secretary's discretion;

* Ensure that patients can get prevention, diagnostics and treatment comparable to what they might expect for similar services outside of a public health emergency;

* Waive restrictions and limitations on access to covered benefits, such as prior authorization requirements and limitations on filling or refilling prescription drugs, when the services are determined to be medically necessary by the patient's health care provider and such restrictions are determined to be unduly burdensome by the Secretary.