Topics
More on Reimbursement

Biden opens up the Affordable Care Act for a special enrollment period

The president's plan will benefit nonprofit hospitals by reducing the number of uninsured or underinsured patients, Moody's says.

Susan Morse, Managing Editor

(Photo by Win McNamee\Getty images)(Photo by Win McNamee\Getty images)

The Centers for Medicare and Medicaid Services is opening a special enrollment period for uninsured consumers to get coverage through the Affordable Care Act.

In addition, those who already have a health plan through the ACA may change their coverage.

The usual open enrollment period ended on December 15, 2020. The special enrollment period will be open from February 15 through May 15.

Focus on Health Equity

Expanding access, ending disparities, empowering communities. See our coverage >>

Consumers may use HealthCare.gov, the marketplace call center or direct enrollment channels to sign up for coverage. 

Insurers using the HealthCare.gov platform must make a special enrollment period available to all marketplace-eligible consumers who are submitting a new application or updating an existing application, CMS said. This is for the 36 states served by marketplaces that use the HealthCare.gov platform.

In addition, CMS strongly encourages states operating their own marketplace platforms to make a similar enrollment opportunity available to consumers in their states.

CMS will conduct outreach to encourage those who are eligible to enroll, spending $50 million on advertising in broadcast, digital and in direct outreach to consumers. 

A network of over 50,000 agents and brokers and over 8,000 trained assisters will be available to help consumers with their applications.

Consumers who are eligible and enroll will be able to select a plan with coverage that starts prospectively the first of the month after plan selection. 

As always, consumers found eligible for Medicaid or CHIP will be transferred to their state Medicaid and CHIP agencies for enrollment in those programs.

WHY THIS MATTERS

The special open enrollment period is in accordance with an executive order issued by President Biden.
 
The goal is to make health insurance available for those who lost their coverage along with their jobs during the coronavirus pandemic. 

"But, today, I'm about to sign two executive orders that are – basically, the best way to describe them, to undo the damage Trump has done," Biden said Thursday.

The move is beneficial to providers who would otherwise face more uncompensated care.

Jennifer Barr, Analyst at Moody's Investors Service, said, "The president's executive order reopening the Affordable Care Act enrollment for 90 days will benefit nonprofit hospitals by facilitating health insurance coverage, reducing the number of uninsured or underinsured patients, and promote patient-volume recovery, which remains below pre-pandemic levels."

Estimates vary on how many Americans lost their employer-based insurance due to the pandemic. Unemployment peaked in April 2020 at 14.7%, according to the Commonwealth Fund.

The Employment Policy Institute estimated that 16.2 million workers lost their employer coverage as of May 2020 and a Kaiser Family Foundation study raised that estimate at 27 million workers, the report said.

But subsequent estimates, including one by the Commonwealth Fund, concluded that, between February and June 2020, 7.7 million workers lost jobs with employer-sponsored insurance. With 6.9 million covered dependents, the loss of coverage affected an estimated 14.6 million people.

Millions of Americans are facing uncertainty, and millions of Americans are experiencing new health problems during the pandemic, CMS said. 

THE LARGER TREND

Biden has promised to strengthen the ACA, a law passed under President Barack Obama while he was vice president.
 

Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com