Biden Administration Declares Special Enrollment Period in Response to COVID-19

President Biden has just signed two highly anticipated government orders related to healthcare. The first is to strengthen Medicaid and the Reasonably priced Care Act and instructs HHS that they should consider making a COVID related special enrollment period (SEP). Biden’s administration has also committed $50 million in outreach and education to help make people aware of the enrollment choice and the financial assistance that is available to offset the cost of care and protection.

Our updated subsidy calculator will estimate the amount you can save on your medical health insurance premiums in 2022.

State officials, insurers and consumer advocates repeatedly asked the Trump administration to open a COVID special enrollment period in 2020. But they were denied. Nearly all state-run exchanges opened COVID-related special enrollment periods in 2020.

When will the HealthCare.gov special enrollment period begin?] The particular enrollment window runs from February 15 through August 15. This gives individuals six months to choose a health plan, regardless of whether or not they have any qualifying circumstances ( edit : this is an extension. Originally, the window was scheduled to end Might 15, 2021 but was then extended to August 15).

Anyone who is eligible to use the market may enroll during this specific enrollment period. It includes people who are uninsured or underinsured. Or, they may be enrolled in the marketplace and want to switch to a different plan.

Prior to now, it had been anticipated that the new special enrollment period would be for People that are uninsured. This was similar to the COVID specific enrollment periods that were already introduced in the District of Columbia (and, at the time, SEPs in Massachusetts also applied to people who had COBRA but wished to change it to a plan offered by the market). CMS published the details of the SEP and it became clear that the CMS wanted to create a wide net, so the special enrollment period would be available for both those without insurance as well as for current market enrollees.

The company has clarified that, ” current enrollees can change to any plan available in their area without restriction to the same level of coverage as their existing plan.” They also note that, ” customers won’t need to provide any documentation of an event qualifying them for SEP eligibility.”

You can enroll in coverage via HealthCare.gov regardless of whether you have no insurance, are enrolled in an existing plan through HealthCare.gov or you already have protection under a Farm Bureau non-insurance program, a fixed indemnity plan or a healthcare sharing ministry plan. [/hio_question]

Do state-run markets also offer a specific enrollment period for uninsured citizens?

HealthCare.gov, which is used in 36 states and includes the COVID State-Specific Program (SEP), is available in every state.

The federal announcement was followed by the state-run exchanges (some had already announced COVID-related special enrollment periods prior to that). Here’s an overview of COVID-related special enrollment periods in states which run their own exchanges. (Note that this list has been updated over time to reflect new bulletins as well as enrollment windows that have finished)

  • Connecticut: October 31
  • California: Through December 31
  • New Jersey: via December 31
  • New York via December 31
  • DC: via the tip of pandemic emergency period

In 2021, the opposite exchanges that are run by state also applied COVID-related specific enrollment periods. However, they have since been discontinued.

  • Idaho: April 30
  • Massachusetts: Via the 23rd of July
  • Minnesota: Through July 16th (this window is closed, but individuals who received unemployment benefits in 2021 may still enroll or switch to a premium silver plan for $0)
  • Colorado: Via August 15
  • Maryland: via August 15
  • Nevada: Via August 15
  • Pennsylvania: via August 15
  • Rhode Island via August 15
  • Vermont: October 1, for those who are uninsured; August 15, for those who need to change plans
  • Washington, via August 15

EDIT : By October 2021, 5 state-run exchanges will still allow enrollment for 2021 coverage without a qualifying event: California, Connecticut (DC), Minnesota (for those receiving unemployment benefits in 2021), New Jersey and New York.

Some of these enrollment windows are only for uninsured individuals or those who have not yet enrolled in the market. Others apply to anyone eligible to use the market, including people with coverage and wanting to switch to a new plan. EDIT : Some state-run exchanges, which initially had a limited enrollment window (i.e. only for uninsured residents), have added flexibility so that people who already have coverage can take advantage of the American Rescue Plan’s enhanced premium subsidies. They can also change plans if necessary.

They encouraged him to take various actions to improve access to health care and protection. Their suggestions included opening a specific enrollment period, as well as ” restoring funding for outreach, restoring flexibility in eligibility rules like failure to reconcile and immediately revoking public price guidelines.”

Insurance coverage commissioners, some of whom represent states that operate their own exchanges, also noted that

We want to ensure that all efforts to promote market enrollment are national and include state-based markets, as well as HealthCare.gov. Please coordinate as soon as possible with state-based markets on the timing and messaging of any SEP. Also, please let us know the key strategies you plan to use to reach the uninsured.

The CMS press release notes that ” strongly encouraged states operating their own Market platforms to provide the same enrollment option to consumers of their states.” By early February, only three state-run Exchanges had not yet introduced COVID related enrollment periods (edit: by mid-February, all three exchanges had introduced COVID related enrollment durations; COVID enrollment dates are available nationwide, but the rules and deadlines vary a little in some states).

How do I continue to receive protection after COVID’s enrollment period ends?

If you are uninsured, and do not enroll during the COVID-related registration period in your state, then your options for coverage for the remainder of 2021 will be limited.

You may still have some options, as described here. If you are eligible for Medicaid, CHIP or both, you can enroll at any time of the year. Your protection may even be retroactive. You may have to consider a plan not governed by the Affordable Care Act. This could be a short-term or health care sharing ministry to tide you over until you can enroll in an insurance plan through the market.

What other actions will the chief orders take?

In a matter of weeks, the uninsured will be able to enroll. The government order will likely direct federal agencies to consider a number of other reforms that could have a much greater impact.

Amongst the many,

  • Restoring funding for navigators, and outreach/training that HealthCare.gov could do under the Obama administration.
  • Rolling back the Trump administration’s relaxed guidelines on short-term health plans (to protect individuals with pre-existing conditions),
  • Now not Approving Medicaid Work Needs or Block Grant Proposals
  • Rolling back the relaxed guardrails of 1332 waivers, which the Trump administration favored.
  • Altering the way in which the affordability of plans sponsored by employers is calculated (to repair the household glitch) and
  • There are a number of options to remove the subsidy slope and make insurance coverage more affordable for people with earnings just above 400 percent of poverty.

The second order of the government is designed to protect girls’ health in America and around the globe, including ensuring access to reproductive healthcare. The order rescinded Mexico Metropolis Coverage, which prohibited U.S. funding to non-profits worldwide that provide abortion referrals or counseling for girls. This rule was initially implemented in the 1980s, and it has been rescinded several times under different administrations.

The order also directs federal agencies to reconsider the Trump administration’s rule that eliminated federal funding for Deliberate Parenthood, and other abortion providers.


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