March 24, 2020


Eleven States Now Letting Uninsured Sign Up for Obamacare (Margot Sanger-Katz and Reed Abelson, March 23, 2020, NY Times)

Eleven states and the District of Columbia have opened enrollment under the Affordable Care Act to allow laid-off workers to get subsidized health insurance, and the Trump administration, which has been gunning to repeal the law, is considering opening the federal exchange to new customers. [...]

There are also an estimated 17 million people already uninsured but eligible for marketplace coverage, according to a recent study from the Kaiser Family Foundation. That study found that more than a quarter of those people were eligible for a bronze plan that would cost them nothing in premiums after federal subsidies were applied (they would still have a high deductible). A broad special enrollment period could protect that group from big bills, too, if they contract the disease known as Covid-19.

"If open enrollment were more broad, and there were fewer barriers, that could make it easier for people to sign up," said Cynthia Cox, a vice president at Kaiser and a co-author of the study.

People in so-called short-term, limited-duration health plans -- those offering skimpier coverage that doesn't meet all the requirements of an A.C.A. plan -- could also sign up. Although the administration has encouraged the availability of alternatives, many may now want more comprehensive coverage.

Washington State, which has been enrolling people since March 10, has had 2,9730 residents indicate they plan to sign up as of last Thursday. About 500 have actually done so. In New York, during the first four days of the enrollment period, 150 people signed up, according to state officials.

In Rhode Island, which has had open enrollment since March 14, "we've had a really strong response," Ms. Lang said. As of Friday, 233 people had enrolled, with a further 150 or so in the process of doing so.

For Americans whose income has dipped low enough to qualify them for Medicaid, that program accepts applications all year long. In the 36 states that expanded their Medicaid programs under the Affordable Care Act, that means anyone now earning less than 138 percent of the federal poverty level -- about $17,000 for a single person and $35,500 for a family of four, annually -- can qualify for coverage right away. Eligibility rules vary in the other states. Many people who have lost their jobs and have very low incomes are now likely to qualify.

Marketplace coverage is more complicated: In addition to the need for an enrollment period, enrollees typically qualify for financial assistance with their premiums based on their income declared on their last tax return. Individuals can use a different estimated annual income but may have to provide documentation that their circumstances have changed, Ms. Cox said.

Anyone who already has marketplace coverage but has had an income change can return to the marketplace to apply for an increased subsidy. This is true even in states that have not yet established a special enrollment period.

Initially hesitant to reopen the federal marketplaces, health insurers recently began pushing for a special enrollment period to insure people who suddenly find themselves without a job. 

Posted by at March 24, 2020 12:00 AM