The White House said Thursday the Affordable Care Act marketplaces will reopen for a limited period amid the COVID-19 pandemic that has spurred significant job losses.
President Joe Biden signed two executive orders aimed at improving access to care amid the deadly pandemic. One executive order will reopen healthcare.gov for a special enrollment period from Feb. 15 through May 15, the White House said in a statement.
The special enrollment period will allow people to enroll in exchange plans without having to show proof of a qualifying life event, such as losing a job, that would allow them to sign up outside traditional open enrollment. A robust marketing campaign and significant outreach is key to ensuring consumers know this is an option as few are aware of the normal deadlines, advocates have said.
"For those newly experiencing job-based coverage loss due to the pandemic, opening the market more broadly gives them more time to sign up and reduces their paperwork burden," Vice President of the Kaiser Family Foundation Cynthia Cox said, adding that income is also volatile and consumers could qualify for more financial help.
Insurers told Healthcare Dive they support such a move.
St. Louis-based Centene, the largest carrier on the exchanges, said it applauds any effort to allow greater access to health coverage, "especially at a time when many Americans are grappling with the health and economic effects of COVID-19," the company said in a statement.
Early estimates show that as many as 14 million people may have lost health coverage and some experts expect it will be the greatest loss of coverage ever recorded.
Molina, another major player on the exchanges, said it supported the move and will work with the administration to assist as many members as possible.
The insurance lobby, America's Health Insurance Plans, cheered the administration's planned reopening of the marketplaces.
"We applaud President Biden for his swift actions to create more pathways for Americans to obtain coverage that is so essential to their health, well-being and peace of mind," AHIP said in a statement.
Typically, insurers are cautious about allowing enrollment outside of the traditional open enrollment deadlines as it can attract consumers who are sick and need to use coverage, resulting in adverse selection.
During the early years of healthcare.gov, insurers complained that too many consumers were allowed to enroll and purchase coverage outside the winter deadline and said those consumers ultimately helped fuel a rise in premiums.
Still, given the magnitude of the crisis, AHIP and others advocated for a special enrollment period, among other requests, in April as lawmakers were crafting federal relief bills. Although unsuccessful, some states that run their own exchanges allowed special sign-ups.
The Kaiser Family Foundation estimates that those uninsured and eligible for marketplace coverage are more likely to be male, Hispanic and a young adult. Of the 15 million uninsured in the U.S. about 4 million would be eligible for a free bronze plan while nearly 5 million would qualify for a partial subsidy. Though about 40%, or 6 million, would not qualify for financial assistance, KFF reported.
Overall, about 8.2 million consumers enrolled in ACA marketplace coverage for 2021, slightly below the prior year.
The executive orders also take aim at changes under the Trump administration. Biden is now directing agencies to re-examine programs that make it more difficult to enroll in Medicaid or reduce enrollment altogether, programs that were ushered in during the Trump administration.