Back in April, in the midst of the earlier stages of the COVID-19 pandemic sweeping through much of the nation, there was a loud outcry for the various ACA health insurance exchanges, including the federal exchange at HealthCare.Gov which hosts enrollment for over 3 dozen states, to re-open enrollment to anyone who missed the official Open Enrollment Period which had ended several months earlier.
Eventually, twelve of the thirteen state-based exchanges did just that, launching COVID-19-specific Special Enrollment Periods of varying time periods for any resident who would normally be eligible to enroll during Open Enrollment to do so. Many of those SBEs would go on to extend the deadlines of their SEPs by a month...or two months...or even more. As of this writing, in fact, California, Maryland, New York and the District of Columbia are are still offering "open" COVID-19 SEPs.
I've been making a LOT of fuss lately about how important it is for CMS Administrator Seema Verma to give the green light to an official "Open" COVID-19 Special Enrollment Period (SEP) via the federal ACA exchange (HealthCare.Gov). Last week I projected that if every state were to offer a full 60-day "open" SEP ("open" means that any uninsured U.S. citizen or eligible documented resident could sign up without requiring a Qualifying Life Event), somewhere between 2.5 - 3.3 million Americans would likely enroll during that 2-month period.
Of that number, I projected that around 1.8 - 2.3 million additional people would likely reside in the 38 states hosted by HealthCare.Gov, with the remainder living in the 12 states which are offering COVID-specific SEPs (although the deadlines in those states vary, and some do require enrollees to jump through at least minimal hoops to enroll).
For over a month now, I (and many, many others) have been pleading with HHS Secretary Alex Azar, CMS Administrator Seema Verma and CMS itself to launch a formal, "open" COVID-19 specific Special Enrollment Period for the millions of people living in the 38 states hosted by HealthCare.Gov who are uninsured but who don't qualify for Medicaid, CHIP or other "year-round enrollment" programs such as the Essential Plan in New York, MinnesotaCare in Minnesota or ConnectorCare in Massachusetts. Even the insurance industry--which normally hates letting people enroll at any time outside of the official Open Enrollment Period--has been calling for them to do so.
Yesterday I ran an exclusive analysis based on existing COVID-19 Special Enrollment Period (SEP) data to figure out a) roughly how many Americans are likely to enroll in ACA exchange coverage using this SEP in the twelve states offering one, and b) how many additional Americans would likely #GetCovered via ACA exchange policies in the other 39 states which don't currently have a CV19 SEP in place.
As I've explained before, while pretty much anyone who loses their employer-based health insurance is automatically eligible for a normal 60-day Special Enrollment Period regardless of what state they live in, under the current pandemic/mass layoff situation, the standard "loss of coverage" SEP is a red tape nightmare under Trump Administration regulations since you have to provide hard-to-get documentation of your status and have it verified by CMS, which can take weeks.
With all the anger at CMS Administrator Seema Verma, HHS Secretary Alex Azar and of course Donald Trump himself over CMS's refusal (to date) to open up a COVID-19 specific Special Enrollment Period on the federal ACA exchange (HealthCare.Gov), last week I decided to try and figure out just how many people are enrolling across the 12 state-based exchanges which are offering CV19 SEPs...and just as importantly, how many people would likely take advantage of a CV19-specific SEP on the federal exchange if and when they ever decide to go ahead and launch one.
"So, we've told you...we'll tell you what we know and don't know. So there's different types of tests which get sent out. The CDC's test that CDC is sending out, that's that 70...enough to send out 75,000 people, that was sent out last week. Those go to public health labs, about 80 labs in the United States, one in each state at least. Those report results back in to the CDC because they're part of the public health network. The larger quantity of tests that shipped, about 900,000 of the tests that shipped by this weekend, and then so many of the remainder of that 2 point...total, 2.1 million tests...those go to hospitals, private labs, others for testing...they don't currently have to report to us that they've conducted a test or what the result of that test is. The CDC is actively working right now to build that IT connectivity with them so we can gather that information. So right now...I could not give you a number of how many Americans have received a test because many will have received a test through hospitals or non-public health labs, and so...let's work with getting the system, the IT system up through the CDC, you want to get the accurate information as we go.
Tomorrow, HHS Secretary Azar will join Governor Haslam in Nashville, Tennessee to deliver remarks at an event hosted by the Nashville Health Care Council.
Secretary Azar will share news regarding the Affordable Care Act marketplace and reflect on lessons for healthcare reform.
In advance of tomorrow, here are a few excerpts of Secretary Azar’s remarks (as prepared for delivery):
“The previous administration’s major healthcare achievement, the Affordable Care Act, was an attempt to use more government regulation and intervention to improve American healthcare.
“As we all know, the results were disastrous, with skyrocketing costs and disappearing choices.
“But today, I am here to share with you some good news.
I read with great interest your Op-Ed piece in yesterday's Washington Post extolling the virtues of "Short-Term, Limited Duration" plans and how awesome it is that the Trump Administration is hoping to flood the individual health insurance market with them. I figured you might appreciate a bit of fact-checking.
Obamacare forgot about you. But Trump didn’t.
For all the discussion of Obamacare since its passage, it is too rarely known that the law effectively split the United States’ individual insurance market in two.
Yes and no. What split the market in two was the fact that premiums have increased faster than expected. Those earning more than 400% of the Federal Poverty Level (FPL)--around $48,000/year for a single adult or $98,000/year for a family of four--don't qualify for financial assistance and have to pay full price.
