Relief is in sight for people who did not have health insurance during the pandemic.
In January, President Joe Biden signed an ordinance to open the federal health insurance market for three months starting Monday so that uninsured people can buy a plan and those who want to change their market coverage can do so.
Consumer advocates welcomed the directive. Since 2016, the number of Americans without health insurance has increased, reaching 30 million in 2019. The economic upheaval caused by the novel coronavirus has made the situation worse and shed millions off their insurance plans.
The move is in stark contrast to the approach taken by the Trump administration. When covid-19 hit the ground running last spring and the economy collapsed, health experts asked the Trump administration to open up the federal market so people could get insurance to protect themselves during the worst public health emergency in a century . The administration refused, noting that people suddenly without cover because they had lost their jobs could register according to the usual rules in the market. They also cited concerns that sick people who had previously resisted taking out insurance would buy coverage and increase premiums.
Biden's government pledges to spend $ 50 million on outreach and education to publicize the new special enrollment deadline. That is critical, said experts. Although the numbers of people signing up for the Affordable Care Act plans have generally remained robust, According to the KFF, the number of new consumers who register on the federal market has fallen every year since 2016, which corresponds to a cut in funding for marketing and public relations. (KHN is an editorially independent program of the KFF.)
"There are many uninsured people who were eligible for high market subsidies or Medicaid before Covid and were unaware of it," said Sabrina Corlette, research professor at the Center on Health Insurance Reforms at Georgetown University. A marketing flash can reach a wide group of people and hopefully attract them, whether or not they are uninsured due to Covid, she said.
Here you will find answers to questions about the new registration option.
Q: When and in which states can consumers register?
The registration window is open for three months from Monday to May 15. Uninsured residents of any of the 36 states who use the bundesgesundheit.gov platform can search for plans and sign up during this time.
States and the District of Columbia, which operate their own marketplaces, have specific enrollment deadlines similar to those of the new federal, although they may have slightly different time frames or eligibility rules. For example, in Massachusetts, the login window stays open until May 23rd, while in Connecticut it closes on March 15th. Meanwhile, Colorado has reopened registration on its marketplace for residents who do not have insurance but are already enrolled in a state. Marketplace plans are not allowed to switch to another plan due to this special registration period.
Q: Can people who lost their job and health insurance many months ago register during the new enrollment period?
Yes. The registration window is open to anyone who is not insured and who is normally entitled to purchase coverage on the exchange (people serving prison or jail sentences and those in the country without legal permission are not allowed to register) .
Individuals with incomes up to 400% of federal poverty (about $ 51,500 for one person or $ 106,000 for a family of four) are eligible for tax credits, which can reduce their costs significantly.
Typically, people can only purchase a marketplace plan during the fall annual open registration period, or when a major life event gives them another option to register called a special registration period. Loss of work-related health insurance is an event that offers a special registration option. so is getting married or having a baby. Typically, however, attendees must register with the marketplace within 60 days of the event.
With the new special enrollment deadline, it is irrelevant how long someone has been uninsured, and no documents need to be presented showing that they have lost their job-related cover.
"The message is very simple: come and apply," said Sarah Lueck, senior policy analyst at the Center for Budget and Policy Priorities.
Q: What about people who are already enrolled in a marketplace plan? Can you change your coverage during this new registration period?
Yes, as long as your reporting is on the federal market. For example, if someone is now enrolled on a gold plan but wants to switch to a cheaper bronze plan with a higher deductible, this is allowed. As mentioned above, some state-run marketplaces may not provide this option.
Q: Many people lost significant incomes during the pandemic. How do they decide if a marketplace plan with premium subsidies is a better buy for them than Medicaid?
You don't have to choose. During the application process, the marketplace asks people for income information. If their annual income is below the Medicaid threshold (138% of federal poverty for many adults in most states, or about $ 18,000 for an individual), they will be put on this program for coverage. If people are eligible for Medicaid, they cannot get subsidized coverage for the exchange.
People can sign up for Medicaid at any time; You don't have to wait for an annual or special registration deadline.
Those who are already enrolled in a market plan whose income changes should come back to the market and update their income information ASAP. They may be eligible for higher premium subsidies for their marketing plan or, if their income has decreased significantly, for Medicaid. (If their incomes have risen and they fail to adjust their market income estimates, they too might be on the lookout for overpayments of their subsidies when filing their taxes.)
Q: What about individuals who have enrolled under the COBRA Federal Act to continue their employer coverage after they lose their job? Can they drop it and sign up for a marketplace plan?
Yes, people in federal states can take this step, say health experts. Under COBRA, individuals may be required to pay the full amount of the premium plus a 2% administration fee. Market coverage is almost certainly cheaper.
If people have COBRA coverage and drop it in the middle of the year, they typically won't be able to enroll in a market until after the annual open enrollment period. But this particular enrollment deadline gives people that option.
Michelle Andrews, Kaiser Health News
Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation that is not affiliated with Kaiser Permanente.