What this means for your health coverage

Last Thursday, President Joe Biden signed a series of executive orders seeking to void former President Trump’s HealthCare.gov insurance policies. One of Biden’s orders involved reopening the HealthCare.gov Marketplace, which would allow people without health insurance the option to purchase all available health insurance offered through the Affordable Care Act (ACA). , also known as “Obamacare”.

According to Sarah Gordon, PhD, MS, assistant professor of health law, policy and management at the Boston University School of Public Health, Biden’s executive order would create a 90-day enrollment period beginning Feb. 15, 2021. “This is important because usually one can only register for market coverage during the open registration period or during a special registration period,” Gordon told Verywell. A new open registration would give people another opportunity and more time to register for health insurance.

In June 2020, 7.7 million people lost their employer-sponsored health insurance due to the pandemic, according to the Commonwealth Fund. While some of those losses appear to have been offset by increased enrollment in Medicaid and market coverage, Gordon says there are still many uninsured Americans eligible for enrollment. According to the Kaiser Family Foundation, four out of 10 uninsured people can get free insurance, largely through the ACA

If implemented, the order would only apply to states that operate a HealthCare.gov platform. According to Gordon, 36 states use this platform and consumers in those 36 states can apply and sign up for coverage directly through the HealthCare.gov website which is operated by the Department of Health and Human Services.

Marketplace reopening

Before the ACA was passed in 2010, if people didn’t have access to health insurance through an employer or government insurance like Medicare, Medicaid, or the Veterans Administration, “You had to go to private health insurance and ask for a policy,” Wendy Netter Epstein, JD, law professor and faculty director at DePaul University’s Jaharis Health Law Institute in Illinois, told Verywell. “The process was very difficult to manage. It was difficult for people to compare options between insurers.”

The ACA market addresses this problem. “The individual health insurance marketplaces created by the ACA sell qualified health plans to individuals and families who lack an affordable offer of employer-sponsored coverage through their work and are not not eligible for other public insurance programs such as Medicaid and Medicare,” says Gordon. .

Consumers in states where the federal HealthCare.gov site does not operate can apply for and register for coverage through marketplace websites established and maintained by their state. Currently, 15 states operate their own state-based marketplaces, including California, Massachusetts, and New York.Inasmuch as

Epstein says that while it wouldn’t hurt to give people another opportunity to sign up, the policy is unlikely to be a game changer. “Affordability is always a key limitation of enrollment,” says Epstein. For reopening HealthCare.gov marketplaces to be a more effective policy, “making the grants more generous and making them available to more people would help,” she says.

Currently, in states that have expanded Medicaid, people with incomes between 100 and 400 percent of the federal poverty level are eligible for grants to reduce monthly premiums. “Those with incomes between 100 and 250 percent of the federal poverty level are additionally eligible for cost-sharing reductions that reduce the portion of the cost of health services that patients must pay out of pocket,” Gordon says. .

Reopening the market would not only allow people who lost their jobs to apply, but also reach the population that chose to go without health insurance before the pandemic, according to Epstein. “The pandemic has made it clear why anyone, even those who are currently in good health, could end up incurring high healthcare costs,” Epstein says. As the first anniversary of the pandemic approaches, “it’s unclear how many people in this insurance-resistant population will take advantage of this new enrollment period,” she adds.

Health policy during the Trump administration

During the Trump administration, Gordon says health policy experts were pushing to open the market’s open enrollment period. “That didn’t happen,” Gordon says. “The Trump administration had also cut funding for outreach and insurance enrollment assistance and reduced the length of the annual open enrollment period.”

Due to the ongoing debate over the ACA, Gordon says there is still understandable confusion among the American people about whether market hedging options even exist and whether they are affordable.

“More information and targeted outreach is needed to ensure people know what coverage options might be available, as many low-income Americans might qualify for a market plan with a zero dollar premium,” Gordon said.

The Marketplace is a one-stop place where individuals, families, and small businesses can go to compare the prices of all available policies. “In addition to providing a one-stop shop, the ACA legislated that private insurers could no longer refuse to cover anyone or charge different rates based on medical history,” Epstein explains. Strengthening the ACA not only supports low-income Americans, but also those with pre-existing conditions who would otherwise have been denied private insurance.

Next steps

“At a time of a pandemic when access to health care is more critical than ever for every American, an open enrollment period in response to the effects of COVID-19 is a no-brainer,” Gordon says. “We should be doing everything we can to make it easier for people to get covered right now.”

If you are uninsured, Epstein recommends that you purchase health insurance during this time. “Markets aren’t perfect,” says Epstein. “But if you’re uninsured during a pandemic, it absolutely makes sense to take a look at what’s available.”

Starting Feb. 15, you can go to HealthCare.gov and enroll in the marketplace if you’re not currently insured. You can check out their guide to getting a health insurance plan on the market here.

The information in this article is current as of the date indicated, which means that more recent information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.