States reopen insurance enrollment as coronavirus spreads

Maryland, Massachusetts and Washington state all announced special enrollment periods this week

Affordable Care Act supporters wave signs outside the Supreme Court. Maryland, Massachusetts and Washington state all announced special enrollment periods for uninsured individuals. (Bill Clark/CQ Roll Call file photo)
Affordable Care Act supporters wave signs outside the Supreme Court. Maryland, Massachusetts and Washington state all announced special enrollment periods for uninsured individuals. (Bill Clark/CQ Roll Call file photo)
Posted March 13, 2020 at 4:00pm

At least three states are reopening their health insurance exchanges amid the coronavirus outbreak in an effort to boost coverage and expand treatment for the uninsured.

Maryland, Massachusetts and Washington state all announced special enrollment periods for uninsured individuals this week as the outbreak worsens and governors declare emergencies. The World Health Organization officially labeled the virus a pandemic on Wednesday, and President Donald Trump declared a nationwide emergency Friday.

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Twelve states and the District of Columbia operate their own health insurance exchanges, which give local leaders the authority to reopen enrollment on their own in the face of an emergency like the coronavirus. 

Maryland’s enrollment window will run from March 16 through April 15. Massachusetts’ sign-up period will run for 45 days from March 11 through April 25. Washington’s will run from March 10 through April 8.

States like Rhode Island are also considering initiating a special enrollment period. The District of Columbia, meanwhile, is already operating an enrollment period through tax filing season for individuals unaware of the district’s new penalty for forgoing health insurance.

Insurance companies are on board with the opportunity to enroll more people, according to exchange officials, with some requesting assurances that the period would be restricted to a specific timeframe and effective coverage date. 

“Surprisingly, I think the carriers understand that this is a pretty big deal, and based on the state of emergency, this is really a unique situation that we've never encountered at this level here in our state,” Washington Health Benefit Exchange Chief Marketing Officer Michael Marchand told CQ Roll Call.

Insurance and medical care costs are a top concern for lawmakers who want to encourage potentially infected people to seek treatment. Leaders in many states have been requiring plans to cover testing or treatments related to the virus, while multiple insurance plans said they would waive out-of-pocket costs for testing and related doctors' visits.

Washington was the first to announce a special period Wednesday following Democratic Gov. Jay Inslee’s emergency declaration last month. The state has been hit hard by the outbreak, with more than 450 cases and 31 deaths. Marchand said the exchange has already fielded around 200 to 300 new applications.

Maryland Health Benefit Exchange Executive Director Michele Eberle said she looked to Washington as Maryland decided to open its own enrollment period. Exchange leaders hold a conference call every two weeks where issues like coronavirus are discussed.

Eberle also urged young and healthy people — a notoriously difficult demographic to enroll — to reconsider purchasing insurance coverage.

“This is a time to reevaluate,” she said.

A spokeswoman for the Centers for Medicare and Medicaid Services, which oversees the federal exchange, said the agency is not currently offering a special enrollment period for COVID-19. 

“We will continue to work closely with states and health plans around the country to assess what additional actions are necessary to ensure the American people have coverage for and access to the services they need during this time,” the spokeswoman said.

Democrats in the House and Senate appealed to Health and Human Service Secretary Alex Azar to launch a special enrollment period to allow anyone who doesn’t have an insurance plan or who are underinsured to select a plan.

“As outbreaks emerge and community spread continues in the United States, our most vulnerable neighbors are those who lack comprehensive health coverage,” a letter signed by more than 100 House Democrats read. “Without that coverage, they are unlikely to seek treatment for COVID-19, leaving all in our community at risk.”

In a separate letter to Azar and CMS Administrator Seema Verma, 25 Democratic senators wrote that the uninsured rate has gone up in recent years and said that people may choose not to get tested for COVID-19 or seek treatment because of affordability concerns.

“In addition, when the uninsured or underinsured are unable to pay their medical bills, it is health care providers who are left to make up the shortfall,” they wrote. “Health care providers are already relying on emergency resources to pay for increased capacity and medical supplies in order to be prepared for further spread of COVID-19.”