Trump Rejects ACA Special Enrollment Period Amid Coronavirus Pandemic

The Trump administration has decided against opening up a special enrollment period for the Affordable Care Act (ACA) in response to the Coronavirus (COVID-19) pandemic, instead doubling down on his support of a lawsuit by Republican states aimed at killing the entire Affordable Care Act.

This decision defied calls by health insurers and Democrats to create a special sign-up window amid the COVID-19 health crisis and the administration instead said that they were “exploring other options.” Insurers providing ACA coverage were initially reluctant to open a special enrollment period, fearing a wave COVID-19 associated costs. However, the medical insurance lobby, America's Health Insurance Plans, signed on with a coalition calling for a special enrollment period saying, “The American people need the peace of mind of knowing that their health and financial futures are secure. That means knowing that they can count on their health care coverage when they need it most.” In a letter to the House and Senate, going on to outline the need for coverage to be affording stating, “Congress should create new funding to support coverage for those who lose their jobs due to the crisis, by providing a 90% subsidy for COBRA or other insurance coverage.”

Insurers had anticipated an announcement on Friday by the Trump Administration that a special ACA enrollment period would be opened based on conversations they had with officials at the Centers for Medicare and Medicaid Services (CMS), which runs HealthCare.gov enrollment, and had hinted that it might open. The call to open a special ACA enrollment period had been made to address the coverage issues and overall cost of the COVID-19 pandemic as more and more Americans are loosing their employer provided insurance.

There are still a few option for coverage however:

• People who have their employer provided insurance still have the option to extend their employer plan for up to 18 months through COBRA, which is however, an expensive option. It seems that the 90% subsidy of this option, as part of the call, was also subsequently rejected by the administration.
• Low-income adults in about two-thirds of states that have adopted ACA expansion can still get Medicaid. Though this is not an option for states that did not accept the expansion program.
• The short-term health insurance alternatives that have been promoted by Trump, also know as ‘skinny plans’, which allow enrollment year-round, are also an options. However the coverage on those plans is considerably less and typically exclude insurance protections for preexisting conditions. Additionally, the quality of the plans varies widely and in some cases insurers can change coverage terms whenever they feel like it and leave patients with exorbitant medical bills. Plans such as these have been widely criticised as an attempt to muddy the waters of ACA enrollment and have even been banned or severely restricted in states like California.

It would seem the move by the Trump Administration to not open a special ACA enrollment period is just one in a series of steps the administration has taken to kill the program, even as America reels under the poorly planned for COVID-19 pandemic. The decision to not open a special enrollment period for ACA was made as the US currently has over 200,00 positive COVID-19 cases and over 4,500 COVID-19 related deaths (as of April 1st). The White House recently projected that the total number of deaths in the US from COVID-19 would range between 100,000 and 240,000 people with social distancing measures in place.