Special Enrollment Periods

Last year, Maryland passed a very clever new law to help expand healthcare coverage through the state's ACA exchange and ACA Medicaid expansion without requiring any additional financial subsidies:

Maryland would use state tax forms to identify uninsured residents and refer them to options for no-cost or low-cost health care under a bill moving forward in the General Assembly.

The bill, if approved, would add a question on state tax returns asking taxpayers if they have health insurance. Those who answer that they don’t have health insurance would be referred to the state's Medicaid program or the health exchange, where individuals can buy health insurance plans.

...Dorn explained to me that the way it would work is much more than that: The state tax returns would include a new line where uninsured filers would be required to check off one of two boxes:

via the Massachusetts Health Connector:

Massachusetts Health Connector offers extended enrollment for uninsured individuals to ease coronavirus fears

BOSTON – March 11, 2020 – To ensure everyone who wants access to covered coronavirus services has it, the Massachusetts Health Connector announced today that uninsured residents can apply and get into coverage through a 45-day window running until April 25.

On March 6, the Division of Insurance announced that Massachusetts health insurers are now required to cover the cost of testing and treatment for members who may be affected by the Coronavirus (COVID-19), including not charging co-pays or deductibles for those services. The Health Connector’s decision to open enrollment to anyone without coverage ensures Massachusetts residents concerned about contracting coronavirus can access necessary services without cost barriers.

Washington becomes 1st state-based marketplace to create a special enrollment opportunity in wake of coronavirus threat. https://t.co/2bYCrboXvl @GtownCHIR

— Sabrina Corlette (@SabrinaCorlette) March 10, 2020

via the Washington Health Benefit Exchange:

Washington Healthplanfinder Announces Special Enrollment Period in Response to Growing Coronavirus Outbreak

I already called attention to this in my last post, but it's so long & filled with data wonk stuff that I'm reposting a separate entry to specifically highlight the SEP specifically:

  • Covered California is announcing a special-enrollment period through April 30 to address concerns that many Californians remain unaware of the new financial help or the new state penalty.

Hmmmm....the Special Enrollment Period is interesting. HealthCare.Gov and some state exchanges did something like this in spring 2015 (the first year people had to actually pay the mandate penalty) and managed to get around 210,000 more enrollees nationally. Of course, the penalty for 2014 was only $95 or 1% of income at the time...now it's up to $695/person or 2.5% of household income, so it's a bigger deal.

New Special-Enrollment Period Announced

I've written several times before about the multi-state scam being run by "Trinity Healthshare", aka "Aliera Healthcare":

New Hampshire:

The court also found that Aliera is a for-profit company and cannot qualify as a health care sharing ministry under state or federal law. The Insurance Department is concerned about potential fraudulent or criminal activity on the part of Aliera. Since the company may be an illegitimate health care sharing ministry, consumers should be aware that if they remain in an Aliera product, they may be covered by an unlicensed insurance company.

Unity Healthshare, now known as OneShare Health, was authorized by the court to reach out to Unity members about their options, and consumers who have purchased a Unity/Aliera product should be aware that they may be receiving this communication.

Washington State:

Last March, I wrote about a clever and absurdly simple (on the surface) bill being passed through the Maryland state legislature which could result in the state lowering their uninsured rate substantially...by up to as many as an estimated 120,000 people:

In early 2018, Maryland state legislators introduced a bill which included a twist on the coverage mandate penalty--those who failed to sign up had another option: They could either pay the penalty or they could choose to have the penalty amount be used to automatically enroll them in the lowest-cost insurance policy available. If they qualified for ACA subsidies, those would even be baked into the equation as well. This was a clever way of softening the blow, while also increasing enrollment and helping out the ACA risk pool.

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