SEPs

The new Pennsylvania ACA exchange, Pennie, just issued their final official 2021 Open Enrollment report and (as expected) is also joining most other states in re-opening for a COVID-19 Enrollment Period:

Press Release – Pennie Exceeds Expectations & Extends Enrollment for COVID-19

  • As a state-based marketplace, Pennie increases new enrollment by 9.7% and raises total enrollment to nearly 338,000. Now, Pennie is offering more time to enroll in plans for those affected by COVID-19.
  • Pennsylvanians who have recently lost health coverage or have been affected by COVID-19 can visit pennie.com and enroll in a plan from February 15 through May 15.

This just in via the MA Health Connector...

February 3, 2021 – The Massachusetts Health Connector announced today a further extension of its Open Enrollment through May 23, providing residents impacted by COVID-19 the opportunity to get access to affordable, comprehensive health insurance.

The Health Connector previously announced an extension of Open Enrollment through March 23, two additional months beyond the original Jan. 23 deadline. Open Enrollment started Nov. 1, and the new deadline of May 23 aligns the Massachusetts health insurance exchange with the new open enrollment period for the federal exchange platform, healthcare.gov, which reopens Feb. 15 and remains open through May 15, and will be accompanied by a national marketing and awareness campaign.

This just in from the DC Health Link...

DC Residents Without Health Insurance Can Get Covered Now Through DC Health Link

Annual Open Enrollment is over, but DC Health Link’s COVID-19 Special Enrollment Period continues through the duration of DC’s public health emergency

(Washington, DC­­) – Uninsured District of Columbia residents have more time to enroll in health coverage for 2021. From now through the end of the COVID-19 pandemic, residents can enroll using DC Health Link’s Special Enrollment Period (SEP) for COVID-19. All DC Health Link plans cover diagnosis, treatment, testing, and vaccination for COVID-19 for free.

via the Nevada Health Link...

Today, the Biden‐Harris Administration announced a Special Enrollment Period, allowing Americans to enroll and purchase on‐Exchange health insurance plans from their respective on‐Exchange marketplaces. On behalf of the Silver State Health Insurance Exchange and Nevadans statewide, we are pleased to see positive change taking place at the federal level and to witness the fast‐moving actions to protect the Affordable Care Act (ACA), upon which so many Americans rely for quality, affordable and comprehensive health insurance coverage.

This news comes on the heels of our announcement that nearly 82,000 Nevadans enrolled on Nevada Health Link for coverage in 2021. That’s nearly a six percent increase from last year’s enrollment total.

Today’s news from the White House speaks volumes about how the new Administration will continue to support the ACA and help to bolster the health insurance marketplace, protecting hundreds of millions of Americans.

...Annnnd add Get Covered NJ to the list:

Governor Murphy Announces Extension of Affordable Care Act Enrollment Period for Uninsured In New Jersey In Response to COVID-19 Pandemic

  • New Jersey Joins Biden Administration in Effort to Assist Residents Through Special Enrollment Period

TRENTON – Following the Biden Administration’s health care action today, Governor Phil Murphy announced the State is extending the health insurance enrollment period for uninsured residents to sign up for coverage through Get Covered New Jersey, the state’s official health insurance marketplace, in response to the coronavirus pandemic.

via MNsure:

Statement of Nate Clark, Chief Executive Officer (CEO), MNsure

Re: New executive orders signed by President Biden today that support state-run ACA insurance exchanges like MNsure

ST. PAUL, Minn.—"MNsure welcomes this news and the Biden Administration’s efforts to strengthen the Affordable Care Act to increase access to quality, comprehensive health coverage. As the nation continues to fight the deadliest pandemic in a century, the changes President Biden is making will benefit Minnesotans who need the peace of mind that comes with knowing you have health care coverage.

"President Biden’s executive order directs federal agencies to look at ways to protect and strengthen access to health insurance and increase protections for those who have preexisting conditions, including complications related to COVID-19.

via the Washington Health Benefit Exchange:

Washington Health Benefit Exchange (Exchange) announced today it will open a special enrollment period that parallels the new federal enrollment period which runs from Feb. 15 through May 15, 2021.

“Having health insurance is critically important in these challenging times of COVID,” said Chief Executive Officer Pam MacEwan. “Opening a corresponding special enrollment period in our state gives more uninsured Washingtonians the chance to get needed coverage for 2021.”

The special enrollment period will apply to anyone seeking health insurance coverage. Individuals shopping for coverage during this special enrollment period that select coverage by the 15th of the month will begin receiving coverage the first of the following month.

This was probably inevitable: via Connect for Health Colorado (email):

Colorado to Re-Open Enrollment for Individual Health Insurance 

DENVER – Today, President Joe Biden issued an Executive Order that re-opens enrollment on the Affordable Care Act marketplaces. While the order pertains to states that use the federal exchange, HC.gov, Colorado’s exchange, Connect for Health Colorado will mirror the order by re-opening enrollment.

Coloradans without health insurance will be able to enroll in coverage through C4HCO.com between Feb. 8 - May 15, 2021. Health insurance coverage will begin on the first day of the month following plan selection. This Special Enrollment period is for people who are without health insurance and begins a week earlier than the federal exchange.

The wording of this is important: This SEP is for uninsured residents specifically; presumably it is not open to those who are simply looking to switch from one ACA policy to another. My guess is there will be a checkbox or whatever for enrollees to attest that they do not currently have health insurance coverage.

As I noted earlier today, the Big News® this today is President Biden's pending Executive Order to re-open HealthCare.Gov to a full 3-month COVID-19 Special Enrollment Period starting on February 15th. There's a whole bunch of other important stuff in today's healthcare XO, but some of them will take months to actually finalize and implement.

Frankly, re-opening HC.gov is actually one of the simplest and most obvious healthcare-related executive orders Biden could give at the moment. Now that the starting/ending dates are known, it raises one other important question.

I wrote about this a few days ago, but today it'll be official:

President Biden to Sign Executive Orders Strengthening Americans’ Access to Quality, Affordable Health Care

The Biden-Harris Administration will open a Special Enrollment Period for Americans to sign up for health coverage and roll back attacks on the Affordable Care Act, Medicaid, and access to reproductive health care

Strengthening Medicaid and the Affordable Care Act.

UPDATE: It's official...and it'll be 90 days starting on 2/15, not 60.

In an news which surprises absolutely no one, this Thursday the Biden Administration is expected to officially announce a COVID-19 Special Enrollment Period at HealthCare.Gov, the federal ACA exchange which hosts enrollment for 36 states:

Thursday: ‘Health Care’ day

...The president is also slated to sign an executive order aimed at strengthening Medicaid and initiating an open enrollment period under the Affordable Care Act.

Trump frequently bragged about gutting the Affordable Care Act by rescinding the individual mandate, though Republicans were unable to fully repeal the law as promised.

This just in via the MA Health Connector...

January 22, 2021 – The Massachusetts Health Connector announced today it is continuing Open Enrollment until March 23, providing additional time for state residents to access affordable, quality health insurance, particularly those hurt by the economic impacts of COVID-19.

With Massachusetts just having become the 3rd state where COVID-19 has killed more than 1 out of 500 residents, this isn't surprising (New York announced an Open Enrollment extension thru the end of March yesterday; New Jersey is still set to end theirs as of January 31st as of this writing Maryland, where COVID has "only" killed 1 out of 900, is extending theirs thru March 15th).

With Open Enrollment ongoing, Massachusetts residents who do not have health insurance have a new opportunity to get coverage through the Health Connector. This includes commercial plans through the ConnectorCare program, which provides help paying monthly premiums, and also offers low co-pays and no deductibles.

Me, June 16th, after several months of various state-based ACA exchanges bumping out their COVID-19 Special Enrollment Period deadlines by a month, then another month, then another month:

At a certain point I'm guessing at least one of the state exchanges will just say "screw it" and open 2020 enrollment up for the full year.

The point of a deadline is a) to prevent people from trying to game the system by deliberately waiting until they're sick/injured before enrolling in coverage (thus driving up premiums for everyone else) and b) to goad people into actually taking action (deadlines do have a clear positive impact on enrollment). With the COVID-19 pandemic having thrown the entire healthcare system into disarray, neither of those seem to be much of a factor this year.

Maryland Connect, August 7th:

Me, June 16th, after several months of various state-based ACA exchanges bumping out their COVID-19 Special Enrollment Period deadlines by a month, then another month, then another month:

I admit that this is starting to get a bit silly. At a certain point I'm guessing at least one of the state exchanges will just say "screw it" and open 2020 enrollment up for the full year.

The point of a deadline is a) to prevent people from trying to game the system by deliberately waiting until they're sick/injured before enrolling in coverage (thus driving up premiums for everyone else) and b) to goad people into actually taking action (deadlines do have a clear positive impact on enrollment). With the COVID-19 pandemic having thrown the entire healthcare system into disarray, neither of those seem to be much of a factor this year.

Maryland Connect, August 7th:

Back in March & April, I wrote a lot about COVID-19 Special Enrollment Periods...and especially about the fact that the largest ACA exchange of all, HealthCare.Gov, kept refusing to do so in spite of massive pressure from governors, members of Congress and nearly every advocacy group under the sun, as well as the U.S. Chamber of Commerce and even the health insurance industry itself...which is especially remarkable given that it was BCBSA & AHIP who insisted on cracking down on Special Enrollment Periods in the first place a few years earlier.

On March 31st, I posted the following:

this just in via Covered California:

Covered California Opens New Paths to Coverage for Wildfire Victims and Those Who Lose Their Job or Income During the Pandemic and Recession

  • Covered California establishes a new special-enrollment period to benefit victims of the 500+ wildfires raging across the state.
  • In addition, Covered California announced new paths to coverage that will run through the end of 2020, for Californians who have lost employment or income due to the pandemic and resulting recession.
  • The moves come during ongoing uncertainty in the lives of Californians caused by the wildfires and the continuing fight against COVID-19.
  • More than 271,000 people have signed up for coverage through Covered California since the exchange’s initial announcement of a special-enrollment period in response to the pandemic.
  • La versión en español de este Comunicado puede ser descargada en este enlace.

Back in April, in the midst of the earlier stages of the COVID-19 pandemic sweeping through much of the nation, there was a loud outcry for the various ACA health insurance exchanges, including the federal exchange at HealthCare.Gov which hosts enrollment for over 3 dozen states, to re-open enrollment to anyone who missed the official Open Enrollment Period which had ended several months earlier.

Eventually, twelve of the thirteen state-based exchanges did just that, launching COVID-19-specific Special Enrollment Periods of varying time periods for any resident who would normally be eligible to enroll during Open Enrollment to do so. Many of those SBEs would go on to extend the deadlines of their SEPs by a month...or two months...or even more. As of this writing, in fact, California, Maryland, New York and the District of Columbia are are still offering "open" COVID-19 SEPs.

Just a few days after the previous COVID-19 Special Enrollment Period expired, NY Governor Andrew Cuomo has ordered NY State of Health to reopen their SEP through September 15th:

Governor Andrew M. Cuomo today announced that the Special Enrollment Period for uninsured New Yorkers will be extended for another 30 days, through September 15, 2020, as the State continues to provide supportive services during the COVID-19 public health crisis. New Yorkers can apply for coverage through NY State of Health, New York State's health insurance marketplace, or directly through insurers.

"While we've crushed the curve of the virus, we are still in challenging times for hard-working families throughout the state who need access to quality, affordable health care," Governor Cuomo said. "The state has maintained low infection rates and is moving in the right direction, but we know we're not out of the woods yet. By offering this special enrollment period, we're making sure New Yorkers who need affordable and at times live-saving health care coverage can get it."

via the Massachusetts Health Connector:

Are you turning 26 soon and still on your parent’s health insurance policy?  Did you know that you will need to take action or you may no longer have health insurance? Don’t worry, you have options!

Turning 26 triggers a special enrollment period that allows you to enroll in new health insurance coverage a within 60-days of your birthday.

Get coverage from your job

If you have a job that offers insurance, you can enroll in that coverage as turning 26—known as aging out—is considered a qualifying life event and will enable you to enroll in job-based coverage outside of your job’s open enrollment period.

Get covered through your school

If you are a college student, you may be able to enroll in a student health insurance plan through your school. Find out more

Apply for coverage through the Health Connector

Back on March 10th, the Washington HealthPlanFinder became the first state-based ACA exchange/marketplace to formally create an official COVID-19 Special Enrollment Period, which was originally scheduled to have a deadline of April 8th.

Since that time, nearly every other state-based ACA exchange (all of them except for Idaho) has done likewise. Some of them required some sort of verbal or written attestation of thier eligibility status, while others didn't, but all of them were wide open to any uninsured resident who would normally be eligible to enroll during the official Open Enrollment Period.

The deadlines for the "open" COVID-19 SEP varied by state...but most of them ended up extending them out as that deadline approached. In some cases, they bumped it out again...and again...and yet again, as it became increasingly clear that the deadly pandemic isn't going away anytime soon.

via the Maryland Health Benefit Exchange:

NEARLY 58,000 MARYLANDERS GAIN HEALTH COVERAGE DURING TWO SPECIAL ENROLLMENT PERIODS

BALTIMORE, MD – A total of nearly 58,000 Marylanders enrolled in health coverage during Maryland Health Connection’s two special enrollment periods that began in February and March and ended Wednesday, July 15.

The Maryland Health Insurance Easy Enrollment program launched Feb. 26 as the first of its kind in the nation. The Comptroller of Maryland asked state tax filers to check a box on their state tax return if they lacked health insurance and desired that information to be shared with the Maryland Health Benefit Exchange. Several states are in the process of looking at creating similar programs.

Since February:

  • More than 41,000 filers checked the box
  • More than 3,700 enrolled as of July 13

Final numbers are pending, because tax filers had until the July 15 tax filing deadline to check the box on their state tax form, and will have several weeks to enroll.

Hardly surprising...again.

via the New York State government website:

Special Enrollment for Uninsured New Yorkers Will Extend for Additional 30 days and Remain Open Through August 15, 2020

Governor Andrew M. Cuomo today announced that the Special Enrollment Period for uninsured New Yorkers will be extended for another 30 days, through August 15, 2020, as the State continues to provide supportive services during the COVID-19 public health crisis. New Yorkers can apply for coverage through NY State of Health, New York State's health insurance marketplace, or directly through insurers.

via the Maryland Health Benefit Exchange:

TWO SPECIAL ENROLLMENT PERIODS FOR HEALTH INSURANCE END JULY 15

  • Nearl​y 53,000 r​esidents have enrolled since mid-March

BALTIMORE, MD – The Maryland Health Benefit Exchange announced it is entering the final week for Marylanders to enroll in health insurance coverage through the Coronavirus Emergency Special Enrollment Period and the Easy Enrollment Health Insurance Program. Maryland made the decision to re-open the Coronavirus Emergency Special Enrollment Period and extend the deadline in an effort to give more residents the opportunity to enroll. Both are set to end on July 15.

The deadline extension for the Coronavirus Special Enrollment Period comes as more than 49,000 residents have received coverage during this special enrollment period that began in March with Gov. Larry Hogan’s announcement of a State of Emergency in Maryland. Even before this extension, Maryland already offered one of the longest special enrollment periods in the country since the emergency began.

The big story with COVID-19 the past few weeks has been, of course, the out-of-control increase in new cases (if not actual deaths...yet) from the virus in red states like Texas, Florida and especially Arizona which were relatively unscathed throughout the spring while the pandemic was raging across Northeastern blue states like New York, New Jersey and Rhode Island, as well as Michigan and California.

While most of the states being hit with the summer wave are historically Republican strongholds (the states being hit hardest in June/July also include Georgia, Arkansas, South Carolina, etc.), there's one important exception to this: California, which was hit early but which clamped down fairly quickly, has re-emerged as a major hot spot. So what gives?

via MNsure (this was actually posted a couple of weeks ago but I missed it):

ST. PAUL, Minn.—99,688 Minnesotans have come to MNsure.org and enrolled in private health insurance through a special enrollment period (SEP) or received eligibility for a public assistance program (Medical Assistance or MinnesotaCare) since March 1. As expected, sign-ups across all programs have been driven by concerns amid the pandemic.

"It’s never been more important to know you’re covered. That’s why we are so glad to have been able to help almost 100,000 Minnesotans gain access to comprehensive health care coverage," said CEO Nate Clark. "But we know there are others out there who are currently uninsured and may qualify to sign up. If you’ve recently lost your employer-sponsored health insurance, had an income change, or have another qualifying life event, come to MNsure.org to see if you’re eligible."

For the past few months, I've been keeping track, to the best of my ability, of how many people have been enrolling in ACA exchange policies utilizing the COVID-19-specific Special Enrollment Periods which have been offered by 12 of the 13 state-based exchanges (SBEs). My most recent update brings the grand total of confirmed SEP enrollments to at least 260,000 across 8 states, averaging around 3,500 per day.

The actual number is obviously higher than this, of course, since I don't have any data from the other four state exchanges (DC, New York, Rhode Island and Vermont), although three of those four are pretty small anyway...and even in New York, their unique "Essential Plan" (the Basic Health Plan program established under the ACA itself) has likely been sucking up the bulk of individual market enrollees earning up to 200% FPL anyway...and you can enroll in the Essential Plan year-round regardless of the pandemic. I therefore doubt that NY's COVID SEP numbers for those earning more than 200% FPL are that dramatic. All told, I'd expect NY, RI, VT & DC to only add perhaps another 25,000 or so QHP enrollees to the table below:

Hardly surprising at this point, but still important to note:

Health Connector extends enrollment an additional month to July 23rd for uninsured individuals

On June 22, 2020, the Health Connector announced in an Administrative Bulletin an extension to the special enrollment period in response to the coronavirus (COVID-19) emergency through July 23, 2020 to assist uninsured Massachusetts residents seeking health coverage. (The extended enrollment period was previously set to end June 23.)

If you need to apply for coverage, you can start by creating an application.

If you apply coverage under this special enrollment, the deadlines to complete enrollment are as follows:

On April 14th, Covered California reported that 58,000 residents had enrolled in ACA exchange coverage during their COVID-19 Special Enrollment Period, of which roughly 20,000 did so via standard SEPs (losing coverage, moving, getting married/divorced, etc), while an additional 38,000 took advantage of the COVID-specific SEP.

On April 28th, they announced that the number was up to 84,000 new ACA exchange enrollees, averaging around 2.5x as many as enrolled via standard Special Enrollment Periods during the same period a year ago.

On May 20th, they announced the total was up to 123,000 new ACA exchange enrollees via the COVID SEP, "nearly" 2.5x the rate of a year before.

Not terribly surprising news; via the Maryland Health Benefit Exchange:

CORONAVIRUS EMERGENCY SPECIAL ENROLLMENT PERIOD DEADLINE EXTENDED TO JULY 15

  • More than 43,000 have enrolled since mid-March

The Maryland Health Benefit Exchange announced today that it has extended the deadline of its Coronavirus Emergency Special Enrollment Period so that uninsured residents will have until July 15 to enroll in health coverage through Maryland Health Connection, the state’s health insurance marketplace.

The deadline extension comes as more than 43,000 residents have received coverage during this special enrollment period that began in March with Gov. Larry Hogan’s announcement of a State of Emergency in Maryland. Even before this extension, Maryland already offered one of the longest special enrollment periods in the country since the emergency began.

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