Max Posner / NPR
At least nine US states are giving their uninsured residents another opportunity to purchase a health plan this year as they seek new ways to fight the novel coronavirus pandemic.
States reopened their health insurance scholarships this month to help allay consumer concerns about the cost of health care so that sick people are not dissuaded from seeing a doctor. Patients need care for a variety of health needs, regardless of their ability to pay, it makes sense. And, on the public health side, uninsured patients who avoid necessary medical care and are infected with the virus are more likely to inadvertently spread it.
Generally, under ACA rules, consumers who purchase their own insurance must purchase a policy during the regular open enrollment period in the fall. If they don’t purchase a plan and don’t qualify for a special enrollment period, they can’t get health insurance from the exchange until the next open enrollment.
States that recently reopened stock exchanges – Colorado, Connecticut, Maryland, Massachusetts, Nevada, new York, Rhode Island, and Washington – have more flexibility than most states to create a special enrollment period, as they manage their own health exchanges.
Another such state, California, announced on Friday that its exchange, which had been opened for reasons unrelated to the outbreak, would continue to allow residents to register until June due to disruption caused by the outbreak. coronavirus. The District of Colombia also allows residents to purchase coverage for reasons unrelated to the epidemic.
Michael Marchand, director of marketing for the Washington Health Benefit Exchange in Washington state, said uninsured residents who did not get tested for the novel coronavirus for fear of testing and treatment costs would be an “extremely weak link. in the string response and would only make matters worse. “
âUltimately, in a pandemic situation, your response will only be as strong as the most vulnerable link in the chain,â he says.
At 3 p.m. ET as of Friday, more than 16,000 cases of COVID-19 – the disease caused by the virus – have been identified in the United States and more than 200 people have died, according to Johns Hopkins University researchers.
Almost 28 million people in the United States do not have health insurance.
In most of the nine states updating their policies, people who enroll now will have health insurance coverage starting April 1.
The federal government, which manages the markets for 32 states on Healthcare.gov, did not make a similar offer.
Twenty-five senators sent a letter to the Department of Health and Human Services on March 12, urging them to give consumers who rely on HealthCare.gov a special opportunity to sign up.
“It is imperative that patients receive covered care, whether they are positive or negative for the virus,” he added. the letter noted.
In a statement, the Centers for Medicare & Medicaid Services, which operate the federal market, say they do not offer a special enrollment period, but continue to assess options in light of the coronavirus outbreak. He encouraged people to check whether they were entitled to a special enrollment period for other reasons, such as job loss that terminates their health coverage.
All consumers are allowed to purchase insurance at any time if they meet certain eligibility requirements, such as loss of health coverage, marriage, or the birth of a baby.
Seth Merritt says he signed up for a health plan Thursday in Providence, RI, after losing his job as a bartender when the brewery closed due to concerns about the spread of the virus.
He is 42 and was uninsured and says he didn’t want to face medical expense issues if he contracted COVID-19.
The night he lost his job, Merritt says, he went online to sign up for a plan and he was signed up the next morning.
âI assumed it would be difficult. I assumed it wouldn’t make sense,â he said, but he was glad it didn’t take long.
Details of the special open registration period vary. Some states, such as Nevada and Maryland, provide coverage for people without insurance and for those with short-term health insurance that does not provide full benefits. Massachusetts and Washington, on the other hand, allow enrollments only for people who have no coverage.
The response, according to state officials, has been positive. In Rhode Island, nearly 175 people signed up for a plan within the first 72 hours of the special enrollment period, said Lindsay Lang, the state’s director of exchange. Michele Eberle, executive director of the Maryland Health Exchange, said more than 1,500 people have signed up within 48 hours. Washington received 2,970 applications and 530 people were registered.
âThere are things out of our control that can happen, like the coronavirus,â says Eberle, âand it really helps to have that peace of mind – like health insurance.â
Renata Marinaro works with a population whose health insurance status is unstable even under ordinary circumstances: employees of the entertainment industry.
As the national director of health services for the Actors Fund, a nonprofit organization that provides support services to professional artists, Marinaro has seen requests for help skyrocket over the past week as businesses that employ artists are closing. Of the 2,000 calls the organization has received, she says, many are seeking financial assistance. But insurance is also a major concern. Because many in the industry are faced with inconsistent working hours and incomes, she says, they tend to switch plans often or go without coverage.
âWe see them going in and out of many different types of insurance – public and private,â says Marinaro. She says she fears more upheavals to come.
Whether motivated by unemployment or the virus, applying for health insurance during the special enrollment period could pose a financial risk to insurers in those states, says Sabrina Corlette, research professor and co-director of the Center on Health Georgetown University Insurance Reforms. . Insurers rely on the coverage of a stable number of people – or a pool of risks – to calculate how much to charge for health coverage.
A race for health coverage now – after insurers priced plans – could cause insurers to pay more to cover sick people than they take.
âThe rules of the game changed for them in the middle of the plan year,â says Corlette.
Requests to the Association of Health Insurance Plans, an industry professional group, for comment on states’ efforts were not returned.
State officials said insurers backed the decision to create a special enrollment period to respond to COVID-19. Nevada has taken steps to mitigate the risk to insurers by prohibiting new registrations for people who have lost their insurance because they did not pay their plan on time, said Heather Korbulic, executive director of the Stock Exchange. the state. But these people can try to work directly with their insurer to resume coverage.
Despite the bet for insurers, state officials say they don’t see the reopening of exchanges as a reward for residents who have ignored regular enrollment efforts. Giving uninsured people a second chance to get coverage can result in younger, healthier people buying plans and offsetting sick costs, some say.
However, only time will tell if healthy or sick people sign up, says Dr. Charlene Wong, pediatrician and healthcare researcher at Duke University.
“It’s hard to know how people are going to behave right now,” Wong says, “because it’s an unusual time.”
Kaiser SantÃ© news is a nonprofit and editorially independent program of the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.
KHN reporter Rachel Bluth contributed to this article.