President Joe Biden is reopening the HealthCare.gov insurance markets to enable Americans to sign up for coverage amid the ongoing Covid-19 pandemic.
Biden signed two executive orders Thursday. One establishes a special enrollment period from Feb. 15 to May 15 and directs federal agencies to reconsider rules and policies that limit access to healthcare. These include policies that make it more difficult for people to enroll in Medicaid and the ACA.
While this move was hailed by providers and payers, it is unclear how many people will avail of this option, as recent research shows nearly half of uninsured adults have not looked to Medicaid or the Affordable Care Act marketplaces for help during the pandemic.
“Reliable and affordable access to health insurance doesn’t just benefit families’ health; it is a critical source of economic security and peace of mind for all,” stated a White House news release.
The second executive order aims to open up access to reproductive healthcare. It will rescind the Trump-era global gag rule, which prohibits international nonprofits that provide abortion counseling or referrals from receiving U.S. funding.
Both orders mark a reversal of the Trump administration’s policies toward healthcare access. Last March, shortly after Covid-19 cases began spiking uncontrollably, the administration refused to reopen ACA enrollment despite requests from payers and Democrats.
The announcement of the special enrollment period was met with applause by America’s Health Insurance Plans, the industry’s advocacy group.
“Health insurance providers stand ready to implement the guidance that will follow this executive order,” said Matt Eyles, president and CEO of the association, in a statement.
Similarly, the country’s most prominent hospital group responded favorably to the announcement.
“Every American deserves access to health coverage, yet millions remain uninsured,” said Rick Pollack, president and CEO of the American Hospital Association, in an email. “We simply need to do better in addressing this basic human need, particularly during a global pandemic. By reopening enrollment in the health insurance marketplaces, the Biden administration is helping more Americans get and stay covered.”
Individual health systems also hailed the move.
“We welcome the Biden Administration’s efforts to broaden access to patients struggling to afford health insurance during this unprecedented time,” said Dr. David Carmouche, president of New Orleans-based Ochsner Health Network, in an email.
It’s not just struggling patients who might benefit from this federal action. Biden’s move could help hospitals stay afloat as patient volumes continue to fall below pre-pandemic levels.
This will “ultimately help hospitals and healthcare organizations struggling with rising bad debt and decreased utilization,” said Matt Hawkins, CEO of healthcare revenue cycle management company Waystar, in an email.
While the announcement paints a potentially rosy picture for providers and payers alike, there remains the question of how extensively the American public will use the new enrollment window to sign up for insurance.
A data brief published Thursday by the Robert Wood Johnson Foundation indicates there may be some hesitation. The brief is based on survey responses from 437 uninsured adults collected in September 2020.
It shows that despite a rise in job losses stemming from the Covid-19 pandemic, 47% of uninsured adults did not look for information on ACA marketplace coverage, nor did they try to obtain Medicaid or Children’s Health Insurance Program coverage.
About half of uninsured adults (53.9%) said they had heard a lot or some about the marketplaces, but nearly 45% said they did not look for information on them, mostly due to cost concerns.
Meanwhile, only 29.3% of uninsured adults tried to obtain Medicaid or CHIP coverage. Among those who did not try, the most common reason cited was that they did not think they would qualify.
There needs to be more effort to inform uninsured people about coverage options, financial assistance, eligibility requirements and how to enroll in coverage, the data brief states.
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