Over 500,000 Americans Got Health Coverage During Affordable Care Act Special Enrollment Period

Over 500,000 Americans have signed up for health care using the Healthcare.gov portal via Biden Administration’s Special Enrollment Period, the Department of Health and Human Services (HHS) announced Wednesday.

“Access to quality, affordable health care is essential – especially as we tackle the COVID-19 pandemic and its aftermath,” HHS Secretary Xavier Becerra said in a statement Wednesday. “Since the beginning of this Special Enrollment Period’s availability on HealthCare.gov, more than 500,000 Americans have already signed up for coverage on HealthCare.gov.”

During the period between February 15 to March 31, the portal saw the highest increase in enrollment among Black consumers and among Americans near the poverty level in two years, according to the Centers for Medicare & Medicaid Services (CMS).

According to HHS, 15 million Americans who lack health insurance, as well as current enrollees, are eligible for additional financial support, thanks to funding from President Joe Biden’s $1.9 trillion American Rescue Plan.

As of April 1, premiums are expected to drop an average of $50-per-person, per month, and $85-per-policy, thanks to additional funding from Biden’s COVID-19 relief bill.

“Thanks to the American Rescue Plan, health care coverage is more affordable and millions of Americans are seeing their premiums reduced,” Secretary Becerra said. “At HHS, we are going to build on the Affordable Care Act (ACA) and work tirelessly to ensure Americans have the chance to sign up for quality, affordable health care coverage that meets their needs.”

Special Enrollment Period Extended Through August

President Joe Biden announced last month that the United States extended the Affordable Care Act special enrollment period by three months to Aug. 15, allowing Americans to enroll, or re-evaluate their health coverage needs “with increased tax credits available to reduce premiums.”

Secretary Becerra said in a statement in March that costs will be brought down for millions of Americans to enroll, thanks to the president’s $1.9 trillion American Rescue Plan.

“Every American deserves access to quality, affordable health care – especially as we fight back against the COVID-19 pandemic,” Becerra said in a statement at the time. “Through this Special Enrollment Period, the Biden Administration is giving the American people the chance they need to find an affordable health care plan that works for them.”

The news comes on the 11th anniversary of the Affordable Care Act being signed into law. President Biden toured the James Cancer Hospital Solove Research Institute in Columbus, Ohio, on Tuesday to explain how his COVID-19 relief bill pumps up Affordable Care Act premium subsidies to address long standing problems of affordability, particularly for people with solid middle-class incomes. 

More taxpayer assistance means that consumers who buy their own policies through HealthCare.gov will pay hundreds of dollars less out of their own pockets. 

The COVID-19 legislation cuts premiums paid by a hypothetical 64-year-old making $58,000 from $1,075 a month to about $413, based on Congressional Budget Office estimates. A 45-year-old making $19,300 would pay zero in premiums as compared with about $67 on average before the law. People who have even a brief spell of unemployment this year can get a standard plan for zero premium and reduced copays and deductibles.

President Biden reopened the HealthCare.gov web portal as one of his first acts as president, citing the ongoing COVID-19 pandemic. Earlier in March, Biden announced that more than 200,000 Americans got coverage within two weeks of the Special Enrollment Period opening.

“These numbers are an encouraging sign,” Biden said at the time, “But we can’t slow down until every American has the security and peace of mind that quality, affordable health coverage provides.”

“Health care is a right, not a privilege — and ensuring that every single American has access to the quality, affordable health care they need is a national imperative,” the president continued. “Never has that been more important than today, in the midst of a deadly pandemic that has infected nearly 30 million Americans.”

What You Need to Know

Biden’s order applies to 36 insurance markets run through the federal government’s platform.

Who Might Get Help

This window could be useful for people who recently lost their coverage or couldn’t find a plan last year. Experts have said the number of uninsured people has risen during the pandemic due to layoffs.

People who don’t have coverage but recently developed a health problem and want better access to care could also use this opportunity. It also could help those who have insurance but may want a new plan because it doesn’t cover their doctors or prescriptions like they expected when they signed up.

“Anybody who doesn’t have coverage or isn’t happy with their coverage should be looking at the marketplace during this extended enrollment period,” said Karen Pollitz, an insurance expert with the nonprofit Kaiser Family Foundation.

Any coverage purchased will start on the first day of the following month.

Less Hassle

A six-week window in November and December is usually the main opportunity insurance shoppers have every year to pick a plan. Those who want to stay covered then have to stick with that plan unless they have a life-changing event like a job loss, marriage or the adoption or birth of a child.

Those events qualify people for a special enrollment period in which they can buy a new plan. Shoppers normally have to submit proof that they qualify before they can shop for coverage. That won’t be necessary for this new enrollment window.

Payment Assistance

People can get help from the government to buy coverage in these marketplaces, depending on their income.

Those who make between 100% and 400% of the federal poverty level are eligible for assistance with premium payments in the form of tax credits. This year, the high end of that range amounts to $106,000 for a family of four.

Shoppers first have to estimate their annual income to get this help. That can be tricky when counting unemployment pay or income from a temporary job. Those who estimate too low — and wind up getting more help than they should – will have to pay back all or part of the assistance at tax time.

Consider Medicaid

People who have lost their jobs and have no income may qualify for Medicaid before unemployment pay starts. That program bases eligibility on current income, not what’s estimated for the year. Marketplace websites or health insurance navigators can help shoppers determine whether they qualify.

“Don’t assume you aren’t eligible. It’s really worth it to look into it,” Pollitz said. “Medicaid is catching a lot of people.”

Shopping Assistance

Shoppers can wind up with dozens of plans to chose from, each with different price tags, deductible requirements or networks of covered doctors. Help isn’t always easy to find.

A Kaiser Family Foundation survey last year found that half of the people who looked for coverage during the main sign-up period had some sort of trouble. That was shortly before the pandemic hit.

Since then, many shoppers have ventured into insurance markets for the first time due to pandemic-related job cuts.

The federal government operates a call center to offer assistance and can connect people to local help for selecting a plan.

Help With COVID-19

The vaccines that are currently being delivered around the country are free, so having health insurance won’t help with that bill. But coverage could offer protection against any medical bills that stem from COVID-19 treatments or any other injury or illness.

“It’s a really good time during a pandemic to have health insurance,” Pollitz said.

What’s Next?

The appeal for uninsured people could become much clearer if Congress increases premium subsidies as part of its next virus relief package.

“That would be a great incentive to get people in the door,” said Tara Straw, a health policy analyst with the Center on Budget and Policy Priorities, which advocates on behalf of low-income people. More generous help would be available not just to the newly enrolled, but to all who are covered through the law’s marketplaces.

By the budget center’s calculations, a family of four making $50,000 would pay $67 a month in premiums for a standard plan, instead of an average of $252 currently, while also qualifying for help with deductibles and copays. The boost in premium assistance would be available for this year and for 2022.

Similarly, a single person making $30,000 a year would pay $85 a month for a standard plan instead of the current $195.

The Democratic proposal would allow more solid middle-class households to qualify for financial help. On the opposite end of the scale, those who’ve experienced unemployment would qualify for extra-generous subsidies.

Republicans who tried but failed to repeal the law under President Donald Trump are calling the Democratic plan a waste of taxpayer dollars. But many Democrats see it as merely a down payment on a more ambitious health care agenda.

The Obama health law now covers more than 20 million people through a combination of subsidized private plans and, in most states, expanded Medicaid.

“As more Americans get covered, it is encouraging to see Congress moving quickly to pass the American Rescue Plan, which will ramp up testing, tracing, and our national vaccination program to get shots into as many arms as possible as quickly as we can,” Biden added in his statement about his proposed $1.9 trillion COVID-19 relief measure. “The American Rescue Plan will also take big steps to lower health costs and expand access to care for all Americans, including those who have lost their jobs. It will increase federal subsidies and decrease premiums in order to ensure that no one pays more than 8.5 percent of their income to purchase meaningful and comprehensive health coverage. And it incentivizes states to expand coverage to an additional four million people with low incomes, and provides states the opportunity to extend coverage for a year to low-income women who have recently given birth.”

“We will get through this crisis if we look out for one another and work together to expand coverage, lower costs, and ensure that health care truly is a right for all Americans,” he concluded.

The Associated Press contributed to this report.