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Politico Pro: Democrats press to reopen ACA exchange during pandemic

March 13, 2020

Democrats are urging the Trump administration to reopen enrollment in the Obamacare exchanges to accommodate uninsured people who may need treatment during the coronavirus pandemic.

More than 100 Democratic lawmakers on Friday urged the administration to set up a special nationwide enrollment period, expanding on efforts in Washington state and Massachusetts, which run their own Obamacare marketplaces. California's marketplace is also accepting sign-ups, though due to a lengthy enrollment period, not specifically in response to the outbreak. Michigan's Democratic governor, Gretchen Whitmer, made a similar plea to HHS, since her state relies on the federal exchange.

"As outbreaks emerge and community spread continues in the United States, our most vulnerable neighbors are those who lack comprehensive health coverage, the lawmakers, led by Rep. Lloyd Doggett (D-Texas), wrote to HHS Secretary Alex Azar. "Without that coverage, they are unlikely to seek treatment for COVID-19, leaving all in our community at risk."

Federal enrollment for the 2020 Obamacare coverage year ended on Dec. 15, well before the coronavirus emerged as a threat. The only options for people who didn't sign up are the barebones short-term plans pushed by the Trump administration, which may not cover care stemming from the pandemic. And they may not even have that option if they live in a state that's banned such plans.

House Speaker Nancy Pelosi hasn't directly addressed reopening the federal marketplace in the emergency stimulus legislation she's negotiating with the Trump administration.

But it could be addressed in the Senate, where Sen. Cory Booker (D-N.J.) is proposing to reopen the exchange to enroll only patients who have a presumptive positive or confirmed diagnosis of COVID-19. The bill would reopen enrollment for employer plans as well.

Big Affordable Care Act exchange plans aren't enthusiastic about the idea, although a few insurers are signaling support. Insurance analysts and lobbyists say if only sick people sign up, health plans will likely ask for new financial protections. The major trade group America’s Health Insurance Plans isn't taking an official position yet, and a spokesperson for the Blue Cross Blue Shield Association said they're concentrating on the House legislation.

Insurers fighting the idea may not get much sympathy from Democrats; health insurers are fresh off a big win with the full repeal of the health insurance tax on track to cost plans $15.5 billion this year. The insurers already priced the tax into their 2020 premiums.