President Joe Biden is expected to sign an executive order Thursday that will reopen the federal health insurance marketplaces, allowing millions of people to sign up for coverage outside of the usual six-week enrollment period. In most states, the enrollment period ends on December 15.
Biden also reportedly plans to boost marketing and outreach efforts to encourage those who currently lack insurance to obtain coverage through the Obamacare exchanges, including those who lost their health insurance due to job losses during the pandemic. Those efforts were curtailed under former President Donald Trump, which may have reduced the number of people signing up for coverage over the last four years.
Could affect millions: The impact on health coverage in the U.S. could be enormous. According to an analysis by the Kaiser Family Foundation, about 4 million currently uninsured people could qualify for no-cost Obamacare bronze plans, with their premiums fully paid by federal subsidies, and another 4.9 million could be eligible for partially subsidized coverage.
“The 8.9 million people eligible for free or reduced-cost coverage represent nearly 60 percent of the approximately 15 million uninsured people in the U.S. who could shop for health insurance coverage on the ACA Marketplaces,” Kaiser said Wednesday.
Compared to the U.S. population as a whole, those who would qualify for fully subsidized, no-cost bronze plans are more likely to live in rural areas, Kaiser said. They also tend to be younger, have no more than a high school education, and be unemployed or working part-time. And more than half of them live in just four states: Texas, Florida, North Carolina and Georgia.
Still, there are questions about how many people will actually sign up, given the chance. Many of those who lost their jobs and incomes have already signed up for Medicaid, and others have gained access to Obamacare plans through the special enrollment period open to those with qualifying events, including job loss. But making it easier to sign up, with assistance from paid navigators and with enough time to supply necessary documentation, could make a difference in participation. More broadly, reopening the marketplaces signals that Biden is taking a different approach on health care, one that seeks to assist as many people as possible.
Changes in Medicaid, too: Biden also plans to take steps Thursday to make it easier for people to sign up for Medicaid by removing barriers put in place by the Trump administration. According to The Washington Post, it’s not yet clear whether Biden intends to reverse specific provisions, such as a Trump-era rule that allows states to impose work requirements on Medicaid participants, or simply order officials to review current laws and recommend changes at a future date.
“You could think about it as announcing a war against the war on Medicaid,” Katherine Hempstead of the Robert Wood Johnson Foundation told the Post.