Time magazine recently published a story about a woman who contracted the coronavirus. Her temperature spiked, her lungs filled with fluid and she needed to go to the emergency room three times. While she eventually improved, at least physically, when she received the medical bill she was stunned: It came to almost $35,000. When she got sick she was one of 27 million Americans without health insurance. So while her health improved, her personal finances may never recover — at least not for a long time.
Most people, thankfully, will never get that sick, and those with insurance will be covered. In fact, the federal government even boosted coverage in response to the coronavirus, or COVID-19. In March, Congress passed the Families First Coronavirus Response Act, which requires most private health plans to cover testing for the coronavirus with no cost sharing during the emergency period. According to the Kaiser Family Foundation, some states have passed similar requirements for insurers in their state, and many private insurance companies have voluntarily expanded coverage for testing.
The new law also requires health plans under the Affordable Care Act to cover coronavirus testing and to waive cost sharing and prior authorization. This requirement applies to visits in physician offices, urgent care centers and emergency rooms associated with testing, but does not apply to short-term plans, sharing ministries or certain Farm Bureau plans, according to KFF.
But what can the uninsured do? And what about the many millions of Americans who have been or may yet be laid off, losing their insurance along with their jobs?
New Open Enrollment Period for ACA
Noah Lang is the CEO of Stride Health, a health insurance company that specializes in coverage for workers in the gig economy. It partners with companies like Uber, Keller Williams and Etsy to find coverage for part-time and freelance workers. (U.S. News is also a partner.) Lang says that many of those without insurance still have the ACA to protect them.
“The ACA is still the law of land, and every state has a marketplace to access affordable coverage,” Lang says. Some states manage their own ACA market, while the others are built off of the federal market, Healthcare.gov.
Normally, individuals can enroll in ACA coverage only during open enrollment, which typically falls at the end of the calendar year. But in the face of the COVID-19 pandemic, every state with its own health care exchange except Idaho has reopened enrollment with a COVID-19 Special Enrollment Period, or SEP. As of March 24, the SEP is offered in the following states and districts:
— New York
— Rhode Island
— Washington, D.C.
All uninsured residents of each state are eligible, but the enrollment period is short. The deadline for enrollment is:
— California: April 30
— Colorado: April 3
— Connecticut: April 2
— Massachusetts: April 25
— Minnesota: April 21
— Vermont: April 17
— Washington: April 8
— All others: April 15
[See: Myths About Coronavirus.]
A Push for More Special Enrollment
Coverage is made affordable through tax credits that help lower premiums. In most states, credits are available to individuals earning up to four times the poverty level, Lang says, and in California, it is now set at six times the poverty level.
As of press time, states that partner with HealthCare.gov have not announced an open enrollment. But the governors of New Jersey, Michigan, Pennsylvania and New Hampshire, along with 25 U.S. senatators, have urged the Trump Administration to do so.
“State governors are pressing the Department of Health and Human Services and the Centers for Medicare & Medicaid Services to provide a special enrollment period for at least 60 days to all eligible uninsured and underinsured residents,” Lang says.
“They say that many states have taken steps to protect their residents like expanding access to screenings, testing and proper treatment. Opening a special enrollment period would remove potential barriers for their residents getting tested and treated for coronavirus. They also all cite that there is precedent for HHS declaring a Special Enrollment Period during emergencies, like natural disasters, and COVID-19 was declared a public health emergency,” Lang says.
Grace Periods for Those With ACA Coverage
If you miss the SEP deadline or lose your job after it, the ACA also allows for enrollment any time of the year when faced with a “life event,” which job loss qualifies for.
Lang also reminds those who do have coverage through the ACA but may have lost their jobs or seen their income reduced that the ACA mandates a grace period for premium payments under certain circumstances. “If you have a plan through the marketplace with a subsidy and have paid your initial binder, you have access to a 90-day grace period,” he says. “The 90-day health insurance grace period starts the first month you fail to pay, even if you make payments for the following months.”
And you can apply for more tax credits if you’re already enrolled and have reduced income. “If you are Uber driver making $40,000, and now you’re making $25,000, you can adjust your income to increase your premium tax credit, and that can help as well,” Lang says. Contact your insurance exchange to learn how.
Signing up for insurance now, in the face of COVID-19, offers both individual and societal benefits, says Joel Ario, a managing director of the Manatt Health consulting arm of Manatt, Phelps & Phillips, an Albany, New York-based law firm. “One is that it could be a lifesaving matter for vulnerable individuals who are nervous about going for and affording a test or who may need hospitalization or treatment they can’t afford,” says Ario, a former health insurance commissioner in both Pennsylvania and Oregon and former director of the Office of Health Insurance Exchanges at HHS.
“There is also the argument that it is good for the overall healthcare system as well,” Ario adds. “The system works more smoothly and efficiently if people have some form of coverage. There is a reason why, when you go to the doctor’s office, the first question always is, ‘Do you have the same insurance?'”
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What to Know About Health Insurance and Coronavirus originally appeared on usnews.com