More than 26 million people have lost their jobs since the COVID-19 public health emergency began, with many also losing their employer-based insurance that was connected to those jobs. They will now be looking for new coverage, potentially turning to Medicaid for coverage or selecting a plan on Affordable Care Act (ACA) health insurance marketplaces.
Numerous studies show that patients without insurance live sicker and die younger. The AMA believes that, to improve the health of our nation and especially to save lives during the pandemic that has already killed more than 58,000 people in the U.S., all Americans should have access to meaningful, affordable health care.
“Millions of people have been suddenly and unexpectedly severed from their health insurance, compounding the everyday stress from an unprecedented economic and public health crisis,” said AMA President Patrice A. Harris, MD, MA. “Unlike past economic recessions, unemployed individuals have more options for buying affordable health insurance. Provisions in the ACA, along with actions taken recently by Congress and some states, mean more opportunities for getting coverage.”
Before the COVID-19 crisis, about 71 million people were enrolled in Medicaid, while more than 11.4 million were covered by a plan offered on ACA marketplaces. The number of people—including workers and their family members—covered by an employer-based plan could drop by as much as 35 million, according to a report by Health Management Associates.
This could drive Medicaid enrollment up by between 11 million and 23 million, while another 2.1 million may gain coverage through plans offered on or off ACA marketplaces, according to the report. Physicians should advise newly uninsured patients to take the following steps:
Check their eligibility to enroll in a health plan offered on HealthCare.gov. Many patients who have lost their employer coverage may be eligible for financial assistance to lower the premiums and cost-sharing responsibilities if they enroll in an ACA marketplace plan.
California, Colorado, Connecticut, Idaho, Maryland, Massachusetts, Minnesota, Nevada, New York, Rhode Island, Vermont, Washington and the District of Columbia operate their own marketplaces. All but Idaho have established special open enrollment periods in which consumers can sign up for coverage. The federal government has chosen not to establish a special open enrollment period, but patients who have lost coverage due to the loss of a job are eligible to enroll.
Avoid short-term limited duration (STLD) health insurance plans if possible. STLD plans are designed to fill temporary gaps in insurance, have very limited benefits and may not cover mental health care, prescription drugs, and preventative and wellness care. They may also not cover COVID-19 testing and treatment. In addition, STLD plans may deny coverage to patients based on pre-existing medical conditions or they may refuse to cover care related to a pre-existing condition.
Gather the documents and materials needed to enroll. The Centers for Medicare & Medicaid Services has developed this checklist of the 10 things needed to complete enrollment in the individual marketplace. These include Social Security numbers, birthdates and mailing addresses for everyone applying for coverage. There is also a list of needed materials to certify loss of coverage because of a “qualifying life event” to apply during this time on a federally run marketplace.
The AMA and dozens of other organizations representing patients, health professionals and hospitals are urging the federal government to open a national COVID-19 special enrollment period to make it as easy as possible for those who lost insurance coverage because of COVID-19 developments and for other uninsured individuals seeking coverage.
In addition, the AMA recommends that the federal government immediately increase funding to states for ACA outreach and enrollment efforts, as well as for navigators to assist consumers in choosing the best plan for their needs.
Unlike the government health insurance marketplace, there is no enrollment period for Medicaid and eligible people can sign-up at any time. State eligibility requirements and income qualifications vary by state. More information is also available at Medicaid.gov.
The AMA continues to advocate for strengthening Medicaid. Steps to do so include:
- Urging states that haven’t done so to expand Medicaid coverage for those with incomes up to 133% of the federal poverty level.
- To encourage states to expand Medicaid, allowing 100% federal matching funding for states that newly opt into Medicaid expansion for the first three years.
- Increasing federal funding to state Medicaid departments to support the expected influx of enrollees.
The AMA has long advocated for health insurance coverage for all Americans, as well as pluralism, freedom of choice, freedom of practice and universal access for patients. Read more about the AMA’s vision for health care reform.
Stay up to speed on the AMA’s COVID-19 advocacy efforts and track developments with the AMA's COVID-19 resource center, which offers a library of the most up-to-date resources from JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization.
