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Biden’s Obamacare Do-Over: Another Chance to Sign Up, This One More Publicized

Evidence from states that also reopened enrollment suggests it could pull more young, healthy Americans into insurance coverage.


By Sarah Kliff and Margot Sanger-Katz


In December, the last Obamacare enrollment period under the Trump administration closed. Now that the Biden administration has arrived, it’s trying a do-over.

The renewed effort reflects the Biden team’s view that the Trump administration did too little to help people find coverage, despite a public health crisis and waves of job losses. Although insurance sign-ups were up a bit compared with last year, the growth did not match the increase in need.

In an executive order he signed Thursday, President Biden created a 90-day enrollment period starting Feb. 15 on Healthcare.gov, the insurance marketplace that serves 36 states. The White House plans to run an outreach campaign with paid advertising and direct-to-consumer marketing.

The 14 states that manage their own marketplaces are likely to follow suit, nationalizing the effort. California already announced it would do so Thursday.

“There’s no question that this is a better-late-than-never situation for this open enrollment,” said Eliot Fishman, a senior director for health policy at the consumer group Families USA, who served in the Biden transition but did not work on this policy.


Around 15 million Americans lack insurance and would be eligible for marketplace coverage, according to a recent report from the Kaiser Family Foundation. Four million of them would qualify for a plan without premiums.

“The four million people who could be getting free coverage who are instead uninsured — that, to me, is just screaming out for outreach,” said Cynthia Cox, a vice president at the foundation and a co-author on the report.

Many people advising the Biden administration emphasize that Obamacare will work better as a safety net if more people understand it exists. Unlike self-employed people who have signed up for Obamacare plans for years, many of the Americans losing their insurance now have never used the marketplaces or Medicaid. They may need advertising to tell them about the opportunity, as well as professional help to select a plan.

Ms. Cox said the marketing needs to emphasize not just that sign-ups are possible, but also that people can get financial help buying insurance — and why insurance is worth having. In 2017, the Trump administration cut the program’s advertising budget by 90 percent. Editors’ Picks


But increasing all the services that help connect people with coverage may take time. Biden administration officials may find themselves hamstrung by the lack of pre-existing networks of outreach workers. State officials say such networks were crucial to getting the word out during their extra sign-up periods.

The Affordable Care Act already allows people who lose jobs or experience a change in income to sign up for coverage outside of the regular fall open enrollment period. What the Biden administration will do is open the marketplaces to all Americans, without requiring them to provide paperwork proving their eligibility.


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