Trump rejects Obamacare special enrollment period amid pandemic

The Trump administration has decided against reopening Obamacare enrollment to uninsured Americans during the coronavirus pandemic, defying calls from health insurers and Democrats to create a special sign-up window amid the health crisis.

President Donald Trump and administration officials recently said they were considering relaunching HealthCare.gov, the federal enrollment site, and insurers said they privately received assurances from health officials overseeing the law's marketplace. However, a White House official on Tuesday evening told POLITICO the administration will not reopen the site for a special enrollment period, and that the administration is "exploring other options."

The annual enrollment period for HealthCare.gov closed months ago, and a special enrollment period for the coronavirus could have extended the opportunity for millions of uninsured Americans to newly seek out coverage. Still, the law already allows a special enrollment for people who have lost their workplace health plans, so the health care law may still serve as a safety net after a record surge in unemployment stemming from the pandemic.

Numerous Democratic-leaning states that run their own insurance markets have already reopened enrollment in recent weeks as the coronavirus threat grew. The Trump administration oversees enrollment for about two-thirds of states.

Insurers said they had expected Trump to announce a special enrollment period last Friday based on conversations they had with officials at the Centers for Medicare and Medicaid Services, which runs HealthCare.gov enrollment. It wasn’t immediately clear why the Trump administration decided against the special enrollment period. CMS deferred comment to the White House.

Trump confirmed last week he was seriously considering a special enrollment period, but he also doubled down on his support of a lawsuit by Republican states that could destroy the entire Affordable Care Act, along with coverage for the 20 million people insured through the law.

People losing their workplace coverage have some insurance options outside of the law's marketplaces. They can extend their employer plan for up to 18 months through COBRA, but that's an especially pricey option. Medicaid is also an option for low-income adults in about two-thirds of states that have adopted Obamacare's expansion of the program.

Short-term health insurance alternatives promoted by Trump, which allow enrollment year-round, is also an option for many who entered the crisis without coverage. Those plans offer skimpier coverage and typically exclude insurance protections for preexisting conditions, and some blue states like California and have banned them or severely restricted them. The quality of the plans vary significantly and, depending on the contract, insurers can change coverage terms on the fly and leave patients with exorbitant medical bills.

Major insurers selling Obamacare plans were initially reluctant to reopen the law's marketplaces, fearing they would be crushed by a wave of costs from Covid-19, the disease caused by the novel coronavirus. But the main insurance lobby, America's Health Insurance Plans, endorsed the special enrollment period roughly two weeks ago while also urging lawmakers to expand premium subsidies to make coverage more affordable for middle-income people.

Congress in last week’s $2 trillion stimulus passed on that request, as well as insurers’ petition for an open-ended government fund to help stem financial losses from an unexpected wave in coronavirus hospitalizations.

Democrats pushing for the special enrollment period are also grappling with the high costs facing many people with insurance despite new pledges from plans to waive cost-sharing. Obamacare plans and a growing number of those offered by employers impose hefty cost-sharing and high deductibles that could still burden infected Americans with thousands of dollar in medical bills.

House Energy and Commerce Chairman Frank Pallone (D-N.J.) on a press call Monday contended that "we also need to have free treatment" after Congress eliminated out-of-pocket costs for coronavirus tests.

"We did the testing, which is now free, and everybody, regardless of their insurance, gets it," Pallone said. "But that has to be for the treatment as well."