Biden Signs Executive Order to Expand Special Enrollment Period for Affordable Care Act

WASHINGTON — President Joe Biden signed an executive order on Thursday, Jan. 28, instructing the Department of Health and Human Services to open a new special enrollment period for the Affordable Care Act from Feb. 15 to May 15. 

The usual enrollment period began Nov. 1 and ended Dec. 15, 2020, but Biden’s order will extend the period marketplace-eligible consumers can enroll or update their existing application through HealthCare.gov. Further, consumers may change their coverage under the ACA during this period. 

State-based marketplaces will have the opportunity to take similar action on their own exchanges. The order was one of two signed by Biden Thursday designed to expand access to health insurance through the ACA and Medicaid. 

In an Oval Office signing ceremony, Biden made it clear the orders would not be “initiating any new law, (or) any new aspect of the law,” but instead were meant to return the exchanges “to what the situation was prior to (former-President Donald) Trump’s executive order.” 

In April 2017, the Centers for Medicare and Medicaid Services — under the direction of Trump — shortened the enrollment period from three months to 45 days, according to HealthAffairs.org. To bolster awareness of the change, CMS will undertake an advertising and outreach campaign to prospective consumers in English, Spanish and other languages. 

“Today’s executive action will allow struggling Americans in desperate need of health care during the pandemic to access affordable coverage,” Ways and Means Chairman Rep. Richard Neal, D-Mass., said in a written statement. “I have called for a special enrollment period since the beginning of the COVID crisis, when millions of people in our nation suddenly found themselves without insurance.” 

Neal continued, “In the midst of this historic health emergency that has intensified existing health disparities, I’m relieved that President Biden is making health care enrollment as straightforward as possible. Together, we can build on the pillars of the Affordable Care Act to make our health care system even more accessible and affordable for all.” 

In December, the Kaiser Family Foundation found preliminary Medicaid data reflected a 6.1% increase in enrollment between February and July 2020. Similarly, managed-care plan enrollment in 30 states climbed to roughly 11.3% between March and September. 

By June 2020, about 7.7 million laid-off workers lost their employer-sponsored health coverage, according to Market Watch. Those coverage plans encompassed dependents as well, leading to roughly 14.6 million uninsured individuals. 

“No Michigander should have to worry about access to quality, affordable health care, especially during a pandemic,” Michigan Gov. Gretchen Whitmer said in a written statement. “In the early months of the COVID-19 pandemic, Michigan saw an estimated 46% increase in the number of uninsured adults, and there are still thousands of people who need coverage.” 

Whitmer continued, “President Joe Biden’s executive order to reopen the health insurance marketplace will go a long way in expanding health coverage to Michiganders and I couldn’t be more grateful for his leadership during this difficult time.” 

Despite the 2021 enrollment period’s expiration in December, roughly 8.3 million people selected or were automatically re-enrolled in plans from Nov. 1 to Dec. 15. Of those 8.3 million enrollees, 267,070 were Michigan residents, according to CMS. 

Of the 36 states with exchanges through the HealthCare.gov platform, Florida and Texas saw the largest increase in enrollment at 2,120,350 and 1,291,972 selections, respectively.

However, not everyone agrees the extension will serve any useful purpose.

“Policymakers understand that the reason the Affordable Care Act instituted an open enrollment period in the first place was to discourage consumers from signing up for coverage only when they get sick,” Hadley Heath Manning, Independent Women’s Forum policy director and health policy expert, said in a written statement.

Manning contends that making Medicaid more accessible to consumers misses the mark in terms of pandemic response. Flooding the exchange with new enrollees stretches the “social safety net” too thin and fails the consumers who rely on the program the most — individuals with limited income and resources. 

 “Of course, the extenuating circumstances of the pandemic have put many Americans in difficult and uncertain circumstances regarding their health and financial security,” she said.