The Trump administration has elected to not reopen the open enrollment period for Obamacare, or the Affordable Care Act (ACA), despite a surge in those who have been laid-off and are jobless due to the spread of the COVID-19 coronavirus. The Trump administration has appealed to other safety net options such as Medicare and Medicaid to support the rising ranks of the uninsured.
This while the Supreme Court has suspended oral arguments, meaning that the case currently pending regarding the constitutionality of the ACA will not be undecided until October, when the Court plans to reopen. This leaves the ACA in continuing limbo, but confirmed to continue for another year.
This could spell good news for Republicans, who may be able to avoid the issue during an election year. Without access to Obamacare, Democrats argue that millions of Americans will be barred from sufficient healthcare.
The idea behind the ACA is that it offers low-cost and subsidized health insurance coverage for Americans who are unable to access insurance through their employers. In practice, the existence of the ACA, and the health insurance "exchanges" that are available at the statewide level, have led many employers to abandon their health benefit programs. Additionally, many of the available plans come with high deductible that can prohibit those who have purchased the coverage from using it.
Democrats continue to tout its praises, and Vice President and Democratic presidential contender Joe Biden claims that “This callous decision will cost lives. Period.”
Many of Trump’s critics agree that if there was ever a time to open the exchanges to an extended enrollment period, this is it. The way that insurance functions in America is that, without it, accessing care at all is an uncertainty. Those who had insurance through their employers are still allowed to pay for the cost of that insurance for up to 18 months not that their jobs aren't footing the bill. However, that practice, called COBRA, can be prohibitively expensive.
The Trump administration has noted that the current insurance programs that are in place for poor and elderly Americans, Medicaid and Medicare, are still available for enrollment. However, the income based qualifiers on those plans would not allow admittance to Americans who had a higher income over the past 12 months, despite the fact that they are not not earning.
Unemployment benefits will be available for those who are without work, but it does not come with a health insurance plan that those who are taking advantage of this benefit can enroll into.
This means that during this COVID-19 coronavirus pandemic there are increasing numbers of the unemployed and uninsured, and concern is growing for those Americans who do not have access to care. There has been a bitter feud between Democrats and Republicans over Obamacare and socialised health insurance in general, and the fear is that the Trump administration is letting the program whither on the vine without offering an alternative for those who have come to rely on the existing programs.
It is believed that HealthCare.gov’s Twitter page did not send out a single message last month encouraging people to check if they were eligible for a special enrollment as a means to intentionally deny people coverage and move people off of the insurance rolls.
The 13 states that run their own Obamacare marketplaces have reopened enrollment in recent weeks, including the District of Columbia and Maryland. D.C. has reported sharp increases in enrollment. “In Maryland, more than 10,000 people enrolled in Medicaid or an Obamacare plan in the past two weeks, and nearly half were under 34, which is typically the most difficult age group to coax into buying coverage.”
But there are some options outside the law’s marketplace. The recently unemployed can extend their employer plan for “up to 18 months through COBRA,” which is an especially “pricey option,” where laid-off workers would have to pay the full price without their employer’s help.
The Trump administration has offered a short-term health insurance alternative that, while allowing enrollment year-round, will offer more less robust benefits and leave out protections for preexisting conditions. There are some blue states, such as California, that have banned or severely restricted this option.
There is no standard quality of care or insurance plan across the country, and it's possible for people in one state to pay the same amount for their monthly premium as those in another, while receiving a drastically inferior insurance product. The quality of healthcare through these plans is turbulent.
Reopening federal Obamacare enrollment, however, is not a simple proposition. Many Democrats are grappling with the high costs facing many new enrollees despite pledges from several insurance carriers to waive cost-sharing. Obamacare could still burden infected Americans with thousands of dollars in medical bills, due to lack of coverage entirely, hefty cost sharing, or high deductible plans.
Despite its clunkiness, Obamacare has enjoyed a rise in its popularity. When it was first passed in 2010, it had a 36 percent approval rating, and now it has a 42 percent approval rating. It is unclear whether its popularity has surged due to the circumstances or if more people are honestly interested in taking advantage of its benefits. What the coronavirus pandemic makes clear is that without adequate coverage, more Americans will be unable to obtain the care they need or pay their medical bills.