Idaho’s health insurance marketplace is the only state-based exchange in the country that hasn’t opened a special enrollment period for its residents seeking coverage amid the global coronavirus pandemic.
Twelve states and Washington D.C. currently operate and have sole authority over their insurance exchanges. The rest must receive federal approval before allowing anyone to sign up for health insurance – something President Donald Trump declined to do earlier this week.
These exchanges typically only allow people to enroll in coverage for a period of a few weeks toward the end of the year.
Those who lose their jobs are generally eligible to either pay the full price for their former employer’s insurance plan for a period of time under the federal COBRA law, or they could file paperwork to enroll under the exchange.
A special enrollment period would drop those requirements and also allow the opportunity for anyone else who might not have insurance to sign up.
A spokeswoman for Your Health Idaho said the organization could not unilaterally open such an enrollment period without approval from the Idaho Department of Insurance.
The department is “continually monitoring the situation daily” and has not ruled out authorizing a special enrollment period according to spokeswoman Jennifer McClelland. It’s unclear what criteria the department is using to base its decision.
Your Health Idaho’s board of directors Friday unanimously voted to give the executive director, Pat Kelly, and chairman Stephen Weeg the power to open up the exchange again without their approval if Gov. Brad Little (R) directs them to do so.
These cheaper, short-term plans do not meet federal standards to be considered health insurance under the Affordable Care Act and enrollees are not eligible for a government subsidy if they purchase one. For example, these plans don’t cover doctor visits or prescription drugs related to pre-existing conditions for six months – including a pregnancy.
They also include a lifetime maximum benefit between $1 million to $2 million, depending on the carrier.
Last November, insurance director Dean Cameron refuted critics who call such plans "junk," telling the Idaho Statesman they have better benefits than short term plans have offered in the past.
Idaho Voices for Children and other advocates sent a letter to health exchange officials Thursday night, urging them to open a 60-day special enrollment period.
“Opening the exchange right now will ensure more Idahoans can purchase comprehensive health insurance and get access to the healthcare they need during this unprecedented health crisis,” said Thea Zajac, Idaho Director of Advocacy for the Leukemia and Lymphoma Society.
Since mid-March, enrollment under Idaho’s Medicaid expansion program has ticked up slightly to nearly 70,000 people out of an estimated 91,000 who are thought to be eligible.
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