Individuals losing eligibility for MaineCare can enroll in plans on CoverME.gov through July 31, 2024
AUGUSTA— The Maine Department of Health and Human Services (DHHS) announced today the launch of a Special Enrollment Period (SEP) through CoverME.gov, Maine’s Health Insurance Marketplace, to help Maine people transitioning from MaineCare coverage after the COVID-19 pandemic explore affordable health insurance options and avoid gaps in coverage. The Special Enrollment Period began on April 15, 2023, and will continue through July 31, 2024, allowing Maine individuals found no longer eligible for MaineCare to apply for plans through CoverME.gov outside of the annual Open Enrollment Period.
According to the essential Louise Norris, there are currently just six states where being pregnant in and of itself makes someone eligible for a Special Enrollment Period outside of the official Open Enrollment Period:
In most states, pregnancy does not trigger a special enrollment period. HHS considered this, but clarified in 2015 that they had decided not to include pregnancy as a qualifying event. This means that in most states, the special enrollment period tied to having a baby does not begin until the baby is born.
But state-run exchanges (there are 18 of them as of 2022) can set their own rules for qualifying events and special enrollment periods. Some of them do allow a special enrollment period triggered by pregnancy. This gives a pregnant person access to health coverage during the pregnancy, rather than having to wait until the baby is born to obtain coverage. As of 2022, pregnancy is a qualifying event in the following state-run exchanges:
As I noted this morning, while the 2023 ACA Open Enrollment Period has now officially ended in all states, there's still a lot of Special Enrollment Period (SEP) exceptions for people who have Qualified Life Experiences (QLEs) such as losing their current coverage, turning 26, moving, getting married/divorced, giving birth and so forth.
There's also year-round enrollment available for members of Native American tribes, as well as those eligible for Medicaid and the Children's Health Insurance Program (CHIP).
Finally, in most states, residents are eligible to enroll year-round as long as their income is below a certain threshold--usually 150% of the Federal Poverty Level (FPL), somewhat higher in some states, including New York, where residents earning. up to 200% FPL can enroll in the Essential Plan year-round.
The press release talks about "more than 35 million" being enrolled, but when you look at the actual data, it's almost certainly over 36 million as of today. Here's how they break it out:
Effectuated ACA exchange enrollment as of March 2022: 13,640,412
Medicaid Expansion (newly eligible) as of October 2021: 16,781,800
Medicaid Expansion (previously eligible) as of October 2021: 4,261,277
Basic Health Plan enrollment as of March 2022: 1,135,190
TOTAL: 35,818,679
Notice that even without delving further, the total is already over 35.8 million.
However, there's two important dates to look at here: First, the Medicaid Expansion totals are only up to date as of last October, a good 6 months ago.
After both the Washington HealthPlan Finder and Pennsylvania's Pennie ACA exchange announced that they were setting up Special Enrollment Periods for residents who were scammed by Benefytt Technologies into buying non-ACA compliant heatlhcare policies, this shouldn't be surprising.
A couple of weeks ago I noted that the Washington HealthPlan Finder has launched a special enrollment period for several hundred WA residents who were misled into enrolling in non-ACA compliant healthcare policies via fraudulent marketing by a company called "Benefytt Technologies."
The Federal Trade Commission Took Action Against Benefytt Technologies for Providing Deceptive Health Plans – Pennie is Helping Impacted Pennsylvanians Enroll in Quality Coverage
FTC action against Benefytt results in refunds for consumers who bought insufficient plansOlympia, WA
Washington Health Benefit Exchange (Exchange) is opening a special enrollment period until Nov. 10, 2022, for 232 Washingtonians who were sold an insufficient healthcare plan from Benefytt Technologies.
Benefytt must contact customers who are currently paying for Benefytt’s plans, inform them of the Federal Trade Commission’s (FTC) complaint against the company, and allow them to cancel their enrollment. Benefytt also must provide refunds for payments made after the order is entered directly to customers who cancel right away.
Today, the Centers for Medicare & Medicaid Services (CMS) posted Frequently Asked Questions (FAQs) regarding compensation paid by issuers to agents and brokers who assist consumers with enrollment during a Special Enrollment Period (SEP) or during Open Enrollment Periods (OEPs). The Biden-Harris Administration has made it a priority to provide those who are uninsured and underinsured with quality, affordable health care coverage and recognizes that agents and brokers play a vital role in helping consumers enroll in coverage that best fits their needs and budget.
New Reports Show Record 35 Million People Enrolled in Coverage Related to the Affordable Care Act, with Historic 21 Million People Enrolled in Medicaid Expansion Coverage
Last June, the U.S. Health & Human Services Dept. confirmed my estimate that total enrollment in healthcare policies either specifically created by (or expanded to more people by) the Affordable Care Act had broken 31 million Americans:
Today, the U.S. Department of Health and Human Services (HHS) released a new report that shows 31 million Americans have health coverage through the Affordable Care Act – a record. The report also shows that there have been reductions in uninsurance rates in every state in the country since the law’s coverage expansions took effect. People served by the health Marketplaces and Medicaid expansion have reached record highs.
