Democratic Leaders Want Extended Obamacare Open Enrollment

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By Sara Hansard

The Democratic leaders of two Senate committees called for the Trump administration to extend the 2018 Obamacare open enrollment period Dec. 12.

“The Administration’s decision to depart from years of agency policy by ending Open Enrollment on December 15th is compounded by many other efforts by this Administration to destabilize the insurance market, making it likely that many consumers miss this deadline and forgo insurance next year,” Senate Finance Committee ranking Democrat Ron Wyden (D-Ore.) and Sen. Patty Murray (D-Wash.), the ranking Democrat on the Senate Health, Education, Labor and Pensions Committee, said in a letter to acting Health and Human Services Secretary Eric Hargan and Centers for Medicare & Medicaid Services Administrator Seema Verma.

Affordable Care Act supporters accuse the Trump administration of trying to sabotage the 2018 open enrollment period by cutting funding for outreach as well as shortening the open enrollment period to six weeks, about half the time period for 2017 open enrollment. The HHS press office Dec. 1 sent an email to media saying the adjusted length and timing for 2018 aligns more closely with Medicare and job-based insurance, and it noted that the Obama administration in 2016 finalized a rule setting the open enrollment period from Nov. 1-Dec. 15 for 2019 and beyond.

HHS: Website Performing Well

“Consistent with our aim to have a seamless open enrollment experience for consumers this year, the website is performing well and consumers can easily access enrollment tools to compare plans and prices,” a CMS spokesperson told Bloomberg Law in an emailed background statement Dec. 12. In the first year the exchanges opened in 2014, HealthCare.gov was largely dysfunctional for the first several months.

In addition to outreach funding cuts, the Trump administration also ceased reimbursing payments to cover cost-sharing reduction (CSR) subsidies that exchange insurers are required to provide for low-income people. A federal court ruled in 2016 that the federal government could not make the payments without an appropriation from Congress, and Congress has not authorized the payments, although they are being considered as part of the deliberations over the Tax Cuts and Jobs Act, which has passed the Senate and the House.

Because insurers thought they wouldn’t get the CSR payments, most of them have loaded the cost of the lost payments onto silver tier plans. ACA premium tax credit subsidies for moderate and low-income people are pegged to the second-lowest-cost silver tier plans. More than 80 percent of exchange enrollees receive the subsidies, but consumers will need to compare plans to get the best deals.

Administration Changing Landscape

“This year, steps taken by the Administration have changed the coverage landscape dramatically, making it more likely that consumers are automatically re-enrolled in plans that differ from their previous year’s coverage,” Wyden and Murray said in the letter.

“The Administration’s decision to stop paying CSRs induced market distortions that may make choosing the right plan even harder for working families, since gold coverage is now cheaper than silver coverage in many parts of the country,” the letter said.

Through Dec. 2, about 3.6 million health plans had been selected by consumers on the federal HealthCare.gov system used in 39 states, according to the CMS.

Millions Fewer Signed Up

On a week-by-week basis, sign-ups for coverage through HealthCare.gov are up more than 22 percent from where they were at this point last year, Wyden and Murray said in the letter. As a percentage of the total remaining open enrollment period, however, “millions fewer consumer have signed up for plans,” it said.

“By cutting Open Enrollment to just six weeks, HHS has left consumers with less time to shop for coverage, sign up for plans, and obtain needed financial assistance, all of which may result in substantially fewer people with coverage,” the senators said.

Ending open enrollment Dec. 15 will cause more than 1 million fewer individuals to find coverage for 2018, according to estimates, they said.

An HHS spokesman told Bloomberg Law in an email Dec. 12 that the agency has “received the letter and will respond to it.”

To contact the reporter on this story: Sara Hansard in Washington at shansard@bloomberglaw.com

To contact the editor responsible for this story: Kendra Casey Plank at kcasey@bloomberglaw.com

For More Information

Weekly Enrollment Snapshot: Week Five is at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-12-06.html.

Initial and annual open enrollment periods from 2016 rule is at http://src.bna.com/uUn.

A Dec. 1 colloquy agreement between Senate Majority Leader Mitch McConnell (R-Ky.) and Sen. Susan Collins (R-Maine) is at https://www.finance.senate.gov/imo/media/doc/121217%20Open%20Enrollment%20Hargan.pdf.

Copyright © 2017 The Bureau of National Affairs, Inc. All Rights Reserved.

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