Doggett, Casey Author Bicameral Legislation to Ensure Special Enrollment Session for Marketplace Coverage During Public Health Emergencies like COVID-19

Statement

Today, on the tenth anniversary of the Affordable Care Act (ACA), and as the COVID-19 pandemic spreads across the United States, Rep. Doggett (D-TX), Chairman of the House Ways and Means Health Subcommittee, and Senator Bob Casey (D-PA) introduced legislation to require a special enrollment period any time there is a public health emergency declaration, such as COVID-19, and to require insurance plans to cover any treatments and services related to the disease that sparked the public health emergency declaration. They were joined in leading this effort by Reps. Diana DeGette (D-CO), Susan Wild (D-PA), Brendan Boyle (D-PA), Mike Doyle (D-PA), and Dwight Evans (D-PA).

"The Affordable Care Act is an invaluable tool in combatting the coronavirus pandemic. Let's give more Americans an opportunity to access affordable health care, especially those who missed last year's Trump-narrowed and little federally-publicized enrollment period. And for those who have discovered that the junk, short-term insurance plan they purchased is really junk, this represents an opportunity to secure genuine health insurance," said Rep. Doggett. "With a public health emergency spreading like wildfire, we need to equip our uninsured and underinsured neighbors with the ability to protect and care for their families. Our entire communities are strengthened by expanding the ability of the health insurance market to respond."

"Our Nation is facing a public health crisis, yet millions of Americans remain uninsured," said Senator Bob Casey. "That's why I introduced Ensuring Coverage in Public Health Emergencies Act of 2020 to provide for special enrollment periods during public health emergencies like the coronavirus (COVID-19) pandemic. We must ensure that hard working families don't go into financial ruin in order to pay for testing or treatment simply because they don't have insurance."

On March 13th, Rep. Doggett led over 100 colleagues in urging Secretary Azar to use his existing authority to establish a Special Enrollment Period for COVID-19. You can read the letter here, which has gone unanswered. "Many among the close to 30 million Americans living without insurance and estimated 44 million who are underinsured would benefit from such a declaration," the lawmakers wrote in that letter. "As outbreaks emerge and community spread continues in the United States, our most vulnerable neighbors are those who lack comprehensive health coverage. Without that coverage, they are unlikely to seek treatment for COVID-19, leaving all in our community at risk."

Holding a special enrollment period during public health emergencies gives many of our most vulnerable the opportunity to get comprehensive coverage, making all of us safer. Likewise, requiring private insurance plans to cover treatment and services related to COVID-19 ensures consumers are guaranteed access to the care they need during the emergency.

"We are in the midst of a global health pandemic," said Rep. DeGette. "Now more than ever, Americans need access to comprehensive health care. By designating a special enrollment period, our legislation would ensure anyone who needs to can enroll in a health insurance plan that will cover them should they get sick from this virus."

"Every single American deserves health care, especially in times in which an individual's health affects our larger public health," said Rep. Wild. "Right now, people need health care coverage and the freedom to get better, more comprehensive coverage without waiting until the next open enrollment period. I'm proud to help co-lead an effort to open the enrollment period during this pandemic so that individuals are not left uninsured or underinsured."

"As this crisis ensues, we must ensure everyone has access to quality, affordable health care," said Rep. Boyle. "Special enrollment periods help Americans get the coverage they need, and during a public health emergency, we must create as many options as possible for our constituents. I'm proud to join my colleagues on this legislation so we can prioritize health care and public health through these troubling times."

"A global pandemic is no time to be without health insurance," said Rep. Doyle. "I believe that authorizing special enrollment periods during national health emergencies like the current pandemic will help save lives. By ensuring more individuals have access to high-quality insurance, we can ensure they'll be able to effectively access the medical system -- staying out of ERs, getting care when they need it, and utilizing preventive care. This bill would help to ensure that no American has to be without health insurance during this -- or any other -- public health emergency."

Rep. Evans commented, "The Affordable Care Act has proven to be a success at getting people covered in Pennsylvania and across the country. It's vital for the administration to put people over politics and agree to a special enrollment period to help people get covered as we all cope with the effects of the virus."

This legislation would lower the barriers to care for patients and provide predictability and assurance for families, particularly in a public health emergency. This means allowing people to enroll in plans that provide comprehensive benefits, regardless of whether they are healthy or, in this case, diagnosed with COVID-19. With this bill, under the declaration of a Public Health Emergency by the Secretary of Health and Human Services, the Secretary would:

-Establish a special enrollment period of at least 30 days, open to anyone who wants to enroll and can be extended at the Secretary's discretion;
-Ensure that patients can get prevention, diagnostics and treatment comparable to what they might expect for similar services outside of a public health emergency;
-Waive restrictions and limitations on access to covered benefits, such as prior authorization requirements and limitations on filling or refilling prescription drugs, when the services are determined to be medically necessary by the patient's health care provider and such restrictions are determined to be unduly burdensome by the Secretary.