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Affordable Care Act

Biden has reopened Obamacare enrollment, but how fast you need to act depends on where you live

WASHINGTON – Millions of Americans have a special opportunity to sign up for government-subsidized health insurance, but residents of two states – Connecticut and Idaho – had better act fast.

Though President Joe Biden directed the federally run HealthCare.gov to reopen enrollment from Feb. 15 through May 15, the 14 states that operate their own insurance exchanges don’t have to go along.

Connecticut’s special enrollment period is scheduled to end March 15, although it could be extended.

Idaho, the last state to decide whether to participate, announced Monday that enrollment won’t begin until March 1 and will end March 31.

One month is a "reasonable and effective timeframe" since the state extended the deadline for 2021 coverage by two weeks in December, said Meghan McMartin, a spokeswoman for Your Health Idaho, the state’s insurance exchange.

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Access Health CT, the insurance exchange for Connecticut residents, will assess near the end of its one-month special enrollment period whether an additional extension is needed.

Some states took the opposite approach, giving residents more time than the federal special period to enroll. 

California, Massachusetts, New Jersey and New York are among the states that reopened their marketplaces at the beginning of February.

Massachusetts extended its special sign-up period one week longer than the May 15 federal deadline.

Some states are joining the federal government in allowing covered residents to switch plans if they find a better option.

The goal is to ensure people don't fall through the cracks during the pandemic when some have lost jobs or struggle with reduced incomes and have a higher risk of unexpected medical bills.

The differences in the enrollment periods are the latest examples of the difficultly many Americans face when navigating the nation’s fractured and often confusing health care system.

"There’s a risk that you're going to have some frustrated consumers who are going to be confused, and maybe they don’t come back," said Sabrina Corlette, a research professor at Georgetown University's Center on Health Insurance Reforms. "I think that's why so many of the state-based marketplaces did try to line up as close as they could to the federal dates."

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Insurance enrollment in Oakland in 2013.

A lack of awareness about options is one reason the Biden administration gave for reopening enrollment after the regular sign-up period ended in mid-December in most states.

Health care advocacy groups applauded the move to expand coverage as particularly important during the pandemic. 

The federal government is spending $50 million on an education campaign that will include broadcast, radio and digital advertising.

“I encourage everyone who needs health insurance to go to HealthCare.gov from today through May 15,” Biden said in a statement Monday.

That site works for residents of the 36 states that participate. Others are redirected to their state-based sites where details vary. 

Even though enrollment in Idaho won't begin until next month, residents can visit YourHealthIdaho.org to find out if they will be eligible for help.

“It never hurts to check," Pat Kelly, executive director of Your Health Idaho, said in a statement Monday.

In the regular enrollment period for 2021 coverage, more than 79,000 Idahoans signed up through the state health insurance exchange – a drop of about 10,000 from the previous year.

The head of an Idaho health coverage advocacy group said she hopes the state will undertake a "robust outreach effort to ensure Idahoans understand their coverage options."

“While this monthlong special enrollment period is short, it does provide a window of time for folks needing health coverage to sign up," said Christine Tiddens, director of Idaho Voices for Children. "We look forward to learning about the state’s marketing plans leading up to March."

Idaho did not join other state-run exchanges that created special enrollment periods after the coronavirus exploded last spring. 

President Donald Trump resisted calls to reopen the federal exchange. His administration cut back on marketing, outreach and enrollment assistance over the past four years.

"They cut it to the bone and then some," Corlette said. 

Although people who lose employer-provided coverage or have another qualifying event can sign up outside an open enrollment period, many aren't aware that they're eligible for help, she said.

Nearly 9 million uninsured Americans could get free or subsidized health insurance through the special enrollment period, according to the Kaiser Family Foundation, a nonpartisan health research organization.

Subsidies are available to those earning up to 400% of the federal poverty level, which is about $51,520 for one person or $106,000 for a family of four.

Of those receiving coverage through HealthCare.gov, 9 out of 10 receive some level of subsidy, according to the administration. 

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