Biden to Reopen Obamacare Markets: What This Means for Your Health Coverage

Key Takeaways

  • In June 2020, an estimated 7.7 million workers lost their employer-sponsored health insurance due to the pandemic. 
  • The reopening of the “Obamacare” marketplace would give people an additional opportunity and more time to apply for health insurance in 36 states where HealthCare.gov is operated. 
  • Every four out of 10 Americans who are not enrolled in insurance are eligible for free insurance under the Affordable Care Act.

Last Thursday, President Joe Biden signed a flurry of executive orders aimed at reversing former President Trump’s HealthCare.gov insurance policies. One of Biden’s orders involved the reopening of the HealthCare.gov marketplace, which would allow people without health insurance to have an opportunity to shop for all available health insurance offered through the Affordable Care Act (ACA), also known as “Obamacare.”

According to Sarah Gordon, PhD, MS, assistant professor of health law, policy, and management at the Boston University School of Public Health, Biden’s executive order would create a 90-day enrollment period starting on February 15, 2021. “This is important because typically one can only sign up for marketplace coverage during the open enrollment period or during a special enrollment period,” Gordon tells Verywell. A new open enrollment would give people another opportunity and more time to enroll in health insurance. 

The federal open enrollment period typically runs from November 1 through December 15 every year for health insurance coverage beginning the following year. You may qualify for a special enrollment period if you’ve recently experienced certain life events, like getting married, having a baby, or losing other health coverage from previous employment.

In June 2020, 7.7 million people lost their employer-sponsored health insurance due to the pandemic, according to the Commonwealth Fund. While some of these losses appear to have been offset by increased enrollment in Medicaid and marketplace coverage, Gordon says that there are still many uninsured Americans eligible for enrollment. According to the Kaiser Family Foundation, four out of 10 uninsured people can get free insurance, largely under the ACA

If implemented, the order would only apply to states that operate a HealthCare.gov platform. According to Gordon, there are 36 states that utilize this platform and consumers of these 36 states can apply and enroll for coverage directly through the HealthCare.gov website which is operated by the Department of Health and Human Services. 

What This Means For You

If you are uninsured during the pandemic, consider enrolling for health insurance via the HealthCare.gov website when open enrollment opens again on February 15. If you live in a state that runs a state-level marketplace, you can apply for a special enrollment period through your state.

Reopening the Marketplace

Before the ACA was passed in 2010, if people didn’t have access to health insurance through an employer or a government sourced insurance like Medicare, Medicaid, or the Veterans Administration, “you had to go to a private health insurer and apply for a policy,” Wendy Netter Epstein, JD, professor of law and faculty director at the Jaharis Health Law Institute at DePaul University in Illinois, tells Verywell. “The process was very difficult to navigate. It was hard for people to compare options across insurers.”

The ACA marketplace tackles this issue. “The individual health insurance marketplaces created by the ACA sell qualified health plans to individuals and families who do not have an affordable offer of employer-sponsored coverage through their job and are ineligible for other public insurance programs such as Medicaid and Medicare,” Gordon explains. 

Consumers in states where the federal HealthCare.gov is not operated can apply and enroll in coverage through the marketplace websites established and maintained by their state. Currently, 15 states run their own state-based marketplaces, including California, Massachusetts, and New York.

Epstein says although it wouldn’t hurt to give people another opportunity to enroll, the policy is not likely to be a game-changer. “Affordability is still a key limitation on enrollment,” Epstein says. For the reopening of the HealthCare.gov marketplaces to be a more effective policy, “making subsidies more generous and making them available to more people would help,” she says. 

Currently, in states that have expanded Medicaid, people with income between 100 to 400% of the federal poverty level are eligible for subsidies to lower monthly premiums. “Those with incomes between 100 to 250% of the federal poverty level are further eligible for cost-sharing reductions which lower the portion of the cost of healthcare services patients must pay for out-of-pocket,” Gordon says. 

Reopening the marketplace would not only allow the folks that lost their jobs to apply, but also reach the population who chose to go without health insurance prior to the pandemic, according to Epstein. “The pandemic has made clear why anyone, even those currently healthy, could end up incurring high healthcare expenses,” Epstein says. As the pandemic’s one year anniversary approaches, “it is unclear how many in that insurance-resistant population will take advantage of this new enrollment period,” she adds.

Health Policy During Trump Administration

During the Trump administration, Gordon says health policy experts were pushing to open the marketplace open enrollment period. “That did not happen,” Gordon says. “The Trump administration had also previously reduced funding for outreach and insurance enrollment assistance and cut the duration of the annual open enrollment period.”

Because of the ongoing debate about the ACA, Gordon says that there is still understandable confusion among the American people about whether marketplace coverage options even exist and whether they are affordable. 

“More information and targeted outreach are necessary to ensure that people know what coverage options might be available to them, as many low-income Americans could be eligible for a marketplace plan with a zero dollar premium,” Gordon says.

The marketplace is a single place where individuals, families, and small businesses can go to compare the pricing of all available policies. “In addition to providing a one-stop-shop, the ACA legislated that private insurers could no longer refuse to cover anyone or charge different rates based on medical history,” Epstein explains. Strengthening the ACA not only supports low-income Americans but those with preexisting conditions who would otherwise have been denied private insurance. 

Next Steps 

“At a time during a pandemic when access to health care is more critical for every American than ever, an open enrollment period in response to the effects of COVID-19 is a no-brainer,” Gordon says. “We should be doing everything we can to make it easier for people to get covered right now.” 

If you are uninsured, Epstein recommends enrolling for health insurance during this period. “The marketplaces aren’t perfect,” Epstein says. “But if you are uninsured during a pandemic, it absolutely makes sense to take a look at what is available.”

Starting on February 15, you can head to HealthCare.gov and enroll in the marketplace if you aren’t currently insured. You can check out their guide to getting a health insurance plan through the marketplace here.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

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