In 2013, the Affordable Care Act (ACA) Marketplaces launched to provide Americans with a uniform entry point to seek health care. Before the ACA, people who did not have access to insurance through an employer or other mechanism had to navigate a complicated individual market with different standards from state to state to get access to care. Over the years, the Centers for Medicare & Medicaid Services (CMS) have overseen the creation and continued improvement of the Marketplaces. At its peak, in 2016, 12.68 million Americans enrolled in health coverage.
The ACA also led to historic reductions in racial disparities in access to health care. After the ACA was implemented, the gap between Black and white adult uninsured rates dropped by 4.1 percentage points, while the difference between Hispanic and white uninsured rates fell 9.4 points.
Unfortunately, the gains made toward health care access and health equity began to slip in 2016 when the Trump Administration implemented drastic cuts to outreach and enrollment funding. The cuts, which significantly reduced the publicity for open enrollment and the number of Navigators available to help people shop for, apply for, and enroll in a health plan, considerably impacted Americans’ ability to get covered. More recently, the Trump Administration rejected the idea of creating a COVID special enrollment period (SEP) to allow more people to access health insurance during the pandemic. As such, a priority for health care advocates and the new Biden-Harris Administration has been the restoration of the Marketplaces and a creation of a COVID SEP.
On Thursday, January 28, President Biden signed several executive orders intended to boost Americans’ access to quality, affordable health care, including by strenghtening the Affordable Care Act and Medicaid. As part of this effort, CMS is opening a new SEP, allowing millions of people the opportunity to get covered. The Biden-Harris Administration will reopen the ACA Marketplace, Healthcare.Gov, for three months, allowing people who have been impacted by COVID-19 to gain the security of health coverage. Many states that operate their own Marketplaces are following suit and re-opening their Marketplaces for additional time. The federal Marketplace will be open February 15 – May 15, 2021. The broad nature of this SEP allows consumers to find a plan that meets their needs without facing unnecessary burdens to prove their eligibility.
We know the COVID-19 health and economic crisis has disproportionately impacted Black and brown people, who, due to systemic and unfair inequities, are more likely to contract the virus, experience pandemic-related job loss, and suffer from long-term illness and death from complications of COVID-19. And While health insurance won’t eliminate disparities overnight, ensuring access to quality health care is a necessary step to address inequities. Advocates can help spread the word about this new enrollment opportunity and in particular, focus efforts on reaching Black, Latinx and Native American communities where the highest percentage of uninsured remain. People of color make up 43.1% of the nonelderly U.S. population but account for over half of the total nonelderly uninsured population.
The Biden-Harris Administration’s actions to open this SEP and strengthen the ACA and Medicaid are critical to reverse the harms imposed by the Trump administration, close the coverage gap and eliminate racial disparities in access to care.