The Scoop: health insurance news – November 25, 2020

A round-up of state and national headlines regarding individual health insurance and health reform

The Get Covered 2021 coalition announced a two-part goal: keeping Americans safe amid the pandemic, and spreading awareness about health insurance options and financial assistance that can make coverage more affordable. | Image: Andrii / stock.adobe.com

Open enrollment for 2021 health plans: Under 3 weeks remaining

If you or a loved one is in need of health insurance, or if you’re already enrolled in an individual-market (non-group) health plan, open enrollment is currently underway nationwide, and we’re past the half-way point. Enrollment started more than three weeks ago, and we now have under three weeks remaining.

open enrollment 2021

Our 2021 Open Enrollment Guide: Everything you need to know to enroll in an affordable individual-market health plan.

Open enrollment is an opportunity for people to newly enroll in health coverage – regardless of medical history or prior coverage – and it also allows people who are already enrolled to actively compare their available options for 2021 and select a different plan if it would serve them better.

(Even if the current plan is still the best choice, this is always a better approach than simply letting the plan auto-renew without checking the other options.)

Still have questions? Read our extensive overview of open enrollment.

Enrollments have surpassed 3 million nationwide

As of November 21, nearly 2.4 million people in 36 states had enrolled in coverage for 2021 through HealthCare.gov. A few of the state-run exchanges (used in Washington, DC, and the other 14 states) have also published enrollment updates:

According to Charles Gaba – who’s tracking enrollments nationwide – enrollment stood at more than 3 million as of November 25, including several hundred thousand enrollees in state-based exchanges whose coverage has been auto-renewed for 2021. (These individuals still have an opportunity to pick a different plan if they choose to do so). Gaba’s tally includes the states that use HealthCare.gov as well as the handful of state-run exchanges that have reported enrollment data, but most of the state-run exchanges have not yet made their enrollment data public.

The daily enrollment pace via HealthCare.gov is higher than it was during the same time period last year, and that appears to be the case in the state-run exchanges as well. But we aren’t yet seeing a significant surge in enrollment that might be expected given the job losses and associated coverage losses caused by the COVID pandemic. However, enrollment in Medicaid has grown significantly this year, thanks to the ACA’s Medicaid expansion guidelines that allow people in most states to enroll in Medicaid if their income drops to under 138% of the poverty level, even if it was higher than that earlier in the year.

Get Covered 2021 coalition seeks to slow the spread of COVID, get uninsured Americans enrolled in coverage

Get Covered 2021 launched last week as a broad coalition of organizations with a two-part goal: keeping Americans safe amid the COVID pandemic, and spreading awareness about available health insurance options and the financial assistance that can make health coverage much more affordable than it would otherwise be. “Get Covered” is a reminder of the importance of wearing a mask to slow the spread of COVID, as well as the importance of having health insurance coverage.

Get Covered 2021 is chaired by Carrie Banahan, who directs Kynect in Kentucky, Peter Lee, who directs Covered California, and Joshua Peck, co-founder of Get America Covered. The Get Covered 2021 coalition includes 15 state-run marketplaces and numerous national health care and consumer advocacy organizations.

KFF finds 40% of Americans eligible for free 2021 health coverage

A new analysis published this week by KFF finds that about 40% of uninsured Americans are eligible for free or nearly free health coverage for 2021. About a quarter of the uninsured are eligible for Medicaid, which is free in most states and has nominal premiums in a few states. And another 16% are eligible for premium subsidies in the exchange that are substantial enough to allow them access to at least one private plan that would have no premiums at all.

The free private plans are generally Bronze plans, although there are free Gold plans available in some areas. Selecting the free plans is not always the best option – some of these individuals will be better off with a Silver plan that includes cost-sharing reductions, even if they have to pay a higher monthly premium. But enrolling in free health coverage is certainly a far better option than remaining uninsured for the coming year.

Maine healthcare organization to gather signatures for universal coverage initiative on 2022 ballot

Three years ago, Maine made history when the state became the first to have Medicaid expansion approved via a ballot measure passed by voters; several other states have since followed suit. Now Maine Healthcare Action – a nonprofit focused on universal healthcare in Maine – has announced that it will begin gathering signatures in 2021 for another ballot measure, which would direct the legislature to create a universal health coverage system for the people of Maine by 2024.

In order to get the measure on the 2022 ballot, 63,067 valid signatures are needed, although advocates are hoping to gather at least 80,000. They will have a year in which to get enough signatures to get the measure on the 2022 ballot.

Healthcare sharing ministry fined $1 million by Washington, cease-and-desist order upheld

For well over a year, Washington Insurance Commissioner Mike Kreidler has been seeking a $1 million fine against healthcare sharing ministry Aliera Healthcare, Inc. Kreidler had ordered the company to stop issuing memberships in Washington in the spring of 2019. (Other states have also stepped in to issue cease-and-desist orders for Aliera.)

Aliera had appealed Kreidler’s cease-and-desist order, but it was upheld earlier this month. And this week, Aliera was ordered to pay the $1 million fine, although the company has 90 days to appeal that as well.

Appellate court hears Oscar suit challenging Florida Blue exclusive broker requirements

Last fall, we told you about a lawsuit involving Oscar and Florida Blue, stemming from Florida Blue’s requirement that brokers who offer their products refrain from offering products from any other insurance company. This is far from the norm; brokers in most states are allowed – and generally encouraged – to become appointed with a variety of insurance companies, in order to offer their clients a broad selection of plans from which to choose.

Oscar sued, alleging that Florida Blue’s exclusive broker requirement amounts to coercion and unfair market practices, but a judge sided with Florida Blue last September. Last week, the case was argued in front of a three-judge panel for the 11th Circuit Court of Appeals in Atlanta, but it’s not yet known when the judges will issue a ruling on the case.

Brookings Institution paper analyzes strategies for reducing healthcare costs

The Brookings Institution’s Matt Fiedler has published a new paper that analyzes various options for reducing healthcare costs, including capping out-of-network prices, capping both in-network and out-of-network prices, and creating a public option. Start with Fiedler’s Twitter thread about this, and then dig into the summaries and the paper itself.

The short story? It’s complicated and there are numerous pitfalls to avoid, but there are strategies that could successfully lower healthcare prices.

Nevada health exchange director discusses increased enrollment

This week, Megan Messerly of the Nevada Independent interviewed Heather Korbulic, the executive director of Nevada’s health insurance exchange (Nevada Health Link). Korbulic and Messerly cover a wide range of topics, including increased enrollment during special enrollment periods earlier this year, the increased plan availability during the current open enrollment period, and the potential impact of the pending Supreme Court ruling on the ACA.


Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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