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13 qualifying life events that trigger ACA special enrollment
Outside of open enrollment, a special enrollment period allows you to enroll in an ACA-compliant plan (on or off-exchange) if you experience a qualifying life event.

Latest News & Topics

Latest News & Topics


Finalized federal rule reduces total duration of short-term health plans to 4 months
A finalized federal rule will impose new nationwide duration limits on short-term limited duration insurance (STLDI) plans. The rule – which applies to plans sold or issued on or after September 1, 2024 – will limit STLDI plans to three-month terms, and to total duration – including renewals – of no more than four months.
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The Scoop: April 15, 2020 Edition

A look at state-level headlines regarding individual health insurance and health reform

coronavirus special enrollment california 2020

Vermont, Rhode Island, Nevada, New York extend COVID-19 special enrollment periods

Twelve of the 13 fully state-run health insurance exchanges are currently allowing uninsured residents to enroll in health coverage. In DC, the special enrollment period depends on when a person files their district tax return; in the others, the deadlines vary.

This week, the special enrollment period for uninsured Rhode Island residents was extended through April 30. And in Vermont, Nevada and New York, the deadlines were extended through May 15. But the COVID-19 special enrollment periods are still currently slated to end this Friday in Connecticut, and next week in Minnesota. Uninsured residents in those states should select a plan as soon as possible in order to have coverage this year (deadlines for COVID-19 special enrollment periods are available here).

California exchange has enrolled 58,000 people during COVID-19 special enrollment period

Covered California’s COVID-19 special enrollment period continues through the end of June – later than any of the others. Since March 20, when they opened this enrollment window, Covered California has enrolled 58,000 people. That’s about three times the exchange’s normal special enrollment period volume (most people enroll during the annual open enrollment period, but all exchanges continue to have off-season enrollments throughout the year, due to qualifying events).

Twelve governors join together to ask HHS for COVID-19 special enrollment period

Although 12 of the 13 fully state-run exchanges are offering special enrollment periods for uninsured residents in an effort to address the COVID-19 crisis, HealthCare.gov – which serves as the health insurance exchange for 38 states – has not opened a special enrollment period. There is always a special enrollment period due to loss of coverage, nationwide, for anyone who loses minimum essential coverage, including an employer-sponsored plan.

But even before the unemployment rate started to spike as a result of the pandemic, there were millions of uninsured people in the United States. And in most cases, they don’t have a qualifying event that will allow them to obtain coverage. If they’re in a state with a COVID-19 special enrollment period, they can enroll now. But if they’re in a state that uses HealthCare.gov, they cannot.

For several weeks, governors in some of those states have been asking the Trump administration to open a special enrollment period on HealthCare.gov. This week, 12 of them sent a letter to HHS, reiterating that request. All 12 governors are Democrats, but GOP governors in New Hampshire and Arizona have made similar requests.

Idaho exchange relaxes documentation rules for loss-of-coverage special enrollment

Your Health Idaho is the only fully state-run exchange that has not opened up a COVID-19 special enrollment period for uninsured residents. But a recent op-ed by Pat Kelly, Executive Director of Your Health Idaho, explains that the exchange is relaxing the documentation rules for people who are losing their employer-sponsored health insurance amid the pandemic. Normally, people in that situation have to submit official proof of their loss of coverage, but Kelly notes that applicants are now allowed to simply submit a written statement explaining that they lost, or will soon lose, employer-sponsored coverage.

Florida law eliminates lifetime benefit cap in Children’s Health Insurance Program

Florida’s Children’s Health Insurance Program, Florida KidCare, used to have a lifetime benefit cap of $1 million per covered child. But last week, Gov. Ron DeSantis signed SB348 into law, repealing the lifetime benefit cap. Across the country, CHIP is providing health coverage to kids in families that are losing their employer-sponsored health coverage amid the COVID-19 pandemic. CHIP has different names in different states, is sometimes combined with Medicaid, and has income limits that vary by state. But in every state, kids are eligible for Medicaid or CHIP at higher household income levels than the Medicaid eligibility limits for adults.

Public comment period for Oklahoma’s Medicaid expansion proposal runs through April 15

Oklahoma voters will have a chance to vote on Medicaid expansion this year, but Gov. Kevin Stitt still hasn’t announced whether the measure will be on the primary ballot in June or the November ballot. Instead, Stitt is pushing an alternative approach, dubbed SoonerCare 2.0. It calls for Medicaid expansion in Oklahoma starting this summer, in July 2020.

But the state would simultaneously be seeking federal approval for new programs that would take effect in the summer of 2021, including a Medicaid work requirement, premiums for Medicaid expansion enrollees, a waiver of retroactive coverage requirements, and a per-capita spending cap. These provisions would essentially serve to reduce the number of people eligible for coverage, and Medicaid work requirements have already proven to be costly and administratively difficult, and have been overturned in court in several other states.

April 15 is the last day for the public to submit comments on the SoonerCare 2.0 proposal. CoverOK, an advocacy organization that is pushing for Medicaid expansion, is encouraging people to speak out against the convoluted SoonerCare 2.0 approach and call for regular Medicaid expansion instead.

Virginia enacts bills to create state-run exchange, limit short-term health plans, limit out-of-pocket insulin costs

Earlier this month, we told you about several health care reform bills that had been passed by lawmakers in Virginia. Last week, Gov. Ralph Northam signed most of them into law.

  • SB732 and HB1428 call for Virginia to establish a state-run health insurance exchange no later than 2023.
  • HB66 caps out-of-pocket insulin costs at $50 per month for people with state-regulated health insurance issued or renewed on or after January 1, 2021.
  • SB404 and HB1037 will limit short-term health plans in Virginia to no more than three months in duration and prohibit their sale during the ACA open enrollment period, but these new restrictions won’t take effect until July 2021.
  • SB95 codifies the ACA’s preventive care requirements into Virginia law.

Gov. Northam did not, however, sign HB795 and SB235 into law. These bills would have allowed self-employed Virginians to join association health plans (although it was doubtful that would have worked within the constraints of the 1332 waiver that lawmakers had hoped to use). But the governor sent the bills back to the legislature with a recommendation that the provisions not take effect unless they’re reenacted during next year’s legislative session.

Aetna, Humana, WellCare oppose health plan association’s lawsuit against Louisiana’s COVID-19 rules

Last week, we told you about the Louisiana Association of Health Plan’s decision to legally challenge the Louisiana Department of Insurance over the rules the Department has implemented in an effort to address the COVID-19 pandemic. But that decision is far from a unanimous representation of the insurers that were part of the LAHP.  At least three LAHP member insurers are opposed to the association’s lawsuit, and two of them have dropped out the Louisiana Association of Health Plans as a result. Aetna and WellCare have both left the Association, and while Humana continues to be a member, the insurer has publicly said that it does not support the legal action against the Louisiana Department of Insurance.

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.


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