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Analysis

487K Gained Coverage Through Special Enrollment Period for Loss of Minimum Essential Coverage

By Jack O'Brien  
   June 26, 2020

CMS stated that 487,000 people gained coverage through health insurance exchanges using the HealthCare.gov platform during the loss of MEC SEP in 2020: more than in any previous coverage year.

Nearly 500,000 people gained health coverage through the special enrollment period for the loss of minimum essential coverage (MEC SEP), according to data released by the Centers for Medicare & Medicaid Services (CMS) Thursday afternoon.

CMS stated that 487,000 people gained coverage through health insurance exchanges using the HealthCare.gov platform during the loss of MEC SEP in 2020: more than in any previous coverage year.

Compared to April 2019, loss of MEC SEP enrollments in April 2020 rose 139%. Though there was a drop in enrollments between April and May, the gains still marked an increase of more than 40% year-over-year.

The CMS report offers an insight into the effects of the ongoing coronavirus disease 2019 (COVID-19) outbreak on the broader economy and health coverage for consumers.

Related: Nearly 8.3M Selected Plans Through HealthCare.Gov

According to the agency, anyone who loses job-based MEC will "qualify for a SEP, and would be eligible to enroll in individual market coverage through the Exchange serving their state."

However, despite the unprecedented unemployment claim filings during March and April, CMS stated that data from the Bureau of Labor Statistics (BLS) indicated that 97% of surveyed employees who experienced job loss identified as a temporary layoff and therefore would be able to "maintain their prior job-based health coverage."

"Overall, due to a combination of factors including expectations of eventually returning to work, employers' ongoing contributions to their furloughed or laid-off employees' health insurance premiums during the public health emergency, COBRA continuation coverage through their former employer, and access to other coverage such as through a spouse, it remains unclear how many people will eventually look to Exchanges using HealthCare.gov to replace job-based coverage," CMS wrote.

Related: President Trump Rejects ACA Special Enrollment Period Amid Pandemic

In late April, the American Hospital Association (AHA), America's Health Insurance Plans (AHIP), and the U.S. Chamber of Commerce sent a letter to congressional leaders that called on them to protect and expand health coverage for employers and workers.

Among the policy proposals listed in the letter, the three organizations pressed Congress to open a special enrollment period for the health insurance marketplaces created under the Affordable Care Act while also increasing the eligibility for subsidies in the marketplace.

"Employers need more support – and workers need to be able to continue their stable, secure coverage," the letter read. "As you consider the next round of legislation to overcome COVID-19, we urge you to prioritize maintaining private health benefits for individuals and families and to increase coverage options for those who are already uninsured."

Related: AHA, AHIP, & U.S. Chamber of Commerce Call on Congress to Expand Coverage Options During Pandemic

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.

Photo credit: Moscow, Russia - 25 April 2020: Mobile phone screen with Health Cate website homepage. Coronavirus concept. / Editorial credit: Olya Gan / Shutterstock.com


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