President Joe Biden announced last month that the Affordable Care Act web portal would be reopened for a limited time so uninsured people could buy plans amid the COVID-19 pandemic, one of his first actions as president.
On Wednesday, President Biden announced that more than 200,000 Americans have gotten covered in the two weeks since they reopened the portal.
"These numbers are an encouraging sign," Biden said, "But we can’t slow down until every American has the security and peace of mind that quality, affordable health coverage provides."
"There is plenty of time left to sign up, and I encourage everyone who needs health insurance to go to HealthCare.gov before May 15," Biden added. "If you already have coverage, you can help family members and friends who are uninsured get themselves covered."
"Health care is a right, not a privilege — and ensuring that every single American has access to the quality, affordable health care they need is a national imperative," the president said. "Never has that been more important than today, in the midst of a deadly pandemic that has infected nearly 30 million Americans."
The Affordable Care Act created state-based insurance markets for people to buy individual coverage either for themselves or their family.
A sign-up window opened for government insurance markets and runs through May 15 in most states. It’s available for people who don’t have coverage through work, and it is expected to make finding a plan less of a hassle for those who lost a job.
Here's what you need to know:
Biden’s order applies to 36 insurance markets run through the federal government’s platform. But nearly all states that run their own marketplaces will offer a similar extended window through May.
This new window could be useful for people who recently lost their coverage or couldn’t find a plan last year. Experts have said the number of uninsured people has risen during the pandemic due to layoffs.
People who don’t have coverage but recently developed a health problem and want better access to care could also use this opportunity. It also could help those who have insurance but may want a new plan because it doesn’t cover their doctors or prescriptions like they expected when they signed up.
"Anybody who doesn’t have coverage or isn’t happy with their coverage should be looking at the marketplace during this extended enrollment period," said Karen Pollitz, an insurance expert with the nonprofit Kaiser Family Foundation.
Any coverage purchased will start on the first day of the following month.
A six-week window in November and December is usually the main opportunity insurance shoppers have every year to pick a plan. Those who want to stay covered then have to stick with that plan unless they have a life-changing event like a job loss, marriage or the adoption or birth of a child.
Those events qualify people for a special enrollment period in which they can buy a new plan. Shoppers normally have to submit proof that they qualify before they can shop for coverage. That won’t be necessary for this new enrollment window.
People can get help from the government to buy coverage in these marketplaces, depending on their income.
Those who make between 100% and 400% of the federal poverty level are eligible for assistance with premium payments in the form of tax credits. This year, the high end of that range amounts to $106,000 for a family of four.
Shoppers first have to estimate their annual income to get this help. That can be tricky when counting unemployment pay or income from a temporary job. Those who estimate too low — and wind up getting more help than they should – will have to pay back all or part of the assistance at tax time.
People who have lost their jobs and have no income may qualify for Medicaid before unemployment pay starts. That program bases eligibility on current income, not what’s estimated for the year. Marketplace websites or health insurance navigators can help shoppers determine whether they qualify.
"Don’t assume you aren’t eligible. It’s really worth it to look into it," Pollitz said. "Medicaid is catching a lot of people."
Shoppers can wind up with dozens of plans to chose from, each with different price tags, deductible requirements or networks of covered doctors. Help isn’t always easy to find.
A Kaiser Family Foundation survey last year found that half of the people who looked for coverage during the main sign-up period had some sort of trouble. That was shortly before the pandemic hit.
Since then, many shoppers have ventured into insurance markets for the first time due to pandemic-related job cuts.
The federal government operates a call center to offer assistance and can connect people to local help for selecting a plan.
The vaccines that are currently being delivered around the country are free, so having health insurance won’t help with that bill. But coverage could offer protection against any medical bills that stem from COVID-19 treatments or any other injury or illness.
"It’s a really good time during a pandemic to have health insurance," Pollitz said.
The appeal for uninsured people could become much clearer if Congress increases premium subsidies as part of its next virus relief package.
“That would be a great incentive to get people in the door,” said Tara Straw, a health policy analyst with the Center on Budget and Policy Priorities, which advocates on behalf of low-income people. More generous help would be available not just to the newly enrolled, but to all who are covered through the law’s marketplaces.
By the budget center’s calculations, a family of four making $50,000 would pay $67 a month in premiums for a standard plan, instead of an average of $252 currently, while also qualifying for help with deductibles and copays. The boost in premium assistance would be available for this year and for 2022.
Similarly, a single person making $30,000 a year would pay $85 a month for a standard plan instead of the current $195.
The Democratic proposal would allow more solid middle-class households to qualify for financial help. On the opposite end of the scale, those who’ve experienced unemployment would qualify for extra-generous subsidies.
Republicans who tried but failed to repeal the law under President Donald Trump are calling the Democratic plan a waste of taxpayer dollars. But many Democrats see it as merely a down payment on a more ambitious health care agenda.
The Obama health law now covers more than 20 million people through a combination of subsidized private plans and, in most states, expanded Medicaid.
"As more Americans get covered, it is encouraging to see Congress moving quickly to pass the American Rescue Plan, which will ramp up testing, tracing, and our national vaccination program to get shots into as many arms as possible as quickly as we can," Biden added in his statement about his proposed $1.9 trillion COVID-19 relief measure. "The American Rescue Plan will also take big steps to lower health costs and expand access to care for all Americans, including those who have lost their jobs. It will increase federal subsidies and decrease premiums in order to ensure that no one pays more than 8.5 percent of their income to purchase meaningful and comprehensive health coverage. And it incentivizes states to expand coverage to an additional four million people with low incomes, and provides states the opportunity to extend coverage for a year to low-income women who have recently given birth."
"We will get through this crisis if we look out for one another and work together to expand coverage, lower costs, and ensure that health care truly is a right for all Americans," he concluded.
The Associated Press contributed to this report.