California and several other states will exempt themselves this year from a new Trump administration rule that cuts in half the amount of time consumers have to buy individual health insurance under the Affordable Care Act.
In California, lawmakers are contemplating legislation that would circumvent the rule in future years, too.
The Trump administration’s rule gives people shopping for 2018 coverage on the federal exchange 45 days to sign up, from Nov. 1 through Dec. 15.
But in California and some of the other states that run their own exchanges — Colorado, Minnesota, Washington and Massachusetts, as well as the District of Columbia — consumers purchasing insurance for themselves this year will have extra time to make decisions.
Consumers shopping for coverage in California’s exchange, Covered California, will still have the full three months they’ve had in recent years, starting on Nov. 1 and ending Jan. 31. Californians shopping for individual market plans outside the exchange will have those same three months to make up their minds.
“We want to make sure our consumers have the time they need to find the best plan that fits their needs,” said James Scullary, a spokesman for Covered California.
The rule that truncated the enrollment period for the federal exchange, published in April by the Centers for Medicare & Medicaid Services (CMS), gives state-based exchanges the ability to extend the amount of time allowed by tacking a “special” enrollment period onto the 45 days set by the federal government.
Because that flexibility is limited to 2018 coverage, California legislators are taking an extra step to keep the three-month enrollment period for 2019 and beyond. Assemblyman Jim Wood (D-Healdsburg) introduced legislation last week that would ensure a three-month enrollment window for consumers seeking coverage in 2019 and subsequent years.
“When the Trump administration issued its new … rules cutting the ACA’s open enrollment period in half, we knew we had to act,” Wood said. “Californians have enjoyed a three-month enrollment period for years, and this change could catch people off guard and not allow them to sign up in time. That would be a travesty.”
Health policy experts say the federal rule is a political attempt to undermine the viability of the Obamacare insurance exchanges.
“It’s no big secret that the Trump administration isn’t a big fan of the Affordable Care Act or the individual market that it created,” said Dylan Roby, associate professor of Health Services Administration at the University of Maryland. “There’s just this general intent of the administration to reduce enrollment, reduce … subsidies and make it a little bit harder for people to enroll.”
The shortened enrollment window was part of a so-called market stabilization rule rolled out by the Trump administration that also offers insurance companies concessions, including the flexibility to sell some health plans that cover less of the enrollees’ cost of care than currently required by the ACA.
California’s insurance commissioner, Dave Jones, expressed concern about the impact of a shortened enrollment period in a letter to the federal government in March, before the rule was finalized.
Jones’ letter cited research that shows younger people tend to sign up for health insurance toward the end of open enrollment, and that putting up barriers to their enrollment could reduce the number of healthy people in the insurance pool.
That would “needlessly destabilize the market” and would “result in increased premiums for those who do enroll in coverage,” the insurance commissioner said.
Shana Alex Charles, an assistant professor of health sciences at California State University-Fullerton, said the pushback by California lawmakers against federal attempts to shorten the enrollment period underscores the state’s commitment to having a marketplace that “actually makes sense.”
“If you want to maximize enrollment, you need to make sure people can get their paperwork together, and have the mindset and the time for people to complete the application,” she said.