It’s not that Congress and the Trump administration have not been responsive to the needs of those who have lost their jobs or have seen their hours cut back during the coronavirus outbreak; major provisions in the recently adopted $2 trillion financial rescue package included $1,200 payments to individuals and a $500 child tax credit, as well as a welcome boost in unemployment benefits, $600 a week through the end of July.
But for many of the millions who have lost work — and their health insurance benefits — because of stay-at-home orders necessary to quell the spread of COVID-19, much of that aid is likely to be eaten up by additional out-of-pocket medical care costs or higher premiums for health insurance, without an employer’s contributions. And while most can purchase their own plans even after enrollment periods have closed, they must show proof they have lost medical coverage, an added step for an already time-consuming process.
Additionally, the Trump administration recently pledged to extend Medicare payments for those who are uninsured and need treatment for COVID-19; drawing from $100 billion allocated for health care providers as part of the larger economic package.
The problem, however, for hospitals and other health care providers may be in separating a coronavirus infection from a patient’s underlying health issues.
It may not be clear for each patient whether pneumonia or other respiratory problems were caused by COVID-19, Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University, told National Public Radio last week.
“Who would qualify for this program?” Corlette asked. “For what services? Who would be the judge of whether or not you qualify?”
And coverage for COVID-19 health issues also doesn’t provide any assistance for those who have lost work and now have to pay for family doctor appointments, medications and other care that are unrelated to the outbreak. With at least 8.7 million Americans filing for unemployment benefits during the last two weeks, an estimated 3.5 million of those have likely lost their employer-provided health insurance, the Economic Policy Institute reported last week.
What would be easier, fairer — and in the long run would assure better health outcomes — would be for the Trump administration to open a special enrollment period for insurance coverage under the Affordable Care Act, also known as Obamacare. Enrollment for coverage this year closed in November or December in most states, but special enrollment periods have been opened in the past for unforeseen events, such as natural disasters.
That’s not happening during the pandemic.
The White House’s promise for coverage of COVID-19 treatment was the consolation prize following its decision that it would not reopen enrollment for coverage under Obamacare.
The good news for those in Washington state, as well as 10 other states and the District of Columbia, is that those states’ foresight in establishing their own insurance marketplaces means they can set their own rules for enrollment for individuals under special circumstances, such as change in marital status, the birth of a child or loss of a job. Those who have been laid off can qualify for enrollment through Washington state’s insurance market at www.healthfinderwashington.org.
The decision, however, leaves out Americans in 39 states who don’t have their own state markets to turn to.
President Trump has long made his distaste for the Affordable Care Act clear, taking opportunities to undermine it while waiting for Republicans in Congress to repeal and replace it — without success — even for the first two years of his tenure when the GOP held control of both House and Senate. When those efforts failed, Republican governors in Texas and other states filed a court challenge against the ACA, questioning its constitutionality.
“What we want to do is get rid of the bad health care and put in a great health care,” Trump said, March 22, in response to a question regarding the lawsuit.
We’re still waiting to see that plan.
Resolution of the case was expected to go before the U.S. Supreme Court this year, and last month the court announced that it had accepted the case. But last week the court canceled oral arguments that justices were to hear in April, leaving in doubt how it will continue its term.
With a decision in doubt from the Supreme Court and action next to impossible this year in a divided and time-constrained Congress, there is absolutely no possibility Trump and Republicans will repeal Obamacare, much less “replace” it.
Trump is loath to use any tool created by his predecessor, but refusing to reopen ACA enrollment for millions of Americans who are now without medical coverage is risking the health and economic wellbeing of those Americans, simply because he doesn’t want to concede to the effectiveness of Obamacare.