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April 2014 St@teside

Marketplaces Shift to Special Enrollment Periods

As of April 17, the federal government is reporting that 8 million individuals have enrolled in coverage through the Health Insurance Marketplaces. This number is expected to rise as individuals who are “in line,” or who attempted to sign-up for coverage prior to April 1 but were unable to do so, complete the enrollment process. A number of states, including Oregon, Hawaii, and Washington, DC, are giving these individuals until April 30 to enroll. However, it remains unclear how many of these 8 million individuals have paid their first premium. The Centers for Medicare and Medicaid Services is further reporting that additional 3 million people have enrolled in Medicaid from October 2013 through February 2014. This number is also expected to climb over the coming months.

Though the open enrollment period is officially over, individuals, in addition to those who were “in line” for coverage prior to April 1, can still enroll through special enrollment periods. In order to gain coverage through a special enrollment period, an individual must experience certain “qualifying life events,” which include loss of health insurance, marriage, giving birth, adopting a child, gaining citizenship, etc. It’s also important to note that there is no open enrollment period for Medicaid – eligible individuals can sign up at any time.

Special enrollment periods are particularly important for 18-34 year olds, who tend to be healthier and are, thereby, crucial to offsetting the risk of older, less healthy populations enrolled in coverage through the marketplaces. According to this report by Young Invincibles, 18-34 year olds are more likely to qualify for special enrollment periods since they are more likely to get married, have a child, move, change jobs, and lose dependent coverage due to turning age 26. Thus, it is important for states to get the word out about the special enrollment period.

Below is a round-up of various states’ messaging tactics around special enrollment periods and continuing Medicaid enrollment.

  • Illinois: Instructions for Special Enrollment Periods
  • Minnesota: MNsure’s website now features a pop-up message providing information on special enrollment periods
  • New Mexico: NMHIX released this video explaining special enrollment periods
  • Rhode Island: HealthSource RI describes special enrollment periods in this blog post