AHIP Releases A Resource for ACA Special Enrollment Awareness

America’s Health Insurance Plans (AHIP) has announced new online resources for the public to help consumers understand their health plan options during the Affordable Care Act special enrollment period.

“COVID-19 has impacted millions of Americans and has clearly illustrated the importance of everyone having coverage to protect their health and financial stability," the payer organization said in a fast facts sheet.

“That’s why health insurance providers are working hard to ensure that Americans have access to the prevention, testing, and treatment needed to help care for those who are sick and prevent the spread of the virus. Individual market plans cover the 10 essential health benefits, including emergency care for infectious diseases and vaccines recommended by the Advisory Committee on Immunization Practices.”

Among the new resources is a tax credit decision tree to help Americans determine whether or not they could qualify for financial support to purchase a plan on the federal health insurance marketplace. This has been coupled with the new landing page that consolidates a few materials for consumers.

The tax credit decision tree provides a visual resource that walks consumers through their subsidy eligibility if they have ben enrolled in the Affordable Care Act marketplace or not. It also provides simple answers about eligibility for those who are uninsured, recently lost a job, or their job-based coverage and may accept COBRA coverage.

To supplement this document, the new landing page includes a fact sheet that covers basic information about the special enrollment period for consumers. The fact sheet highlights the timeframe for the special enrollment period and the payer organization advised consumers to assess the differences in out-of-pocket healthcare spending when comparing health plans.

A separate blog post—accessible through the landing page—provides an overview of the potential impacts by insurance type, including those with off-exchange coverage and unemployment compensation.

Additionally, the payer organization offered the link to the Get Covered Connector, a site which connects enrollees with local enrollment support.

Additionally, the landing page directs readers to the Kaiser Family Foundation’s “Health Insurance Marketplace Calculator.” The calculator estimates what premiums might be on the Affordable Care Act marketplaces. The tool has been updated to account for the American Rescue Plan’s subsidy changes.

“Health insurance coverage is an important way to protect your health and financial stability, especially during the COVID-19 pandemic,” said Matt Eyles, president and chief executive officer of AHIP. 

“Health insurance available through the individual marketplaces cover products and services such as COVID-19 care and vaccines, mental health care and support, $0 copay preventive care, regular doctor visits and prescription medications to keep you healthy, and much more.”

The special enrollment period on the federal health insurance marketplace started on February 15, 2021 to increase access to healthcare coverage. The special enrollment period was extended to last through August 15, 2021.

As part of the American Rescue Plan, 14.9 million uninsured Americans may find themselves eligible for financial support on the Affordable Care Act marketplace, along with current Affordable Care Act marketplace enrollees looking to switch to a lower cost marketplace plan.

In offering these resources, AHIP may be attempting to thwart the influence of low healthcare literacy on the special enrollment period.

Low health insurance literacy can be the cause for healthcare disparities, particularly for communities of color, according to a study published in the American Journal of Managed Care. Participants frequently confused premiums and deductibles and avoided care due to out-of-pocket healthcare costs that participants perceived as higher than the reality.

“A demonstrably effective HIL educational campaign, coupled with point-of-care health insurance navigation support and efforts to simplify health insurance designs, can enhance the value of health insurance for all,” the study stated.

Disparities in coverage have been amplified by the coronavirus pandemic, but the special enrollment period offers an opportunity to reverse that trend. In order to do so, payers must provide clear guidance to their members and potential Affordable Care Act marketplace enrollees in order to avoid deepening the disparities.