Obamacare particular enrollment for individuals who lose Medicaid

An Obamacare sign is seen outside the Leading Insurance Agency offering plans under the Affordable Care Act (aka Obamacare) on January 28, 2021 in Miami, Florida.

Joe Raedle | Getty Images

Millions of people across the US risk losing Medicaid this year when coverage introduced during the Covid-19 pandemic expires in April.

To make it easier for these individuals to transition to alternative coverage, the Department of Health and Human Services has announced a special enrollment period for Obamacare.

Individuals who lose Medicaid protection between March 31 and July 31, 2024 can apply for Obamacare outside of the normal enrollment period at healthcare.gov if they live in a state served by the federal market, according to new guidance from HHS.

A majority of states, 33 in all, use healthcare.gov as their marketplace for insurance. The 17 states that operate their own marketplaces can introduce a special registration period, but are not obliged to do so.

Individuals who lose Medicaid do not need to provide additional documentation to purchase Obamacare. The application simply asks them if they lost Medicaid coverage.

Consumers have 60 days after submitting their application to choose health insurance. Once they have decided on a new plan, coverage begins on the first day of the following month.

Typically, consumers must submit documentation of a life change to apply for health coverage outside of the open enrollment period, but HHS is streamlining the process for those who lose Medicaid.

Medicaid enrollment surged during the pandemic after Congress effectively banned state governments from kicking people out of the program for the duration of the public health emergency.

Medicaid enrollments have increased 28% since February 2020 to nearly 84 million people in September, according to the Center for Medicare and Medicaid Services.

Congress passed federal spending legislation in December that separated Medicaid coverage from public health emergencies. States may begin withdrawing coverage for people in April if they no longer meet eligibility criteria or do not respond to requests for information.

HHS has estimated that 15 million people will lose Medicaid protection once pandemic protection ends. Eight million of them have to switch to other forms of coverage, according to HHS estimates. But 6.8 million will lose Medicaid despite still being eligible for the program, according to HHS.

States must make a good faith effort to contact the person whose eligibility is being verified using more than one method of communication.

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