Skip to main content
Sister Publication Links
  • ESG: THE IMPLEMENTATION IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Digital Health
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Unwell in America
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
April 09, 2014 01:00 AM

Health coverage enrollment is still open—for those in the know

Harris Meyer
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    Even after the end of extended open enrollment later this month, a little-known fact about Obamacare is that Americans can legally continue shopping for health insurance for the rest of the year. And insurers, depending on the state, may legally be able to continue selling coverage through the federal and state exchanges.

    But experts say few or no insurers will actually sell coverage beyond the extended open enrollment period because of the risk of signing up sicker enrollees. The one exception could be in Nevada, which requires all insurers that sell plans outside the insurance exchange to offer those plans throughout the year, according to Kaiser Health News.

    Most public discussion has centered on buying coverage through the exchanges. Exchange-plan sales end this month under special enrollment periods allowed by the federal and state exchanges to accommodate consumers who tried, but could not sign up before April 1 for various reasons.

    After that, many people—even some experts—thought no further enrollment would be allowed, and that anyone who wanted health insurance would have to wait until the open enrollment period for 2015 coverage starts Nov. 15. The known exception is for those with qualifying life events such as losing job-based coverage, moving, getting married or divorced, or making more money and losing their Medicaid eligibility.

    But the CMS issued a rule last year permitting insurers to continue offering Obamacare-compliant plans outside the exchanges after open enrollment ends. The catch is, no one knows any insurers that plan to do so. That's because under the Patient Protection and Affordable Care Act, insurers generally are barred from considering applicants' preexisting medical conditions or charging people more than the allowed three-to-one premium variation for comprehensive coverage, based solely on age.

    “I do not expect many, if any, insurance companies to offer these policies outside of open enrollment,” said Sabrina Corlette, project director of Georgetown University Center on Health Insurance Reforms. “I would imagine they would view the risk of adverse selection to be too great.”

    A spokesperson for the National Association of Insurance Commissioners said the NAIC was not aware of any insurers planning to sell plans after open enrollment ends.

    UnitedHealthOne, a major carrier in the off-exchange individual insurance market, will sell ACA-compliant plans after open enrollment ends only if there is a qualifying life event, according a company spokeswoman.

    Assurant, another prominent insurance carrier in the individual market, also said it will only offer ACA-compliant plans during open enrollment or if there is a qualifying life event. But that company will continue selling limited-benefit, non-compliant plans that do not offer comprehensive benefits, such as short-term and fixed-benefit products. Consumers buying these non-compliant plans could face Obamacare tax penalties for not obtaining qualifying coverage, a company spokeswoman said.

    Hans Leida, an actuary with Milliman in Minneapolis, said it would be financially risky for insurers to sell plans after open enrollment ends, because they could attract people who sign up only when they need medical care, and insurers wouldn't be able to turn them away as they could before Obamacare took effect this year. “During open enrollment, insurers know all insurers are in the same boat,” Leida said. “But off open enrollment, you might be the only insurer accepting people.”

    The only insurers that might be willing to take that gamble are those that proactively want to increase their market share or sign up more members to spread out their overhead costs, he said. If an insurer offered the exact same plan both inside and outside the exchange, it could qualify for federal risk-corridor payments to offset the costs of more expensive members. Still, Leida added, “it's a pretty risky proposition.”

    “They'd basically have to decide to be their own private high-risk pool, and no insurer is going to do that,” said Tim Jost, a law professor at Washington and Lee University, who is an expert on the healthcare reform law.

    Still, consumers who want to buy Obamacare-compliant coverage off the exchanges do have options in at least 14 states during the next few weeks. The insurance broker eHealth has identified more than 20 insurers that are selling plans in those states until the middle or end of April, even if customers have not experienced a qualifying life event.

    Follow Harris Meyer on Twitter: @MHHmeyer

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Abortion clinic
    Idaho hospital halts obstetrical care as abortion laws become stricter
    mh_20160711p29_bills_i.jpg
    State, local governments pay off medical debt relief with COVID funds
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Digital Health
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Unwell in America
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing