“No Greater ‘Exceptional Circumstance’ Than a Global Pandemic”

States Assert Refusal to Reopen Enrollment Is “Irresponsible,” “Dangerous” — “Leaving Millions Without Health Care Options” and Impeding “States’ Ability To Protect The Health of Their Residents”

States That Opened Special Enrollment Periods Emphasize Importance of Reopening Enrollment in Response to COVID-19

Washington, D.C. — Fourteen states, led by California and Michigan, submitted an amicus brief late Monday in support of Democracy Forward’s lawsuit — filed on behalf of the City of Chicago — challenging the Trump administration’s unlawful refusal to open a special enrollment period on the 38 Affordable Care Act (ACA) exchanges managed by the federal government. The administration’s decision prevents millions of uninsured Americans affected by this once-in-a-century pandemic from enrolling in the affordable, high-quality health insurance offered on ACA exchanges and impedes the states’ ability to stem the spread of COVID-19.

California, Michigan, Connecticut, Delaware, the District of Columbia, Hawaii, Maryland, Minnesota, New Mexico, North Carolina, Oregon, Pennsylvania, Rhode Island, and Virginia explain that the Trump administration’s refusal to open a special enrollment period in the 38 states on the federal exchange “is not only irresponsible, but also dangerous, leaving millions of Americans without healthcare options.” They add that the refusal “interferes with states’ ability to protect the health of their residents and abdicates federal responsibility to run healthcare exchanges.

In their brief, the coalition argues that “There is no greater ‘exceptional circumstance’ than a global pandemic” and that a special enrollment period would:

  • “assist individuals who have lost coverage due to the COVID-19 pandemic”
  • “benefit individuals who never enrolled in healthcare coverage in the first place, such as low-wage and ‘gig workers’ who would otherwise be without coverage until 2021”
  • “improve public health, as residents with insurance are more likely to seek out appropriate medical care if they need not worry about the potentially catastrophic costs of doing so”

Of the fourteen states that penned the brief, six run their own health care exchanges and have opened independent special enrollment periods in response to COVID-19. These states’ experiences make clear that a special enrollment period for the federal exchanges would “benefit all Americans.” “States with open special enrollment periods,” the amici explain, “have enrolled more than two hundred thousand new residents during the pandemic …. In California, for example, the rate of sign-ups during the pandemic has been nearly 2.5 times as high as the rate during the same period last year.

In short, the states affirm that: “It is crucial that HHS utilize the tools it has available to ensure as many people have access to affordable healthcare as possible.”

The lawsuit seeks to ensure the Trump administration follows the law and opens a special enrollment period in response to COVID-19. The ACA and its implementing regulations require the administration to provide a special enrollment period when consumers face “exceptional circumstances” like a global pandemic. President Trump’s administration, however, has refused to open enrollment based on nothing more than his personal opposition to the ACA — despite calls from a diverse and bipartisan group of stakeholders to do so. The Trump administration’s refusal harms thousands of Chicago residents and millions of Americans who cannot enroll in quality and affordable health insurance amid the pandemic. It hampers the efforts of cities like Chicago to control COVID-19, and it forces them to bear the financial and human costs of providing forms of uncompensated care to the increasing number of uninsured.

The U.S. House of Representatives also filed a brief in support of Chicago’s suit, concurring that “a special enrollment period is required.”

The City of Chicago’s suit was filed on June 15 in the U.S. District Court for the District of Columbia. Learn more about it here. The states’ amicus brief was filed on June 22. Read it in full here.

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Democracy Forward is a nonprofit legal organization that scrutinizes Executive Branch activity across policy areas, represents clients in litigation to challenge unlawful actions, and educates the public when the White House or federal agencies break the law.

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Charisma Troiano
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