Trump Admin’s Records Reveal Its Failure to Estimate How Many Americans Would Enroll in ACA Coverage Amidst a Raging Pandemic

As COVID-19 Cases Fly Past 4.3 Million, Suit Challenges Admin’s Decision to Deny Millions of Uninsured Access to High-Quality, Affordable Health Insurance 

U.S. COVID-19 Deaths Have Increased 30% Since Suit Was Filed Six Weeks Ago

Washington, D.C. — On behalf of the City of Chicago, Democracy Forward responded to the Trump administration’s mystifying argument that, in the face of 150k COVID-19 deaths nationwide, a special enrollment period (SEP) in response to the pandemic is “unwarranted,” and is neither “necessary” nor “justified at this time.”

The Affordable Care Act (ACA) requires the Department of Health and Human Services (HHS) to reopen enrollment for the federal health insurance exchanges in the face of “exceptional circumstances,” like a once-in-a-century pandemic. The administration’s unlawful refusal to do so denies tens of thousands of uninsured Chicagoans and millions of Americans the opportunity to enroll in high-quality, affordable health care when they need it most. On June 15, Chicago sued the Trump administration over its unlawful decision. The U.S. House of Representatives and 14 states filed amicus briefs in support of the suit shortly thereafter. No briefs were filed in support of the Trump administration’s position.

Administration records newly released in the course of this litigation reveal that the Trump administration not only unlawfully refused to open a COVID-19 SEP, but made no effort to consider the impact of its decision at the time.

  • As explained in this latest filing, the Department of Health and Human Services “made no effort to estimate the number of people who might use an SEP to purchase ACA-compliant health coverage — or assess how providing an SEP might benefit them, healthcare providers, and the public by encouraging them to seek testing and treatment for the novel coronavirus without the risk of large medical bills. ” The administration, therefore “failed to grapple with the substantial public health benefits of increased coverage.”
  • In addition to failing to assess the potential benefits of an SEP, HHS claims that it didn’t open an SEP because of concerns about adverse selection, which were, as the administrative record released by HHS last week makes clear, disputed and discounted by the very industry — insurers — that adverse selection affects the most.
  • In order to argue its decision does not constitute a final agency decision, the Trump administration also argued half-heartedly that it remains open to the possibility of opening a special enrollment period. But that assertion is undermined by the administration’s own record and a variety of news reports (and, of course, the administration’s relentless efforts to sabotage the ACA), which make clear that it definitively rejected the proposal at President Trump’s instruction at the end of March.

The Trump administration also jumped through hoops to argue that Chicago cannot bring suit and that the ongoing pandemic is not an “exceptional circumstance” simply because HHS has never had to provide an SEP in response to a pandemic like this before. This, the latest filing makes clear, “defies logic.”

As this latest response to the Trump administration’s specious claims shows, “refusing an SEP was irrational.” Accordingly, the Trump administration’s unlawful decision not to open an SEP should be overturned.


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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