By Melissa Attias, CQ Roll Call
August 13, 2015 -- Almost 944,000 people in the 37 states that use healthcare.gov signed up for coverage between the close of the official enrollment period in February and the end of June because they qualified through special circumstances, according to federal data released last week.
While most of the focus has been on the number of sign-ups during the health law's first two open enrollment periods, the data shows the growing importance of enrollment outside of those official windows—particularly as awareness of those opportunities grow. Changes such as a loss of other health insurance, a divorce or marriage, a change in family size or a move are among the other pathways to coverage during other times of the year.
"Life changes are often impossible to predict, but access to affordable and quality health care coverage should never be," Kevin Counihan, CEO of the Health Insurance Marketplace, said in a statement.
The number of people taking advantage of the special enrollment is substantial, but only a fraction of the number of people who may be eligible because they recently lost jobs or faced other changes, said Larry Levitt, Senior Advisor to the President at the nonpartisan Kaiser Family Foundation, a health policy research organization.
"When people lose their jobs and health benefits, their hope is often that unemployment will be only temporary so they may not go immediately to the marketplace to sign up for health coverage," he said.
The Centers for Medicare and Medicaid Services (CMS) figures only illustrate how many people with special circumstances chose a plan through the federal exchange website from February 23 to June 30. The information does not say how many individuals paid their premiums and remained insured. The number of people enrolled in health plans sold in both state and federal insurance markets fell from 11.7 million near the end of February to 10.2 million customers who had paid their premiums at the end of March, according to the Department of Health and Human Services.
Of the roughly 944,000 people who used a special enrollment period to choose coverage on healthcare.gov, 50 percent resulted from the loss of qualified health coverage, 19 percent from being found ineligible for Medicaid or the Children's Health Insurance Program (CHIP), 15 percent during a grace period for people who owed taxes because they weren't covered last year and 16 percent for other reasons.
The number of people signing up through special circumstances ballooned during tax-filing season. The agency reported that the people using this route increased from an average of more than 5,000 a day before March 15 to more than 38,000 on April 30, the last day of the tax special enrollment period for people who paid tax fines because they weren't covered. From May 1 to June 30, health plan selections through special enrollment fell again to an average of more than 6,000 a day.
People who enrolled during special enrollment were younger than those choosing plans during the regular open enrollment window. The CMS suggests that the exchange is "providing valuable continuity in coverage for younger consumers as they transition between jobs, move off their parent's health insurance plan, or experience other life changes, such as getting married or the birth of a child."
The report says more than 180,000 people chose plans through special enrollment after they were determined ineligible for Medicaid or CHIP. But technical troubles with healthcare.gov are currently preventing people who no longer qualify for Medicaid and may be eligible for special enrollment to enroll through the federal website. Instead, those people have to sign up by phone or other avenues.
"Consumers trying to enroll in coverage through one particular special enrollment period are experiencing issues at this time and are unable to complete their application," Health and Human Services Department spokesman Ben Wakana said in an email. "We are making sure that these individuals know that they are in fact eligible for marketplace coverage and providing the help and support consumers need."
The next open enrollment period for coverage through the exchanges set up under the health care law begins Nov. 1 for coverage beginning in January.