Daily COVID-19 Briefing April 6, 2020

United Church of Christ – Wider Church Ministries
Humanitarian Development Team
Coronavirus (COVID-19) Daily Briefing
Barbara T. Baylor, MPH – Temporary Health Liaison

April 6, 2020

Americans Losing Healthcare Coverage Now!

According to Johns Hopkins University, as of today (April 6) at noon, the United States had 338,995 recorded cases and 9,683 deaths due to the novel coronavirus (COVID-19).

Many Americans have lost jobs and the health coverage that came along with those jobs. Others have had their work hours reduced, making monthly premiums that were manageable before now out of reach. Many of us are facing the possibility of getting sick with COVID-19 in the coming months, and we’ll have to deal with the bills afterward.

Open enrollment for 2020 ended well before the COVID-19 outbreak. Many people are left wondering how they will pay for healthcare should they be stricken with COVID-19.

You may still be able to get health insurance in the following ways:

1. Some states (e.g. New York State) have reopened their healthcare exchange for a specified period of time. Go to Healthcare.gov or your state-run exchange for state-specific information.
2. You may qualify for a Special Enrollment Period (the time outside the yearly open enrollment period when you can sign up for health insurance). You are eligible if you have certain life events, like getting married, having a baby, or losing other health coverage due to a death in which you are no longer eligible for your current health plan.
3. If you quality, you can apply and enroll in Medicaid or the Children’s Health Insurance Program (CHIP) any time of year. Medicaid is a joint federal and state program that provides free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities. The Children’s Health Insurance Program (CHIP) is the insurance program that provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid but not enough to buy private insurance. In some states, CHIP covers pregnant women.

   Legal Immigrants are generally eligible for coverage through Medicaid and the Children’s Health Insurance Program (CHIP), if they meet their state’s income and residency rules.

   a. In all states you can qualify for Medicaid based on income, household size, disability, family status, and other factors. Eligibility rules differ between states.

   b. In states that have expanded Medicaid you can qualify if your income is below 133% of the federal poverty level (FPL) alone.

   c. In states that have not expanded Medicaid, you won’t quality for either Medicaid or for savings on a private health insurance plan even if your income is below the federal poverty level. States that have not expanded Medicaid under the Affordable Care Act 2010 include: Alabama, Florida, Georgia, Kansas, Montana, Mississippi, North Carolina, Oklahoma, South Carolina, South Dakota, Wisconsin, Wyoming, Tennessee, and Texas.

4. Click here to see if you qualify for Medicaid alone.
5. Insurance Exchanges under the Affordable Care Act. Losing health insurance that you got through your job is considered a “qualifying event” to enroll in a plan on all the health insurance exchanges. That means you can go to Healthcare.gov or your state-run exchange and shop for a new plan.

Gaps in the health coverage system during COVID-19

1. Unfortunately, under the Affordable Care Act, undocumented immigrants are not eligible for Medicaid under federal guidelines nor are they eligible to enroll in coverage through the health care exchanges. Some states have implemented programs to cover undocumented immigrants, particularly children and/or pregnant women.
2. There are numerous attempts to undermine and roll-back provisions of the Affordable Care Act: 

   a. The “individual mandate” was eliminated. The mandate was intended to help keep the premiums for ACA policies low by ensuring that more healthy people entered the health insurance market.

   b. States are allowed to add “work requirements” to Medicaid. The COVID-19 economic downturn will remove more and more people from work, making it next to impossible to fulfill work requirements.

   c. Cost-sharing reduction subsidies ended. These were payments from the federal government to insurers to motivate them to stay in the ACA insurance exchanges and help keep premiums down. This raises costs for the most vulnerable. 

   d. Access to short-term “skinny” plans has been expanded. These plans offer less protection and offer limited coverage if you have a serious health condition.

3. Due to COVID-19, new unemployment claims recently hit 6.6 million. We can expect to see increased enrollment in Medicaid. While Medicaid does provide some protections for states facing higher Medicaid costs as a result of COVID-19, states that have expanded Medicaid coverage will have more individuals qualifying for coverage and fewer likely to become uninsured. More than 2 million poor uninsured adults below poverty don’t qualify for Medicaid and fall into the coverage gap because they live in one of 14 states that have not yet adopted the ACA expansion. Individuals in these states will not have the same coverage options and more people may become uninsured. 

Following the passage of the CARES (Coronavirus Aid Relief Economic Stimulus) Act:

Health insurance providers are committed to help prevent the spread of the coronavirus strain COVID-19. According to the Association of America Health Insurance Plans (AHIP), emergency plans are being activated to ensure that Americans have access to the prevention, testing, and treatment needed. Several insurance companies have indicated that in addition to waiving testing costs, they will also waive member cost-sharing for selected methods of treatment for COVID-19 or health complications associated with COVID-19. Check with your insurance company for details – specifics will be different company by company and policy by policy.

What can churches do?

Work in partnership with local faith and community-based organizations and human service agencies to advocate expansion of Medicaid if you are in a state that has yet to expand it.

References

Do You Qualify for Special Enrollment?

COVID-19: Expected Implications for Medicaid and State Budgets

The Coverage Gap: Uninsured Poor Adults in States that Do Not Expand Medicaid