Extend the sign-up period for healthcare.gov

Give all consumers what Minnesotans already have — extra time.

November 29, 2017 at 11:45PM
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iStockphoto.com (The Minnesota Star Tribune)

The Trump administration should seize the chance to lend a hand to the 12 million farmers, Realtors, consultants and small-business owners who buy health insurance on their own.

Some fancy bureaucratic footwork is all it would take to give these consumers extra time to shop for 2018 coverage. An extension is necessary after federal health officials ill-advisedly cut in half the time window for buying health insurance that opens near the end of the year. Health insurance is a complex purchase and consumers are still navigating a learning curve when it comes to financial assistance available through the Affordable Care Act to instantly discount premiums.

Open enrollment is the formal term for the year's-end insurance sign-up period. This year, it began on Nov. 1 in Minnesota and elsewhere. But the end point differs depending on where consumers live. In Minnesota, consumers have until mid-January to buy on MNsure, the state-run insurance marketplace. But Dec. 15 is the deadline in 39 other states where consumers buy on healthcare.gov — the federally run website.

The 45-day window is an abrupt change from last year, when healthcare.gov consumers had three months to sign up for 2017 coverage. A sharp cutback in federal funding for open enrollment advertising this year heightens the need for an extension. Consumers may not be aware of open enrollment or the tax credits available to help them buy insurance.

Neither President Donald Trump nor those he appointed to top U.S. Department of Health and Human Services (HHS) positions are fans of the ACA — former President Barack Obama's signature health reform law. That's why it's important to point out that helping consumers is in their interest, too.

An extension would generate positive publicity and burnish the agency's reputation — one that was tarnished by the resignation earlier this year of Secretary Tom Price over his private jet travel. It also would serve the Republican policy goals of boosting private health insurance enrollment.

Tim Jost, one of the nation's top legal experts on health care, said in an interview this week that the HHS has "broad authority" to lengthen open enrollment. It might have to do some expeditious new rule-making or move quickly to implement a special enrollment period, but Jost said these actions could be accomplished in time.

"The problem is the will, not the way," he said.

Insurers, who loathe uncertainty, would likely complain about such a move, fearing that additional time would allow more unhealthy and costly-to-care-for enrollees to sign up. But there's also some data suggesting that those who enroll later during open enrollment are younger and healthier, undercutting the industry's risk argument. It's also important to note that Minnesota has previously extended the deadline in the midst of open enrollment with little evidence of disruption for consumers or insurers.

Open enrollment shouldn't have been cut in half. Extending it an extra two weeks — until the end of this year — is doable and would benefit consumers. HHS leaders need to summon the will and make it happen.

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