Will COVID-19 Advance Automatic Health Insurance Enrollment?

by Leslie Small

As the COVID-19 pandemic continues to ravage the U.S. economy, it would seem to be the perfect time for policymakers to explore a policy option that has garnered rare bipartisan support: automatic health insurance enrollment.

"We have huge numbers of people who are losing employer-based coverage; most of them are eligible for some kind of help, but we know historically most laid-off workers do not enroll in coverage for which they qualify," said Stan Dorn, director of the National Center for Coverage Innovation and senior fellow at Families USA. "It's just overwhelming to be grappling with job loss and therefore it becomes imperative to make enrollment as easy, seamless and automatic as possible."

Dorn was among several panelists who spoke during a May 18 webinar about automatic health insurance enrollment, hosted by the USC-Brookings Schaeffer Initiative for Health Policy and the American Enterprise Institute. Current crisis aside, Dorn said he advocates helping eligible uninsured individuals sign up for coverage when they’re filing their tax returns.

Christen Linke Young, a fellow at the USC-Brookings Schaeffer Initiative for Health Policy, said that "retroactive enrollment" is the best option. A federal "backstop" program would pay all claims for uninsured people when they receive care, but when filing taxes they would be responsible for paying income-adjusted premiums for the "plan" they used. "It's the path toward universal coverage that is in my view most feasible," she said.

Other panelists advocated for a more state-driven approach. One way to accomplish that would be for the federal government to create an incentive program that grants states new tools and authorities to build automatic enrollment programs, according to James Capretta, a visiting fellow at the American Enterprise Institute and senior fellow at the Ethics and Public Policy Center.

During the current pandemic-related economic downturn, one solution could be for states to move people who have lost their employer-based coverage to a comparable Affordable Care Act marketplace plan, suggested Lanhee Chen, a David and Diane Steffy fellow in American public policy studies at the Hoover Institution. "I think certainly that would be a more affordable route than, for example, subsidizing COBRA continuation coverage," he said.

From Health Plan Weekly