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8:44 PM / Thursday April 9, 2020

19 Mar 2020

Gov. Wolf requests that federal government allow special enrollment period for Affordable Care Act coverage in response to COVID-19

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March 19, 2020 Category: Coronavirus, Health, Local, Stateside Posted by:

Governor Wolf announced on Wednesday that his administration has sent a formal letter to U.S. federal agencies requesting a Special Enrollment Period (SEP) for uninsured or underinsured Pennsylvania residents in response to the COVID-19 outbreak.

Governor Wolf, in collaboration with the Pennsylvania departments of Health, Human Services and Insurance, issued the request in a letter sent to U.S. Department Health and Human Services Secretary Alex Azar and U.S. Centers for Medicare and Medicaid Services Administrator Seema Verma.

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“During this unpredictable health crisis, we are asking for a special enrollment period so all eligible uninsured and underinsured Pennsylvanians can purchase comprehensive health coverage through the federal platform, and for that coverage to be effective immediately,” Wolf said. “Establishing a special enrollment period during this crisis is the responsible precaution that will not only benefit Pennsylvanians, but will also contribute greatly to the management of the virus.” 

“These are steps being taken to protect our residents, but more can be done, particularly for those currently uninsured and in need of testing and treatment,” Wolf added.

States currently operating as a State Based Exchange (SBE) have already implemented an SEP in response to COVID-19. States that are on the federal platform, Healthcare.gov, need federal action for the establishment of an SEP. While Pennsylvania is transitioning to a SBE for coverage beginning on January 1, 2021, the Commonwealth currently remains on the federal platform and needs the federal government to take action in order for Pennsylvanians to have access to an SEP.

“As confirmed positive COVID-19 cases increase in Pennsylvania, it is imperative that individuals have expanded access to screenings, testing and the proper treatment,”  Wolf said. “The Department of Insurance has worked with Pennsylvania’s major health insurers to confirm they will cover medically appropriate COVID-19 testing without any copays, deductibles, or cost-sharing for consumers. The Department of Human Services has announced the state’s Medicaid program and Children Health Insurance Program (CHIP) will cover COVID-19 testing treatment and that prior authorization will be lifted in some cases.”

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