A University of Minnesota School of Public Health study found that a large number of people are eligible for special enrollment periods in the federal and state-based health insurance exchanges. These special periods are outside regular enrollment periods when people can enroll in or change their insurance plans.

[Photo: Ms. Lacey Hartman]

Study findings include:

• An estimated 8.4 million people were likely to become eligible for a special enrollment period because they lost minimum essential coverage, got married, or became parents of a newborn child. More than three quarters of these people were uninsured.
• In states that did not expand Medicaid coverage, 1.9 million people experienced upward income shifts outside of the regular enrollment period that would make them eligible for marketplace subsidies (because their incomes increased above 100 percent of poverty). However, because they did not have Medicaid coverage, they would have to wait until the next period to enroll in a marketplace plan.  In contrast, people in states that have expanded Medicaid would be eligible for a special enrollment period in this situation because they would have most likely become ineligible for Medicaid and experienced a loss of minimum essential coverage.

“[The Medicaid situation] adds to the burden for low-income individuals in non-expansion states because even once their income increases to a level that would make them eligible to receive subsidies, they have to wait for the next regular open enrollment period to access coverage,” said lead author Ms. Lacey Hartman, senior research fellow at the State Health Access Data Assistance Center in the School of Public Health.

The study was published in Health Affairs.

“We think that the findings should be helpful for policymakers and marketplace officials as they structure long-term plans for outreach and enrollment,” Ms. Hartman said.