Idaho’s lubrication for ACA enrollment

Idaho is an odd state for health insurance.  It is a conservative state with a Republican trifecta.  It has reluctantly expanded Medicaid through a voter referandum.  It has moderately regulated short term limited duration plans.  And it runs a state based exchange.  They are the only state based marketplace that has not created a Special Enrollment Period (SEP) that is explicitly designed to catch folks that are currently unemployed and uninsured to go to the ACA marketplaces.  Healthcare.gov also does not have a special COVID SEP.  The standard loss of insurance SEP is active but it has lots of administrative friction and paperwork requirements.

However, Idaho is seeking to  minimize administrative friction:

Idahoans who have lost employer-sponsored health insurance as a result of termination, layoff, or furlough due to COVID-19 are eligible for a Special Enrollment Period. Previously this process would require several steps of documentation and validation. Under the newly relaxed policy, in lieu of documentation and proof of termination, Idahoans can now submit a written statement explaining their loss of employer health benefits. This new process removes time-consuming barriers and ensures an expedited path to coverage.

We are getting a massive lesson in administrative burden and administrative friction in the delivery of public benefits.  Public benefits can be readily and easily available.  Public benefits can be legally available and “accessible” after jumping through a lot of hoops.  If a public benefit is easy to access, then lots of people will use the public benefit.  If a public benefit is difficult to access, not many people will use that benefit.  And the people who get a hard to receive benefit tend to be systemically different than folks who are blocked from access by paperwork barriers. 

This applies to food stamps. 

This applies to voting. 

This applies to Medicaid. 

This applies to college financial aid. 

And it applies to to ACA special enrollment periods as well.

Idaho’s removal of a documentation requirement and replacing it with an attestation dramatically reduces the administrative burden for people who have lost insurance.  This is a good step to increase enrollment and provide some financial protection for folks who have gotten hit hard right now.