After making all the appropriate statements about how awful the restrictions were and about the tragic loss of life, people will be talking for years about the positive things that came out of the COVID-19 pandemic. America—and the world, really—has re-evaluated its priorities and changed the way we think about work. People discovered how to do things remotely. We learned how to Zoom, homeschool children, order groceries, food, and pretty much everything else to be delivered to our door, and even visit the doctor from the comfort of our own home. And the uninsured rate reached record lows.
Agents and brokers had a big role in getting and keeping people covered during the pandemic. We explained the importance of health insurance to prospects who were previously on the fence about enrolling. We took advantage of special enrollment periods to get prospects enrolled in group and individual health plans. We encouraged people who were losing their job-based coverage to sign up for COBRA because the government was paying the bill. We helped clients apply for tax credits for which they qualified, financial assistance that was increased thanks to one of the COVID relief bills. And we did much of it remotely, without ever meeting with our clients face to face. Yes—we, too, changed the way we work.
Unfortunately, as the COVID numbers continue to decline in the U.S. and the pandemic—fingers crossed—starts to come to an end, we’re seeing some of the positive changes start to unwind. People are going back to the office, even those who would prefer to stay at home. Most of us are Zoomed out and are returning to in-person meetings, even when they’re less efficient. And the uninsured rates are once again starting to climb back up.
Axios writes about this trend in a March 4 article entitled “End of the pandemic could usher in spike of uninsured.”
The very first sentence paints a scary picture: next year, we could be “facing one of the largest increases in the U.S. uninsured rate in recent history.” That’s because many of the “Temporary pandemic-era reforms to Medicaid and the Affordable Care Act marketplaces [which] caused enrollment in each to swell” will soon be ending, and “millions of people could lose their health coverage” as a result.
In 2020, Congress increased funding to states that “offered continuous coverage to enrollees,” reducing the “usual churn” in the program. And in 2021, congressional Democrats passed the American Rescue Plan Act (ARPA), which “expanded who was eligible for premium assistance” in the federal and state marketplaces. But, as Axios points out, “the extra allowances are due to sunset with the end of the public health emergency or at the end of the year.”
President Biden talked about this in his State of the Union address, saying we should “close the coverage gap and make those savings permanent.” Republican lawmakers, however, do not seem so keen on the idea.
Larry Leavitt with the Kaiser Family Foundation (KFF) agrees with Axios that the number of people without health insurance could soon increase, saying "If continuous coverage in Medicaid ends and the extra ACA premium assistance isn’t extended, we could see one of the biggest jumps in the number of people uninsured ever.”
KFF writes about this possibility in a March 2 article, pointing out that President Biden’s “Build Back Better Act (BBBA) would have continued enhanced Marketplace subsidies, but negotiations on the Hill have stalled.” With no Republican votes and without the support of Democrats like Joe Manchin and Kyrsten Sinema, the legislation seems unlikely to pass.
Here’s an unnecessary reminder: You only get paid if your clients keep their health insurance. Brokers who focused on sales during the pandemic must now shift gears and focus on retention, but it won’t be easy. Those who decided that health coverage was in fact a necessary monthly expense when hundreds of thousands of people were being diagnosed with COVID every week may soon decide that they’re once again willing to take their chances. And those who qualified for significantly reduced premiums may soon have to pay much more for health insurance; indeed, some will no longer qualify for a subsidy and will have to pay full price. Many will need help shopping for new, affordable options for coverage.
The one bit of good news for brokers is that the enhanced Medicaid will likely expire before the enhanced premium tax credits do, so there may be a small window in the second half of 2022 where we can help many former Medicaid recipients qualify for heavily subsidized coverage through the Marketplace. Whether it will be possible for those individuals to keep their coverage after January 1, though, remains to be seen.