Las Vegas Sun

March 28, 2024

Sun editorial:

Trump turns his back on uninsured Americans in the middle of a crisis

Trump

Alex Brandon / AP

President Donald Trump speaks about the coronavirus in the James Brady Press Briefing Room of the White House, Wednesday, April 1, 2020, in Washington.

In a time of desperate need for Americans without health insurance, President Donald Trump is cutting a lifeline to tens of millions of them.

This week, it was reported that despite the rapidly escalating COVID-19 crisis, the Trump administration had opted not to establish a special sign-up period for Americans seeking coverage through the Affordable Care Act. Although the administration could have established a special enrollment period — something that has been done several times in recent years, generally after natural disasters — it chose to keep the federal ACA marketplace closed.

This a merciless move that will imperil a huge swath of Americans in two categories. For those who have lost their employer-provided insurance amid the COVID-19 outbreak, it will make it more difficult to obtain ACA coverage. For Americans who were uninsured going into the crisis, it leaves them completely out in the cold with no ability to obtain coverage.

Fortunately, Nevadans are protected — we’re one of 12 states (plus the District of Columbia) that control our own marketplaces and have done the right thing by establishing special enrollment periods to help residents during this crisis.

But in the 38 states that rely on the federal marketplace, the human cost of Trump’s action is terrible to consider. Who knows how many Americans without coverage will put off or forego early treatment for a cough or fever due to financial constraints, and then wind up battling a full-blown coronavirus infection? What about those who need treatment for other medical problems, or who are injured?

They’ll suffer, both health-wise and financially. Those who are forced to put off early treatment tend to end up receiving acute care in emergency rooms or urgent care clinics, which is more expensive than preventive care.

But this will affect all of us, not just those who lack insurance. If people postpone or avoid treatment, they run the risk of infecting others and perpetuating the consequences of the outbreak. That’s a nightmare from a public health perspective, a society perspective and from simple common sense.

And all because of Trump’s hatred of former President Barack Obama. Make no mistake: If the ACA were known as Trumpcare instead of Obamacare, the federal marketplace would be wide open and Trump would be throwing his shoulders out of their sockets patting himself on the back.

Instead, though, Trump is putting the lives of millions of Americans in extreme risk in his futile attempt to chisel Obama’s name out of the history books.

Keep in mind that some economic experts say up to 40 million Americans will lose their jobs due to the outbreak. Some 28 million went into the pandemic without coverage. Meanwhile, the 12 states with their own marketplaces (plus Washington, D.C.) make up less than 28% of the population.

For Americans who’ve recently become unemployed, the good news is that they’re still eligible for ACA coverage on the federal marketplace for up to 60 days after losing their job. But the lack of a special enrollment period will force them to provide proof that they lost their coverage, which can cause delays and complications in the process.

In Nevada, on the other hand, residents have until April 15 to take advantage of our special sign-up window, during which anyone who is uninsured or underinsured is encouraged to apply.

Last fall, the Guinn Center for Policy Priorities estimated that 400,000 Nevadans were uinsured at that time. Of those, about 120,000 were eligible for the exchange, and 77,000 of the eligible individuals would qualify for federal subsidies to offset costs of premiums.

Heather Korbulic, executive director of the state’s marketplace, Nevada Health Link, stressed to the Sun that the state marketplace was open both to the recently unemployed and to those who were uninsured going into the pandemic. There are no caps on the number of Nevadans who can receive coverage through the exchange, which the state funds by charging participating insurance companies a percentage of their gross revenues.

“The special enrollment period we established a few weeks ago was designed to capture people who didn’t get insured for plan year 2020 or who were currently in plans that are not on the exchange,” she said, referring to short-term plans that provide limited coverage and often don’t apply to pre-existing conditions. “But for people who lose their employer-sponsored coverage, those folks are eligible year-round. Anytime that happens throughout the year, you’re eligible (to enroll) within 60 days.”

Korbulic said a key reason the state established its own marketplace was to avoid the exact situation now being faced by the 38 states that rely on the federal government. For that decision, credit goes to Nevada state lawmakers who placed the best interests of Nevadans above partisan priorities — leaders like former Republican Gov. Brian Sandoval, who was an early adopter of Medicaid expansion, and current Democratic Gov. Steve Sisolak, a strong supporter of the ACA.

“I just think it’s negligent to leave so many uninsured, vulnerable people without an option for coverage,” Korbulic said. “I feel really grateful to live in a state where we have made this a priority.”

So do we. We urge Nevadans who need coverage to visit nevadahealthlink.com or call 800-547-2927 to learn more.