The Trump administration has refused to reopen Obamacare exchanges to allow millions of laid-off workers get health insurance, even though the White House estimated that hundreds of thousands of Americans will die as a result of the coronavirus pandemic.
Nearly a dozen states have reopened their enrollment period to help the millions of workers who lost their jobs amid statewide lockdowns, but a White House official told Politico that the administration had no plans to relaunch HealthCare.gov and was instead "exploring other options."
The Obamacare enrollment period ended months ago, but millions of people have filed for unemployment since the coronavirus crisis began. Though some Democratic states have reopened their insurance marketplaces, the Trump administration oversees enrollment for the vast majority of states.
The decision surprised insurers, who said last week that they expected Trump to announce a special enrollment period after conversations with officials at the Centers for Medicare and Medicaid Services, according to the report.
Trump himself said last week that he was considering a special enrollment period at the same time as his administration supports a lawsuit seeking to repeal Obamacare in a move that would strip insurance coverage from more than 20 million people.
"It's something we're talking to a lot of people about," the president said. "We'll see what happens."
People who lose their employer-based insurance are eligible to apply for health care on the marketplace but must provide proof that they lost coverage while a special enrollment period would make the process easier and would not require that paperwork, The New York Times' Margot Sanger-Katz reported.
Aside from the marketplace, some laid-off workers have the option to extend their employer-based insurance through COBRA, which costs users far more than the insurance they get through their job. Low-income workers can also apply for Medicaid, though many Republican states have refused to expand Medicaid under the Obamacare law.
Trump has promoted cheaper short-term health plans as an alternative to the Obamacare exchanges, but these plans typically do not cover pre-existing conditions and often result in larger bills than the out-of-pocket costs on the Obamacare marketplace.
Many lawmakers have called for Trump to reopen the marketplace since the crisis began, though Congress did not include a special enrollment period in their $2.2 trillion coronavirus relief bill.
Even insurers urged the administration to announce a special enrollment period.
"Given the risk posed by COVID-19, it is more important than ever for people to have health coverage," the heads of America's Health Insurance Plans and Blue Cross Blue Shield Association wrote in a letter to Congress, according to CNN.
The move comes as the White House grapples with projections showing unprecedented death tolls. The White House estimated that between 100,000 to 240,000 people would die — even with extensive mitigation efforts — compared to more than 2 million who may die without sustained intervention.
Without a special enrollment period, many people will face the crisis without coverage, "leaving them potentially exposed to tens of thousands of dollars in costs if they get sick from the novel coronavirus and need medical treatment," HuffPost's Jeff Young wrote. "Sick people not being isolated and treated means they are at risk of spreading the coronavirus to more people."
Democrats on Tuesday condemned the decision.
"This isn't just an outrageous decision, but it's also a deadly one," Rep. Veronica Escobar, D-Texas, tweeted. "Moments ago, Donald Trump announced we should expect 100-200k deaths in the U.S. For those without health insurance, this is fatal. It's time to end this senseless war on healthcare."
"In the middle [of] a pandemic that could kill hundreds of thousands, Trump and his toadies are deliberately blocking Americans from buying healthcare," Rep. Bill Pascrell, D-N.J., added. "Theirs is fanatical cruelty that will kill people."