On Monday, the Centers for Medicare & Medicaid Services (CMS) opened the Affordable Care Act Marketplace for enrollment as Americans continue to face the health and economic consequences of the coronavirus pandemic. This move ensures that everyone—including those who lost employer coverage and those who were uninsured before the crisis—can get covered beyond the standard open enrollment period. The Trump administration refused to take this important step despite pleas from health care experts, health insurers and lawmakers.
Open enrollment under President Biden will look significantly different from the past four years. In 2017, Trump cut the outreach and advertising budget for enrollment by 90 percent. Funding for advertising and outreach remained at diminished levels for the 2021 enrollment period, even as millions lost coverage as a result of the pandemic. The Trump administration also cut the number of days people could sign up for coverage during open enrollment by half, from 90 days to 45 days. This was on top of ongoing efforts to dismantle the ACA, which undoubtedly created confusion among consumers. Unsurprisingly, millions lost coverage under Trump even before the pandemic.
The Biden administration, on the other hand, is spending five times more on education and outreach during this special enrollment period than Trump spent for the standard enrollment period. The Biden administration has also pledged to prioritize reaching groups that historically have experienced lower access to health coverage and greater disparities in health outcomes. President Biden is also leading the charge to pass the American Rescue Plan which includes key provisions to expand coverage and lower health care costs for American families.
| Trump’s Plan | President Biden’s Plan | |
| Efforts to expand health coverage during the pandemic | None
Trump instead pursued harmful waivers to reduce Medicaid enrollment, including block grants and work requirements, in the middle of the pandemic. |
Opened a special enrollment period
Biden directed the HHS to examine policies that undermine the Affordable Care Act and Medicaid. Additionally, the Biden administration announced it would end Medicaid work requirements as part of its efforts to remove enrollment barriers. |
| Funding for education, outreach & advertising | Cut funding for outreach and advertising to just $10 million for the standard enrollment period | Dedicating $50 milion for the special enrollment period alone |
| Duration of enrollment period | 45 days | 90 days for the special enrollment period in addition to the standard enrollment period later this year |
| Efforts to enroll hard-to-reach populations, including communities of color & non-English speakers | None — the Trump administration stopped engaging with partner groups, such as the Latino Affordable Care Act Coalition, women’s groups, medical organizations, and churches. | CMS will collaborate with community partners to reach groups that historically have experienced lower access to health coverage and greater disparities in health outcomes. |