New Hampshire is in economic free fall, with more than 127,000 filing unemployment claims as a host of businesses shut down.
But for the newly unemployed, there’s another necessity: health insurance. And if you were recently laid off, the clock is ticking.
Most people have 60 days after the day they lose their job to sign up for a health insurance plan on the individual market. After that, the options get more sparse.
The New Hampshire Insurance Department and the “New Hampshire Health Care Coalition,” a group of nonprofits and advocacy groups focused on health insurance, are encouraging people to reach to navigators for information.
Here’s what you need to know.
Those looking to buy health insurance have several options, according to Jeremy Smith, project director for New Hampshire Navigator, a nonprofit. But you shouldn’t delay.
The best bet is a health insurance plan on the individual market through healthcare.gov. Your income and family size will determine how much you pay for that.
It’s best to use one of the state “navigators” by calling 1-877-211-NAVI or visiting https://acanavigator.com/nh/home. Depending on income level, you may qualify for subsidies that may make certain plans cheaper than others. The navigator will be positioned to help you through that.
A secondary option is COBRA. That’s the classification for programs that let you continue the plan you received through your last employer by paying full price for it. It’s one of the most expensive options and is usually only used when people are between jobs — less ideal in an ongoing crisis.
Both Healthcare.gov and COBRA have 60-day windows of eligibility for the special enrollment period that follows a loss of income or employment.
Translation: After more than 2 months out of the job, they will be closed off.
Those who were laid off in March — when most restaurant layoffs occurred — are already halfway through the window to sign up for health insurance on the individual market, advocates warn.
Making the right choice early on is crucial.
“If you pick COBRA now and then want to drop it later, you won’t be able to go into the Marketplace and pick up a plan,” Smith said, referring to the ACA market places. “So it’s really important that people weigh those options now and try to see what’s going to be best for them the rest of the year.”
There are still options for health insurance if you miss out on the sign-up window.
To start, there’s Medicaid expansion. Anyone in a household making 138% or less above the federal poverty line — $35,535 for a family of four and $12,490 for someone living alone — you can qualify for Medicaid expansion, which has a separate sign-up process and is administered by managed care organizations on behalf of the state.
That might seem like a low amount. But the program eligibility is determined by current monthly income. If you’re laid off with no income, you’ll likely qualify after a month of unemployment.
“A lot of people I talk to just think of the old rules and they just assume that they’re not going to qualify,” Smith said. “But there’s a lot of people out there that have been affected by layoffs that will be able to sign up for expanded Medicaid.”
There’s one alternative option for some: If you’re married and out of work, you can check with your spouse’s employer’s insurance.
One thing Smith warns against: Using Google to hunt down plans. Doing that will invite plans that might have terrible hidden deductibles or sparse benefits — or might be a complete fraud.
Smith’s nonprofit organization was chosen by the federal government to help Granite Staters sign up for the plans.
“A lot of people that have been affected by these layoffs, they’ve traditionally had employed-based insurance,” Smith said. “So they’ve never really paid attention to other insurance options available to them, and they don’t really know where to begin to look.”
The current 60-day special enrollment period was built into the system long before COVID-19.
The idea is that by limiting availability, the system will avoid “adverse selection” — the phenomenon where people sign up for insurance only when they think they need it, which drives up costs and premiums.
But amid the COVID-19 crisis, there have been new calls for Washington to relax that cap and allow more people to sign up.
After pressure from the New Hampshire Health Care Coalition, Gov. Chris Sununu urged the federal government to open a special enrollment period for the Affordable Care Act during the COVID-19 crisis.
That enrollment period would allow sign-ups to the ACA exchanges even to those who didn’t lose their job lately.
Sununu advocated for it in a March 18 letter to Centers for Medicare and Medicaid Services Administrator Seema Verma and Health and Human Services Secretary Alex Azar.
New Hampshire must wait for the federal government to act. It is one of 32 states that chose to allow the federal government to run its individual market exchanges. That means only the federal government has the authority to reopen the markets, which necessitated Sununu’s request.
But on March 31, the White House said it would not create a broader special enrollment period, rebuffing the requests of many governors.
It is unclear how much the economic crisis has taken a toll on health insurance rates in New Hampshire.
Before the crisis hit the state, about 77,000 of New Hampshire’s 1.3 million residents were uninsured. Now, with sweeping unemployment claims, that’s certainly changed.
“There’s real potential that we have a much higher rate of uninsured in our state now,” said Zandra Rice Hawkins, executive director Granite State Progress, which helps coordinate outreach for insurance sign-ups.
Yet people are so far not seeking out the resources. Likely, that’s because people are more concerned with getting their unemployment benefits before they sort out their health care coverage.
“So far we have not seen an uptick in calls,” Smith said, “and that’s a little bit concerning to me.”