Washington, D.C. June 15, 2020 — Today, Democracy Forward sued the Trump administration on behalf of the City of Chicago for unlawfully refusing to open a special enrollment period to allow millions of uninsured Americans affected by a once-in-a-century pandemic to enroll in health insurance offered on Affordable Care Act (ACA) exchanges.
Despite over two million Americans infected and over 115,000 dead from COVID-19, the Trump administration refused to open a special enrollment period for the 38 health insurance exchanges operated on HealthCare.gov. According to reports, President Trump did not want to open a special enrollment period solely because of his opposition to the ACA — which he has repeatedly made clear in his public statements, his tweets, and his actions. President Trump’s Department of Health and Human Services failed to provide a cogent rationale for its decision not to open a special enrollment period — despite bipartisan calls to do so — in light of the unprecedented public health crisis.
Now, thousands of Chicago residents and millions of Americans cannot enroll in quality and affordable health insurance as they worry about whether they or their families might contract the virus, and as they face the economic crisis caused by the pandemic. The Trump administration’s failure to open enrollment also forces municipalities like Chicago to bear the financial and human costs of providing uncompensated care to the uninsured.
“The ACA clearly mandates a special enrollment period be opened during a crisis time such as this,” said City of Chicago Corporation Counsel Mark A. Flessner. “Although never OK, now is not the time to play politics by blocking our residents from lawful access to the health benefits they desperately need.”
More than 49,000 Chicagoans have been infected with COVID-19, and 500,000 Chicagoans have lost their jobs because of the crisis. While the City of Chicago runs health clinics and provides ambulance services to all of its residents, including the uninsured, it often cannot recoup those costs — meaning that the Trump administration’s decision imposes additional financial strain when the City is already being hit hard. The Trump administration’s refusal to open ACA enrollment also exacerbates the spread of COVID-19 by making it more difficult for families to obtain testing and treatment.
The Affordable Care Act aims to expand Americans’ access to quality, affordable health care. The statute and its regulations require the Department of Health and Human Services to open a special enrollment period when consumers face “exceptional circumstances,” including the outbreak of COVID-19. As HHS has explained, exceptional circumstances include “unanticipated events, often outside of [the consumers’] control” — like a global pandemic. In fact, the ongoing pandemic so clearly constitutes an “exceptional circumstance” that 11 of the 12 states plus the District of Columbia that run their own exchanges have opened special enrollment periods to allow uninsured residents to get covered.
There is widespread support for opening a special enrollment period. A special enrollment period would allow Americans to enroll in quality health insurance that provides access to needed care and financial peace-of-mind — not to mention that it encourages them to seek the testing and treatment necessary to reduce the spread of COVID-19. As the Kaiser Family Foundation has cautioned, the “uninsured are likely to face significant barriers to testing for COVID-19 and any care they may need should they contract the virus.” Democratic and Republican governors alike, including the governors of Arizona, Michigan, New Hampshire, New Jersey, and Oregon, have asked the Trump administration to open enrollment. And America’s Health Insurance Plans, the largest association of health insurers in the country, joined with the BlueCross BlueShield Association to call for “a one-time special enrollment period.”
“President Trump has once again put his personal desire to sabotage the Affordable Care Act ahead of the health, safety, and financial security of the American people,” said Democracy Forward Executive Director Anne Harkavy. “But that’s not how the law works. Our lawsuit seeks to ensure that the federal agency in charge of implementing the Affordable Care Act follows the law and opens a special enrollment period so that Americans affected by the pandemic can get the quality and affordable health care they need.”
President Trump and his administration have no sound explanation for denying millions of uninsured Americans access to affordable health insurance when they need it most. The president’s opposition to a special enrollment period stunned administration officials, who had begun to inform the insurance industry that one would be opened. It was, as one source close to the White House put it, “purely ideological.”
This refusal to reopen enrollment is consistent with President Trump’s and his administration’s systemic and wide-ranging efforts to sabotage the ACA. His administration is urging the Supreme Court to invalidate the law. It has promoted junk insurance plans that do not provide adequate coverage, including for COVID-19, has sought to reduce enrollment numbers by cutting funding for open enrollment advertising and outreach, and has repeatedly shortened the annual enrollment period. Democracy Forward also represents the City of Chicago, four other cities, and two residents of Charlottesville, Virginia, in another lawsuit challenging this wholesale sabotage of the ACA.
This lawsuit challenging the refusal to open a special enrollment period, and a motion for a preliminary injunction, were filed on June 15 in the District Court for the District of Columbia. Read the full complaint and motion for a preliminary injunction.
Democracy Forward is a nonprofit legal organization that scrutinizes Executive Branch activity across policy areas, represents clients in litigation to challenge unlawful actions, and educates the public when the White House or federal agencies break the law.