House Bill Backs SEP, COBRA, Cost-Free COVID Treatment

By:  Amy Lotven

House Democrats’ $3 trillion coronavirus response bill unveiled Wednesday (May 12) would require HHS establish and promote an eight-week special enrollment period for, would fully subsidize COBRA coverage, and would mandate that group and individual health plans provide COVID treatment cost-free to enrollees.

It also would pump an additional $100 billion into the Health Care Provider Relief Fund created by the CARES Act and designate $75 billion for testing and contract tracing, increase Medicaid matching funds by 14% and make other investments in public health infrastructure.

“The Heroes Act continues our ongoing commitment to providing the health care resources and support needed to combat the coronavirus crisis,” House Ways & Means Chair Richard Neal (D-MA), Energy & Commerce Chair Frank Pallone (D-NJ) and Education& Labor Chair Bobby Scott (D-VA) said in joint statement. “This legislation requires the Administration to finally develop comprehensive plans for robust testing and contact tracing and provides the funding necessary to implement it. Our legislation ensures that everyone has access to health care coverage and can seek treatment for COVID-19 without any out-of-pocket costs,” they added.

The bill is expected to stall in the GOP-controlled Senate, but the package shows Democrats’ opening negotiating position.

Several sources had indicated that, while Democrats were expected to go big in their package, they’d likely avoid provisions that would never make the final version and that would only serve to antagonize the GOP.

Since the administration has been so steadfast against opening up health, some believed that the SEP might not make it in the bill, even though issuers, hospitals, unions, employers and even some GOP governors had urged HHS to open the enrollment window. But the package calls on the Affordable Care Act exchanges to create an eight-week SEP within one week of enactment. The policy applies to all exchanges, but exempts any state-exchange that has already established its own SEP. Of the 13 state-based exchanges, all but Idaho created a SEP.

The bill further demands HHS conduct outreach and education campaign to inform Americans about the opportunity and authorizes $25 million for that effort. And it bars the administration from using the funding to promote non-ACA compliant products, including short-term plans or association health plans.

Protect Our Care Executive Director Leslie Dach pointed out that creating a SEP and funding outreach are both overwhelming popular with the majority of Americans regardless of political party.

“By putting Americans’ health care needs front and center, House Democrats are tackling the problems exacerbated by this crisis head on and expanding access to health care at a time when it’s never been more critical,” Dach said.

The package also includes Scott’s legislation that would fully subsidize COBRA from March 1 through Jan. 1, 2021, and make the coverage available to still-employed furloughed workers. Wide-ranging stakeholders, including unions, businesses, issuers and hospitals, support strong subsides for COBRA and, although there are bipartisan disagreements over how much of the policy should be covered, sources had expected leadership would pick up Scott’s bill.

The Democratic package also would require all group and individual health plans, including grandfathered plans, to provide treatment for COVID-19 without cost-sharing throughout the public health emergency. HHS and Treasury would be required to generate a list of covered items within a week of the bill’s enactment. The bill emphasizes that all services on the list must be covered even if they’re not ordinarily covered under the terms of the plan.