Implementation update: The Division of Insurance moves forward rules to establish a Special Enrollment Period for pregnancy as required by Cover All Coloradans
The Children’s Campaign, together with nearly ten partner organizations, recently submitted comments to the Colorado Department of Insurance (DOI) in support of a proposed regulation that will create new opportunities to enroll in insurance for people who are pregnant and those who lose Medicaid or CHIP coverage as a pandemic-era policy that kept people enrolled in public coverage comes to an end.
A special enrollment period (SEP) is a time outside of the normal open enrollment period when an individual or family can enroll in and receive financial assistance for health coverage. SEPs are triggered by qualifying life events (such as a marriage, divorce, or move) that make families eligible for new types of health coverage.
Cover All Coloradans (HB22-1289) established pregnancy as a qualifying life event that triggers an SEP. Prior to the passage of Cover All Coloradans, the birth of a child was included among the list of qualifying life events, but the beginning of a pregnancy was not. This meant that while people could sign up for coverage once a baby was born, they were not able to sign up early in their pregnancy to ensure access to critical, high-value prenatal care. The implementation of an SEP for pregnancy has led to positive outcomes in other states, including New York, Connecticut, and Maryland. A study published by the JAMA Health Forum found that New York’s establishment of an SEP for pregnancy was associated with increased marketplace coverage and decreased uninsurance among pregnant and postpartum people. Evidence from other states suggests that the implementation of this SEP will have little or no effect on premium costs for consumers.
The DOI is also implementing a 16-month SEP for individuals and families who lose their coverage during the unwinding of the continuous coverage mandate that has kept people enrolled in public insurance since early 2020. This will give Coloradans more time to enroll in new health coverage and find financial assistance for that coverage through Connect for Health Colorado. This is especially important for families who have switched residences due to housing instability, who may not receive timely notice that their coverage has ended.
Special enrollment periods mitigate gaps in health coverage for children and families, ensuring that they can access the health care services they need. Find more information on this proposed regulation on DOI’s website, where you can also sign up for the rule-making hearing on March 30. Subscribe to KidsFlash for updates on how the Children’s Campaign continues to engage in regulatory implementation processes.