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December 15, 2017

Following King Letter, Centers for Medicare and Medicaid Services Agrees to Provide a Special Enrollment Period for Maine People Affected By Wind Storm

Announcement Comes on Final Day of 2018 Affordable Care Act Open Enrollment Period; King Notes Uncertainty of Individual Eligibility for Special Enrollment Period, Urges Maine People to Enroll Before Today’s Deadline

BRUNSWICK, ME – Today, Senator Angus King (I-Maine) received a response to his November letter to the Centers for Medicare and Medicaid Services, in which he urged CMS Administrator Seema Verma to extend the 2018 Affordable Care Act Open Enrollment Period for Maine following the severe storm that caused more than 400,000 Maine people to lose power. In today’s letter, the full text of which is included below, Administrator Verma agrees that “individuals who were unable to enroll in coverage…due to the impacts of the severe wind-storms and resulting power outages across Maine should qualify for an exceptional circumstances [special enrollment period]…” The letter does not describe the criteria for attributing the inability to enroll to the wind storm, and does not define how much longer affected Maine people will have to enroll.

“First and foremost: if you are a Maine resident who has yet to enroll in the 2018 Open Enrollment Period, it’s not too late to sign up today,” Senator King said. “I know this posed a challenge for many in Maine: With an already shortened Open Enrollment Period, October’s storm and the resulting power outages that affected hundreds of thousands in Maine caused a large number of people to lose valuable days that could have been used to explore the different plans available and secure healthcare coverage for 2018. While I’m pleased CMS will consider special enrollment periods for those affected by the storm, Administrator Verma’s letter does leave several questions open: notably what information is required to qualify, how the determination will be made, and how long the special enrollment periods will be available. Regardless of this possible option, I once again urge the people of Maine to secure coverage for 2018 before today’s deadline.”

Administrator Verma’s letter comes on the final day of the 2018 Open Enrollment Period. Per the letter, any resident of Maine who has not secured coverage by the end of the Open Enrollment Period and was affected by the storm should contact the Marketplace Call Center at 1-800-318-2596 to speak with a Marketplace representative.

The ACA’s Open Enrollment Period had previously been shortened from 12 weeks to 6 weeks, and included a 12 hour shutdown of the Affordable Care Act website during most weekends. Earlier this year, Senator King hosted three events in South Portland, Lewiston and Bangor to highlight the importance of healthcare coverage to protect individuals and families from medical or financial trouble in the event of an unexpected injury or illness. He also sought to raise awareness of the shortened deadline, and the wide range of affordable plans that were available on the Marketplace.

The full text of Administrator Verma’s letter can be found below.

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The Honorable Angus S. King, Jr.

United States Senate

Washington, DC 20510

Dear Senator King:

Thank you for your letter requesting that the Centers for Medicare & Medicaid Services (CMS) extend the 2018 Open Enrollment Period for Maine residents served by a Federally-facilitated Exchange (FFE) so those recovering from the recent wind-storms have additional time to shop for health insurance coverage. We share your concerns related to the ability of affected individuals to review their healthcare coverage options and make decisions within the current open enrollment period.

CMS recognizes that certain exceptional circumstances, including a natural disaster such as a severe wind-storm, can prevent an individual from enrolling in coverage before an open enrollment period expires. In these cases, the FFE has the authority to provide a special enrollment period (SEP) to give these consumers more time to enroll in a health plan. CMS agrees that individuals who were unable to timely enroll in coverage during Open Enrollment due to the impacts of the severe wind-storms and resulting power outages across Maine should qualify for an exceptional circumstances SEP that will provide them more time to enroll in coverage.

Therefore, Maine residents who were unable to complete enrollment during Open Enrollment due to the wind-storms should contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) to speak with a Marketplace representative. Maine residents who are affected by the wind-storm should provide detailed information about their situation so the Marketplace representative can appropriately assist them. Additional SEP information related to natural disasters is available on HealthCare.gov at https://www.healthcare.gov/sep-list. We intend to publicize the availability of this special enrollment period through assisters and agents in Maine.

CMS is committed to providing help and support to the areas and individuals impacted by this storm. We appreciate your support in assisting individuals in accessing health coverage and recovering from this event. Thank you again for your letter and for sharing your concerns.

Sincerely,

Seema Verma


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