11 States Are Allowing the Uninsured to Sign Up for Obamacare

Fran Majidi
March 24, 2020

It used to be the rule that you had to sign up for health insurance during Open Enrollment. If you missed the January deadline, you had to wait another year to enroll in order to buy health insurance.

All the old rules have recently gone out the window, due to COVID-19 pandemic quickly sweeping the country. In 11 states, including the District of Columbia, Washington, Nevada, California, Colorado, Connecticut, Massachusetts, Rhode Island, Vermont, Minnesota, New York and Maryland, you can now enroll in new health coverage under the Affordable Care Act at any time.

People who’ve been laid off can now get subsidized health insurance without jumping through too many hoops. The Trump administration is hesitant about opening up the federal exchange to even more customers, despite pressure from insurers. It’s not yet clear whether the administration will open the enrollment period for all 32 states whose markets it currently manages.

In states that have opened up Obamacare again, many state officials have chosen to create this special enrollment period so that people will not hesitate to get tested for coronavirus. Also, those carry COVID-19 will now have the coverage for treatment if they fall sick.

Losing a job is a qualifying event, which would make any individual anywhere in the U.S. eligible to buy health insurance, but by opening up the marketplace health officials want to send a broader message that people should sign up for healthcare before they get sick and without the hurdle of having to prove their special condition. Time will tell if the Trump administration will follow suit.

According to a Kaiser Family Foundation study, there are approximately 17 million uninsured people who are eligible for Obamacare. More than 25% of these people would pay nothing in premiums if they were to elect a bronze plan, due to federal subsidies. On top of this large demographic, people with short-term health plans that do not meet the Affordable Care Act’s guidelines would also be able to enroll if the administration were to allow it.

One thing that will complicate coverage for low income individuals is that marketplace coverage is dependent on the prior year’s tax returns. Individuals in suddenly dire straits will have to provide documentation proving that their circumstances have changed.

We suggest finding documentation of job loss, loss of hours or any document that shows that you are undergoing a time of financial hardship, as compared with the previous year’s earnings. Paystubs, letters from employers, and even bank statements may help.

What if I Have a Marketplace Health Plan and I Lost My Job?

If you already have coverage through the marketplace, you can report your income change and apply for an increased subsidy. This is true for all states, not just the ones that opened up enrollment again.

Who’s at High Risk Besides Seniors?

In general, diabetes patients are more susceptible to viral infections and tend to have more serious health outcomes than the general population. Diabetes impacts your immune system which may result in decreased immune system response to the coronavirus. Researchers in China have documented more hospitalizations and higher mortality rates in their diabetic coronavirus patients. Factors that are important to consider are coexisting risks including age, other serious chronic conditions and how well-managed your diabetes is.

There is some good news. Diabetics are not more likely than the general population to contract the coronavirus. Leading manufacturers of insulin are also not reporting an impact on their current manufacturing and distribution capabilities for insulin and other diabetes-related supplies at this time.

Just make sure you get insured.

What if I’m Diabetic and Get Sick from Coronavirus?

Your diabetes coronavirus wellness plan should include:

  • Gathering the contact information of your healthcare professionals, pharmacy and insurance company.
  • Creating a list of all your medications, vitamins and supplements with their dosages listed.
  • Stocking up on simple carbs such as soda, Jello-O or popsicles to keep your blood sugar up in case you are too ill to eat.
  • Getting extra refills on your prescriptions and setting up prescription delivery by mail-order if possible. Experts recommend having a 30 to 90 day supply of prescriptions available.
  • Having enough insulin at least for the week ahead. If you are struggling to pay for insulin, the American Diabetes Association has resources to help.
  • Obtaining Glucagon and ketone strips in case of blood pressure lows or highs.
  • Stocking up on cleaning supplies like rubbing alcohol and soap .
  • Asking your doctor when to contact them regarding ketones, changes in food intake and medication adjustments.
  • Asking your doctor when to check for ketones and how often to check your blood sugar.
  • Asking your doctor which medications you should use for colds, viruses, flus and infections.
  • Asking your doctor if you should change medications when sick.

As a Diabetic, What Should I Do to Protect Myself From Coronavirus?

As with any virus, you can take preventative measures to avoid contracting coronavirus, including:

  • Regular handwashing with soap and water for at least 20 seconds.
  • Using hand sanitizer with at least 60% alcohol to clean hands if soap and water are not available.
  • If you must be in public, avoid touching high-touch surfaces such as door handles or elevator buttons.
  • If you must touch a high-touch public surface use a tissue or your sleeve as a barrier
  • Avoiding touching eyes, nose, or mouth.
  • Avoiding close contact with infected persons.
  • Clean and disinfect your home regularly, especially frequently touched surfaces such as faucets or light switches.
  • If someone in your household tests positive for the coronavirus, keep everyone at your home.

If you are a diabetic, take extra precautions to avoid contracting the coronavirus, including:

  • Establishing a protected space for you.
  • Having only one family member care for you if you cannot care for yourself.
  • Making sure your caretaker washes their hands thoroughly before they are in direct contact with you.
  • Continuing to monitor your health conditions and keeping appointments with your medical team by telehealth appointments and virtual check-ins whenever possible.
  • Avoiding leaving your home whenever it is not absolutely necessary.
  • Avoiding crowds, especially in poorly ventilated spaces.
  • Avoiding all non-essential travel.

What Are the Symptoms of Coronavirus?

Symptoms of coronavirus may appear 2-14 days after exposure and include:

  • Fever
  • Cough
  • Shortness of breath
  • Breathing difficulties

More severe symptoms may include:

  • Confusion or inability to arouse
  • Bluish lips or face
  • Severe acute respiratory syndrome
  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in chest
  • Lower Respiratory tract illness
  • Pneumonia
  • Kidney failure

What Should I Do If I Suspect I Have Contracted Coronavirus?

It is especially important to seek immediate treatment if you suspect you have contracted the coronavirus. You should also contact your healthcare provider if you may have been exposed to a person with coronavirus or you live in/have traveled to an area with a high concentration of infected people.

Have the following information available when you call your healthcare professional:

  • Glucose reading
  • Ketone reading
  • Fluid consumption log

There are tests that will help your medical practitioner identify if your symptoms are in fact coronavirus. Once you have been diagnosed, your doctor may suggest:

  • Taking pain and fever medications. If you are diabetic or a senior make sure you know how these interact with your current medications.
  • Drinking plenty of liquids. If you are struggling to keep water down, take small sips every 15 minutes or so throughout the day to avoid dehydration.
  • Staying home to rest, in a protected space if possible.
  • Taking a hot shower to ease sore throat and cough.
  • Using a room humidifier to help with respiratory symptoms.
  • Support for vital organ function in severe cases.

If you are diabetic, be aware that some sensors (Dexcom G5, Medtronic Enlite and Guardian) are impacted by Acetaminophen (Tylenol). Check with finger sticks for accuracy. You may need to check your blood sugar more often throughout the day and night (generally every 2-3 hours).

Your doctor may suggest eating 15 grams of simple and easily digestible carbs if you are diabetic and experiencing low blood-sugar levels below 70mg/dl or your target range. Check for ketones to avoid DKA if you are diabetic and your blood sugar has registered high (BG greater than 240mg/dl) more than 2 times in a row. Immediately contact your doctor if you have medium or large ketones (or if instructed by your doctor, for trace or small ketones).

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