State health insurance exchanges open enrollment after disasters: Colorado, California part of new trend
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* Mark Barna

![Figure1](http://www.thenationshealth.org/http://www.thenationshealth.org/content/nathealth/52/3/9.1/F1.medium.gif)

[Figure1](http://www.thenationshealth.org/content/52/3/9.1/F1)

A woman shows off tote bags from kynect, the Kentucky-run health exchange, which offered a special enrollment for people impacted by tornadoes in Kentucky. State-run exchanges have advantages of nimbleness and knowing their customers.

Photo courtesy kynect

On Dec. 30, a wind-fueled fire swept through Denver suburbs, destroying over 900 homes in six hours. Communities and state agencies rallied to help people who lost almost everything they owned.

One of those agencies was Connect for Health Colorado, which runs the health insurance marketplace. The agency extended its 11-week 2022 enrollment by two months to March 16 to accommodate not only people devastated by the wildfire, but also uninsured residents concerned about the COVID-19 omicron variant, cases of which surged in the state in January. About 1,000 people a week signed up during the special enrollment period.

“We are just happy people are getting their needs met,” said Kevin Patterson, MURP, MPA, CEO of Connect for Health Colorado.

The agency also waived the requirement to document losses to qualify for special enrollment disaster relief for people impacted by the wildfires.

“Why give them one more thing to stress over when they are trying deal with an immense loss?” Patterson told *The Nation’s Health.*

Patterson lauded Connect for Health Colorado’s ability to be flexible, act fast and waive a disaster-relief requirement that would have slowed the process.

“You have the flexibility to do things that fits your state’s needs and it’s made our desire to be nimble, adaptable and targetable much more realistic.”

In addition to Colorado, 17 other states run their own health insurance marketplaces. Three states run marketplaces on a federal platform where people can choose health insurance plans for themselves, their family or their business. Thirty states use the federal marketplace, [HealthCare.gov](http://HealthCare.gov).

The health insurance marketplaces are part of the Affordable Care Act, which became law in 2010. The ACA requires each state to offer several comprehensive health insurance plans for residents to choose from. While most states initially opted for the federal insurance marketplace, an increasing number have switched to the state-run model. Since 2020, seven states have transitioned to their own health insurance exchanges.

Besides flexibility, state officials say state-run platforms offer lower costs, better customer service and more accurate data on residents.

Colorado, for example, knows who is uninsured in each ZIP code and eligible for the marketplace, enabling navigators to reach out to those residents. And while [HealthCare.gov](http://HealthCare.gov) also offers special enrollment for disaster relief, state-run exchanges have more local data to know when to act and can make quicker decisions, Patterson said.

Besides Colorado’s, other state health exchanges have also opened for disaster relief, a trend likely to continue given climate change’s role in fueling extreme weather events.

Covered California, the Golden State’s health exchange, opened last summer for residents in counties where a state of emergency had been declared from wildfires.

Kentucky has bounced between a state and a federal exchange in recent years depending on the controlling political party. In October, Gov. Andy Beshear announced the return of its state-run health exchange, with sign-up Nov. 1 to Jan. 15. When tornadoes struck western Kentucky in December, state officials extended enrollment through January to accommodate people impacted.

Health insurance enrollment periods in the U.S. are limited to encourage people to sign up when they are well, not just when they become sick. Disasters can cause people to take stock of their situation and foresee a need for health insurance. Given the risk of catastrophic health cost from a hospital stay, people realize it is better to have health insurance than not.

The program works in Colorado because “we know our clientele and serve them each and every day in every corner of the state,” Patterson said.

For more information on state-based health exchanges, visit [www.cms.gov](http://www.cms.gov).

*   Copyright The Nation’s Health, American Public Health Association