President Donald Trump decided not to reopen new sign-ups across the 38 Affordable Care Act marketplaces the federal government controls, despite the ongoing coronavirus pandemic.

The administration had faced increasing pressure to launch a special enrollment period to allow the uninsured to enroll in the program, but Trump has instead opted for paying hospitals directly, rather than insuring Americans.

Asked if he would reopen the Affordable Care Act, Trump said that “opening it up doesn’t help as much” as compensating hospitals on the condition that patients will not face separate charges.

“This should alleviate any concern uninsured Americans may have about seeking the coronavirus treatment,” Trump said of his hospital payment plan during a Friday news briefing. “So that, I think, answers the question pretty well and very much in favor of our great people.”

Democratic frontrunner Joe Biden criticized Trump’s decision, attacking him for putting “pettiness and ideology above helping those who are in the greatest need.”

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“Donald Trump needs to reopen Obamacare enrollment immediately,” Biden tweeted. “This is no time to put pettiness and ideology above helping those who are in the greatest need. Lives are at stake.”

Some officials in the Health and Human Services Department were surprised and dismayed by Trump’s decision.

Eleven states that run their own Affordable Care Act exchanges, along with the District of Columbia, have opened special enrollment periods, so those without insurance can obtain coverage during the pandemic.

The typical enrollment period for states using the federal exchange, healthcare.gov, is Nov.1 to Dec. 15.