The Affordable Care Act is still the law of the land after multiple attempts by Congress to repeal it in recent years.
As such, enrollment for 2018 health coverage through the public marketplace is currently open and will continue until Dec. 15. The sign-up period is six weeks shorter than last year’s.
Signing up is done at healthcare.gov.
Early reports leading up to open enrollment were that numbers were expected to dip given higher premiums and decisions by President Donald Trump’s administration to shorten the enrollment period, cut advertising and limit counseling assistance.
However, the Centers for Medicare and Medicaid Services (CMS) released a report Thursday detailing that almost 601,500 people selected plans on healthcare.gov in the first four days of enrollment. So on average, about 150,000 signed up per day during the first week, which is much higher than the 84,000 that signed up per day in the first report released last year.
The enrollment numbers only include the states that use healthcare.gov, such as Texas. CMS reported that of those people signing up, about 137,300 were new customers.
Jay Claborn, a member of the Lubbock Area Association of Health Underwriters and an independent health insurance broker at The Claborn Agency, said enrolling for marketplace coverage is similar to years past, and Lubbock again has two insurance options through the public exchange.
But Claborn said premiums, on average, for the better plans have gone up about 35 percent compared to last year. Because of that, he’s seeing more people sign up for plans with lower premiums, but higher deductibles.
“Whether you’re on exchange or off exchange, if you’re on one of those middle-tier plans that have co-payments for prescriptions and doctors, those premiums went up about 35 percent,” Claborn said. “The bronze level premiums went up, just not as high. Those plans are a lot more affordable, but whenever you go to the doctor you pay a lot more… The process of enrolling is still the same, but you’ll have to look around a lot more now.”
Claborn suggested people wanting to sign up for Obamacare take time to compare plans, not just automatically renew. If someone is changing plans, Claborn recommended making sure their preferred doctor is covered in the new plan.
President Donald Trump in an executive order cut subsidies to insurers originally in place for cost-sharing reductions, which has been attributed partly to the rising cost of premiums. Claborn said he thinks the more significant drivers in the higher cost of premiums are increased emergency room traffic, where costs are much higher than normal doctor visits, and the continual increase in prescription drugs that insurance companies are passing along to consumers.
Besides that, the key components of the ACA are still intact. So there’s still the individual mandate that creates a financial penalty for anyone without health insurance, the employee mandate that creates a penalty for companies with at least 50 full-time employees not offering insurance, and the protections on pre-existing conditions.
Claborn said health care agents and brokers in Lubbock like himself can assist with consumers that need help signing up.
The Community Health Center of Lubbock also has certified application counselors the organization says will meet with consumers needing assistance.
The Community Health Center of Lubbock told the A-J the center can help people enroll either by appointment or in walk-in meetings. Consumers are reminded to bring identification, proof of address, proof of household income and login information for returning applicants to these meetings.
Certified application counselors will assist consumers with completing and submitting the online applications, as well as review, compare, and discuss the application and application options, a representative of the community health center said.
Claborn said a misconception out there is that the Trump administration also took away the subsidies available for low-income individuals or households, but those are still in tact. These subsidies are paid to qualifying consumers in the form of tax credits, and people earning between 100 to 400 percent of the Federal Poverty Level qualify to help pay their monthly insurance premiums.
The U.S. Health and Human Services Department estimates more than 80 percent of healthcare.gov customers get subsidies that lower their premiums.
According to numbers released by the prior administration, 11.5 million people signed up for coverage in 2017. Estimates released on healthcare.gov showed almost 19,000 people in U.S. House District 19 (that includes Lubbock, Plainview, Abilene and Big Spring) were enrolled in the ACA Marketplace as late as March 2016. This number doesn’t include the amount of people who were able to get coverage because of the ACA’s provision saying insurance companies can’t reject or charge more because of a pre-existing condition.
Still, Texas has the highest number and rate of uninsured people in the country. The Texas Medical Association reports Texas still has 4.3 million people without health insurance, which is 1.75 times the national average. Of those uninsured, 623,000 are estimated to be children without health insurance.