5 things to know about enrolling in Affordable Care Act, or Obamacare, insurance this year — and how to do it

Oct. 28--Open enrollment for insurance on the Affordable Care Act health exchanges -- "Obamacare" -- begins Nov. 1. But misinformation and misconceptions about the 2018 enrollment period have been circulating. Here's what you need to know about getting insurance on the exchange.

Every county in Tennessee will have insurance. Yes, Humana is pulling out of the ACA marketplace after 2017, but BlueCross BlueShield Tennessee has stepped in to provide policies in those counties, offering bronze, silver and gold plans in Knox and the surrounding counties as well as in Upper East Tennessee. In addition, Cigna and new player Oscar Health will offer plans in some counties. Many counties will have only one option for a provider, but each insurer will offer bronze, silver and gold-level plans, and Oscar will offer a catastrophic plan in the greater Nashville area.

The enrollment period will be shorter this year. Enrollment will be 45 days long -- Nov. 1-Dec. 15 -- and the healthcare.gov website will be unavailable most Sundays because of maintenance. In the past, open enrollment ran through January. Sevier County volunteer assister and nurse practitioner Richard Henighan said that will impact new enrollees as well as those who've signed up to be automatically re-enrolled: If they have a Humana plan, for example, the replacement Blue Cross Blue Shield plan might have changes in price, coverage or what providers are in network.

"In previous years, when the enrollment period went through the end of January, they could go online and change it" after the policy started, Henighan said. "This year, they're going to either have to drop it altogether, or continue. They won't have the option of looking to see if there's another plan that would work better for them."

The government isn't publicizing ACA enrollment as before. The current administration cut the budget for advertising from $100 million to $10 million -- meaning there won't be the billboard, radio and television ads of the past. Navigators and volunteer assisters have been looking at creative ways to get the word out but worry about reaching people in rural areas, especially, where fewer have in-home internet access. Union County internal medicine physcian and volunteer assister Dr. Mary Headrick, a former Democratic candidate for Congress, said she's seen politics prevent local publications and radio stations from promoting what people perceive as a "Democrat" program.

Lack of publicity also contributes to the perception that the ACA marketplace was shut down after the 2016 election, said Walter Davis, former president of the nonprofit Tennessee Health Care Coalition in Nashville.

"I often got calls from people trying to find out what else there is to replace the Affordable Care Act, because they thought it was gone," Davis said.

Premiums may go up, but most Tennesseans qualify for tax credits to help pay for them. Earlier this month, the federal government announced it would end cost-sharing reduction payments that help offset insurers' cost of offering silver plans to low-income customers. The current administration has also suggested it might end the individual mandate requiring all Americans to have health insurance coverage. Such uncertainty led insurers to ask the state to approve an increase in premiums -- an average of 36.5 percent for Cigna, a 21 percent average for BlueCross BlueShield. However, insurance plan prices released by the state don't include the tax credits that 88 percent of Tennesseans who purchase individual insurance policies on the marketplace receive, which can significantly reduce the price they pay out of pocket.

"Some people bought bronze plans" with lower premiums but much higher deductibles "because they didn't know there are subsidies to help them buy a silver plan," Headrick said.

The healthcare.gov website is better -- but signing up still is not an easy or quick process. Henighan said in recent years, the website has improved, with fewer pages and fewer outages, but it still takes him a minimum of 40 minutes to sign up someone even with no complications. And many people still arrive missing paperwork or without having set up an email address, which the site requires. In addition, assisters often find applicants qualify for TennCare/Medicaid instead of the ACA marketplace -- and many still fall in the "gap" left by a federal ruling that states don't have to expand Medicaid programs, so they qualify for neither. Too, people who mistakenly go to healthcare.com and healthcare.org will find lookalike sites that offer insurance quotes but are not the official government site with information on tax credits.

Tennesseans can get assistance free from an independent certified navigator by calling 844-644-5443 (615-724-1339 for Spanish) or visit enrollment events to get help in person.

In Knoxville, an event at 1 p.m. Wednesday at Overcoming Believers Church, 211 Harriet Tubman St., will kick off open enrollment. Other events:

Cherokee Health Systems, 2018 Western Ave.: 10 a.m.-2 p.m. Nov. 11 and 18 and Dec. 9; and 4-9 p.m. Dec. 15.

Mt. Calvary Baptist Church, 1807 Dandridge Ave.: Noon-5 p.m. Nov. 4; 5-8 p.m. Nov. 21; and 10 a.m.-2 p.m. Dec. 2.

South Knoxville Community Center, 522 Maryville Pike: 3-7 p.m. Nov. 15 and 30 and Dec. 5 and 12.

Blount County Public Library: 508 N. Cusick St., Maryville: 3-7 p.m. Nov. 2, 9 and 30 and Dec. 7 and 14.

King Family Library, 408 High St., Sevierville: 3-7 p.m. Nov. 13 and 20 and Dec. 9 and 11.

Sevier County Senior Center, 122 W. Main St., Sevierville: 1-3 p.m. Nov. 8, 15 and 29 and Dec. 6 and 13.

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