ACA shortened enrollment adds time crunch

WOOSTER — A shortened enrollment period for the Affordable Care Act’s health insurance exchange will have navigators working overtime to make sure everyone gets the coverage they need in 2018.

The open enrollment period for 2018 coverage will run from Nov. 1 to Dec. 15. The deadline in past years had been Jan. 31.

“That is a quick turnaround for families to investigate their options, make a choice, and go through the steps to enroll,” said Jamie Parsons, executive director of Viola Startzman Clinic. “We encourage people to start looking at options now.”

The clinic will provide extended hours during that time period to assist anyone new to the health exchange or help those find a new provider if their previous insurance company pulled out of the marketplace. It’s also offering the same services to residents of Ashland and Summit counties as they currently lack an insurance navigator, but are actively seeking a replacement.

“If someone already has a plan through the marketplace, they will receive a notice to renew or to choose another option,” said Carol Labuza, the only health care navigator in Wayne and Holmes County.

Last month, officials from the Department of Health and Human Services announced funding for advertising and education outreach for Obamacare enrollment would be cut from $100 million last year to $10 million this year. Currently, the Startzman Clinic receives a grant to provide insurance navigator and ACA outreach in Wayne and Holmes counties and should be able to maintain the funding for its outreach programs.

“These cuts will hurt our communities if we can’t get the information out,” Labuza said.

Parsons added, “If the funding for our Insurance Navigator is cut, we will mobilize community resources to continue providing enrollment assistance, education, and outreach to our community.”

The clinic will have a booth at the Wayne County Fair in the Industrial Building to provide information about the open enrollment period and services it provides as well as address any other questions and concerns.

When Anthem pulled out of the marketplace in June, it left Holmes County and 19 other Ohio counties with no health exchange options. Since then, Molina Healthcare of Ohio filled the void in Holmes County and four other companies have stepped in to cover the remaining counties left without an option.

More than a quarter of Holmes County residents elect to take no health insurance, even without a religious waiver, an option used by the county’s Amish community. Instead, these residents choose to pay the federal fine and don’t get primary care, according to Michael Derr, health commissioner for the Holmes County General Health District.

Wayne County residents will have two insurance options for 2018 throughout the marketplace. CareSource and AultCare have provided insurance options for those residents in the past and likely will again next year.

Each provider offers plans with four levels — bronze, silver, gold and platinum. Most people choose a silver plan because it provides a tax credit and cost reductions options, according to Labuza.

Even with an insurance plan throughout the marketplace, it can be hard to find healthcare providers that accept the coverage. The Viola Startzman Clinic provides a safety net for Wayne County residents when they can’t find physicians that accept their insurance.

“Unfortunately, many of the plans sold on the marketplace and many of the Medicaid Managed Care plans are not widely accepted by local healthcare providers,” Parsons said. “We are committed to accepting patients regardless of the insurance they have. Because of this commitment, we are contracted with almost all carriers, and work with patients who have other plans to ensure everyone has access to healthcare.”

Holmes County residents can schedule an appointment with Labuza to receive assistance with finding an insurance plan through the marketplace, but the county lacks the same safety net if residents can’t find healthcare providers to take their insurance.

Three years ago, the Holmes County General Health District stopped providing primary care and patients were sent to Pomerene Hospital and other local healthcare providers.

“Residents should be able to go to a primary physician with insurance so there was a sense the district didn’t need to provide primary care,” Derr said.

Holmes County ranks second to last among all Ohio counties in providing clinical services, but seventh in overall health due to other factors.

Parsons described the current state of health insurance as a “lose-lose-lose situation.”

“Insurance companies claim they are losing money. Individuals are often paying more out of pocket for premiums and copays/​deductibles/​co-insurance fees than the total value of care they receive each year. And healthcare providers are typically paid less than what it costs them to provide the care,” the executive director said.

“So everyone is frustrated and feels like they are the loser.”

Reporter Emily Morgan can be reached at 330-287-1632 or emorgan@the-daily-record.com.

CREDIT: EMILY MORGAN