As deadline looms, insurance enrollment help offered

Jan. 11--Have changes and uncertainty caused enrollment in the Affordable Care Act Marketplace to drop? A local agency assisting enrollees is noting lower numbers, but statewide enrollment seems to be on track with previous years.

By this time last year, Cherokee Health Systems had signed up 900 more people for health insurance through the ACA Marketplace, said Derrick Folsom, Director of Outreach and Enrollment Services.

Folsom attributes that to uncertainty around the federal legislation. First, many people may not know the deadline for enrollment is Jan. 31 -- so there's still time to sign up for a policy, he said. In fact, those who sign up by Jan. 15 can get coverage that starts Feb. 1.

Second, he thinks many people aren't bothering to sign up for insurance because they think the ACA, or "Obamacare," will be repealed or replaced in 2017, under a new administration.

"We anticipate, however, that even if the Act is repealed, those who have insurance coverage through the marketplace will be able to retain their plan through the end of 2017," he said.

But the U.S. Department of Health and Human Services said Tuesday that last year, enrollment numbers dipped, then spiked again just before the deadline. Last week, HHS released numbers showing that across the state, 234,222 people selected a plan or were re-enrolled as of Dec. 31. That's in line with the number of enrollees at the same time last year.

In East Tennessee, Cherokee manages a team of trained certified application counselors who help residents determine what insurance they can best afford, and whether they qualify for ACA subsidies, TennCare/Medicaid or CoverKids, the state's Children's Health Insurance Program. The organization, which provides primary and behavioral health services in 15 counties, offers appointments at locations throughout East Tennessee by calling 1-866-672-1979.

Cherokee and other certified volunteers also are offering several community information sessions this month, at its main office at 2018 Western Ave. as well as at the South Knoxville Community Center and Mount Calvary Baptist Church in East Knoxville.

The higher costs and more narrow networks for the 2017 Marketplace Plans -- available only through Humana in Knox County -- are also leading some of the 15 percent of Tennesseans who don't qualify for subsidies to look off the exchange for other options that don't qualify for tax credits or alternative plans and risk paying a tax penalty.

But others, like freelance writer and web designer Kristina McLean, 42, said even at higher costs, the ACA provides security.

Before the ACA's Marketplace, McLean said, she and her husband, both self-employed, applied for insurance 44 different times.

"We tried for years and years," she said. "They either 'lost our paperwork' or denied us."

In 2013, McLean was diagnosed with breast cancer, which her doctor discovered as she prepared to start trying to get pregnant with her first child.

"Finding out you have cancer is stressful, just a little bit; not having insurance and finding out you have cancer is even more stressful," McLean said. "We were just wondering what is going to happen, were we going to lose our house, how are we going to pay for this?"

McLean qualified for an exception that provides TennCare to women with breast, cervical or ovarian cancer, which covered her lumpectomy, complications and radiation.

"It was a very difficult time," she said. "I look at how many bills built up, even having insurance. We're still struggling to pay a lot of those off. And I think about if we hadn't had insurance. ..."

After her cancer treatment, she no longer qualified for TennCare -- but at that point, she and her husband were able to buy a Marketplace insurance plan, since the ACA mandated insurers could not deny or penalize applicants for pre-existing conditions.

Tuesday's breakdown from the HHS showed 177,664 of Tennesseans who have signed up for 2017 Marketplace plans through Dec. 24 were returning customers, while 56,675 were enrolling for the first time. HHS said 82 percent will receive tax credits that lower their premiums; the average is $432 a month.

Of Tennessee enrollees by Dec. 24, 125,932 were women and 108,407 men; 17,882 black and 136,915 white; and 61,537 living in rural areas. By age, adults 35-54 made up the largest group, at 84,150, followed by adults 55 and older (72,231), adults 18-34 (61,775) and children (16,182).

In 2015, after having been diagnosed with infertility, McLean got pregnant with her "miracle baby." Her ACA policy covered prenatal care, including being hospitalized for pre-eclampsia, as well as her daughter's wellness checks, vaccines and other care.

"I'll never be able to get insurance again if they take away Obamacare," McLean said. "They say they're going to keep the part about pre-existing conditions, and they can't, without the individual mandate. There's no way to pay for that."

Tennessean reporter Holly Fletcher contributed to this article.

ACA information sessions:

Mount Calvary Baptist Church, 1807 Dandridge Ave.: 4-7 pm. Thursday; 3-8 p.m. Jan. 31.

South Knoxville Community Center, 522 Maryville Pike: 3-7 p.m. Jan. 17

Cherokee Health Systems, 2018 Western Ave: 10 a.m.-2 p.m. Saturday; 10 a.m.-4 p.m. Jan. 21; 10 a.m.-4 p.m. Jan. 28; 8-11 p.m. Jan. 31.

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