Enrollment for Affordable Care Act starts Wednesday

Nov. 01--Open enrollment starts Wednesday, Nov. 1, for health insurance in 2018 under the federal Affordable Care Act, widely known as Obamacare.

But a shorter registration period this year, coupled with misinformation about the program and reduced advertising money, has some tasked with enrollment concerned that fewer people who need the insurance coverage will sign up. Meanwhile, Alabama's top insurer is set to offer health care plans through the ACA next year and a new study shows those new plans could be cheaper for some customers than the ones offered this year.

"We have made a concerted effort to reach out to former clients, to check in on them and let them know we're still here," said Julie Hope, an Anniston-based, federally paid navigator who helps people enroll through the ACA.

Enrollment in the health insurance marketplace will last from Nov. 1 through Dec. 15, more than a month shorter than previous years. The program offers tax-subsidized plans to low-income Americans who qualify.

Along with shorter registration, the U.S. Department of Health and Human Services this year cut advertising for the marketplaces from $100 million to $10 million because of alleged diminishing returns from the service.

Also, earlier this month the White House announced it would cut the tax subsidies given to insurance companies participating in the marketplaces. Referred to as cost-sharing reduction payments, insurers use the subsidies to provide discounts so more low-income Americans can afford coverage through the ACA.

Hope said all the cuts and changes with the program this year could have confused people, making them think the health care plans offered would be more expensive or had been canceled.

"We are concerned," Hope said. "I think we are all concerned also about young, healthy consumers who might think there is no longer a reason to apply ... we really want to see more of those get enrolled."

According to Enroll Alabama, a nonprofit created to inform people about the marketplaces and help them enroll, approximately 200,000 Alabamians have ACA health insurance plans.

Hope, who covers about eight counties in the region, said she and her fellow navigators in the state have had to adjust their schedules this year to accommodate the shortened enrollment period.

"We've tried to move and arrange our enrollment sites to provide as much coverage as we can," Hope said.

Hope said she would be in Anniston for a full day each week during this enrollment period, starting today.

Blue Cross and Blue Shield of Alabama, the state's top private insurer, will still offer plans in the marketplace next year despite the cuts in subsidies. Blue Cross is the only insurance company in the state that offers ACA marketplace plans.

"We are offering 9 ACA-compliant individual plans and 6 ACA-compliant small business plans in all counties in Alabama for 2018," Koko Mackin, spokeswoman for Blue Cross, wrote in a Tuesday email to The Star. "We continue to offer the broadest choice of doctors, hospitals and other healthcare providers in Alabama, making quality healthcare easily accessible for our members."

Mackin has said that Blue Cross had anticipated the subsidies cuts and factored them into the plans it'll offer next year in the health insurance marketplace.

Those cuts affect costs to insurers, but not to customers.

A study released Monday by the Kaiser Family Foundation shows that while the subsidies' cuts have caused premiums to rise, the tax credits that make the plans affordable have risen too, as is required by the ACA. Kaiser is a nonprofit, nonpartisan group that focuses on health care issues facing the country.

The study shows that in many cases, lower-income consumers receiving premium tax credits will pay less for premiums in 2018 than in 2017 because their tax credits will rise dollar-for-dollar.

For example, a 40-year-old making $35,000 who is eligible for a tax credit will on average pay 39 percent less in 2018 for their share of the premium for the lowest-cost bronze plan, 7 percent less for the lowest-cost silver plan, and 13 percent less for the lowest-cost gold plan offered in the marketplace. The bronze plans offer the lowest amounts of coverage while the gold plans offer the most coverage.

Jim Carnes, policy director for Alabama Arise, a nonprofit that advocates for people in poverty, said that despite rumors and rhetoric to the contrary, the ACA hasn't gone anywhere.

"There's all kind of confusion out there ... if you listen to just part of the news or certain sources, you'd think the ACA had gone away," Carnes said. "But the primary message is that the ACA is still the law of the land and affordable plans are still available."

Shafpel Benson, community outreach officer who helps enroll people in the ACA marketplace for Quality of Life Health Services, said all the confusion surrounding the program this year has her and her fellow enrollers on edge. Quality of Life manages health clinics that provide primary care to the poor in Calhoun and 12 other counties.

"We do have some concern about what the interest will be," Benson said.

Benson said Quality of Life has six employees trained to help people enroll in the marketplace this year. One of those employees is assigned to Calhoun County, but more could be relocated here if demand warrants it, she said.

Benson said her department has been receiving many calls over the last week from people wanting information about the marketplaces.

"A number of those have come from rural areas where there wasn't interest before," Benson said. "It shows there are still many individuals who need health insurance."

To set up an ACA enrollment appointment with Julie Hope, call 205-305-6506. To set up an appointment with Quality of Life, call 256-439-6312.

Staff writer Patrick McCreless: 256-235-3561. On Twitter @PMcCreless_Star.

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