Health insurance marketplace open for plan previews

By Ricardo Alonso-Zaldivar

The Associated Press

WASHINGTON -- Consumers can now begin previewing 2018 plans and premiums for health insurance under the Affordable Care Act, even as President Donald Trump pursues his drive to dismantle the Obama-era law that has helped bring coverage to millions.

In many cases, prospective customers will see higher premiums and less choice. Experts say that's due to a combination of "Obamacare's" underlying problems and the uncertainty generated by Trump and Republicans. Consumers eligible for income-based tax credits will be protected from rising premiums but those who pay full cost face a second consecutive year of double-digit premium increases.

On Wednesday, officials at the Health and Human Services Department posted plans and premiums for the coming year on HealthCare.gov so consumers can begin "window shopping." Starting next week on Nov. 1, new customers can submit applications, and returning ones can make changes to their coverage. Open enrollment will end early, on Dec. 15, about half the time allotted under Barack Obama's administration.

The Trump administration's launch comes after the president abruptly pulled the plug on federal payments that reimburse insurers for reduced copays and deductibles they're required to provide to people of modest means. That exposes insurers to a potential $1 billion loss for the remainder of this year, and state regulators have been approving premium increases for next year to compensate.

In Rhode Island, the state insurance marketplace announced an 18 percent to 20 percent increase and dubbed it a "Trump tax." Administration officials say the payments were not properly approved by Congress and Trump is following the U.S. Constitution by denying them.

Bipartisan legislation to resolve the problem is pending, and Wednesday the Congressional Budget Office said the bill would reduce federal deficits and "would not substantially change the number of people with health insurance coverage." The outlook for the legislation, sponsored by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., is uncertain. Trump has sent mixed signals about whether he would support it.

About 10 million people have private health insurance through government-sponsored markets like HealthCare.gov. More than 8 in 10 customers receive tax credits to help pay their premiums, and that aid is still available despite the political turmoil.

Unlike the Obama years, the Trump administration has set no enrollment goal for 2018.

"We are really focused on having a smooth consumer experience," said Randy Pate, director of the HHS office that oversees the program.

"That is our target for this year."

Administration officials say they have made a series of improvements to the sign-up process unheeded in the acrimonious political debate over health care.

Among them:

-- Greater use of plain language on HealthCare.gov and easier searches for covered prescription drugs and network medical providers.

-- An option to request a call-back from the federal consumer assistance center, which is intended to minimize long hold times.

-- An online option for consumers to request enrollment assistance from a private insurance agent or broker in their area. (This move could prove controversial, since the administration also cut funding for nonprofit programs that provide enrollment assistance.)

HHS officials also took issue with criticism that they plan to take HealthCare.gov down for maintenance for extended periods as a way to undercut enrollment. They say they deliberately scheduled maintenance early on Sundays because in the past that time period has one of the slowest for the website. HealthCare.gov serves 39 states. The rest operate their own websites.

"This year, more than ever, consumers should shop around for a better deal," said Larry Levitt of the nonpartisan Kaiser Family Foundation, who has followed the health law from its early days.

"These premium hikes sound scary, but the reality is that in most cases consumers won't be paying that much," he added. "Those receiving subsidies from the government to help pay their premiums will be shielded from any increase at all because the government subsidy will rise along with the premiums."

That's not the case, however, for an estimated 7 million unsubsidized customers, most of whom buy individual plans outside the government markets.

"There is a danger that middle-class people who don't get government help in paying their premiums could be increasingly priced out of the market," he said.