It’s the law: Providers, advocates urge signing up for health insurance under ACA

Oct. 29--BLOOMINGTON -- The Affordable Care Act remains the law and, starting Wednesday, people can sign up for coverage for next year.

That may come as a surprise to people who've heard President Donald Trump call Obamacare dead.

But Central Illinois health care professionals urge people to learn this fall what health insurance options are available to them and make educated choices.

"The Affordable Care Act is a law of the land and OSF HealthCare encourages everyone to sign up for health care under its provisions," said OSF HealthCare CEO Bob Sehring. "We are concerned about anything that makes access to care more difficult."

"With all the repeal-and-replace options being debated, some people are assuming that the insurance exchanges are not functioning," added Cathy Coverston Anderson, interim director of the McLean County Health Department. "That's not true. The exchanges still exist and Illinois still has Medicaid expansion."

From Wednesday through Dec. 15, Central Illinoisans can go to healthcare.gov, getcoveredillinois.gov or call 866-311-1119 to get information and enroll in health insurance plans through the federal ACA.

While there may be fewer plan options and premiums are increasing, people still should be able to secure coverage through the online marketplace (exchange) created for people who aren't insured through their jobs. Lower-income applicants may qualify for government subsidies to reduce the cost.

"We would encourage everyone to learn about what options are available to them through the exchanges," Sehring said. "Our health care system, and the health of our communities, is better when people seek timely care."

Meanwhile, people with employer-provided plans also are going through open enrollment for insurance for 2018.

The Trump Administration has shorted the ACA open enrollment period and cut the ACA advertising budget and grants to organizations that helped people to sign up.

"Those items create more barriers," Coverston Anderson said. "The result may be fewer people enrolled," which is unfortunate because people without health insurance are more likely to put off treating medical conditions until they are more difficult and costlier to treat.

That's why a group being organized by Debbie Lubbert of Bloomington, and supported by activist groups Voices of Reason and Indivisible, has started a grassroots campaign to remind McLean County residents about the open enrollment period.

The group is passing out fliers, volunteering to speak with community groups, working on social media and hopes to have an open enrollment event, said Lubbert and Voices of Reason leader Jodie Slothower.

Debbie's husband, Michael Lubbert, 59, was an assistant manager of a Bloomington retail store until he was among 700 employees who lost their jobs in a corporate restructuring in April. Debbie, 56, is not able to work because of bursitis and arthritis in her left knee.

"I had health insurance through May," Michael Lubbert said. "Then I could do COBRA but it was expensive. So I went through the ACA on healthcare.gov and did my research."

The Lubberts chose a mid-range Blue Cross Blue Shield plan and learned that, because of their income, they were eligible for a government subsidy of $1,400 a month. They pay $500 a month, but have a $3,000 deductible. They have been on the plan since June 1.

The Lubberts plan to return to healthcare.gov in November to search for a 2018 plan. "We'll probably go with a plan with a lower deductible but will pay more in premiums," he said.

With their experience, Debbie Lubbert decided to get the word out about the open enrollment period.

"Everyone should have good and affordable health insurance," she said. "What they (Trump Administration) are doing is sabotaging the Affordable Care Act. But the ACA is still the law. If you don't have health insurance, you will be fined."

Twenty million more Americans have health insurance because of the ACA, meaning they are more likely to go to the doctor's office and more likely to take their medicine, said Coverston Anderson.

"The Affordable Care Act is not perfect but has provided greater access to those who could least afford insurance," said Sehring.

"We continue to be concerned about the increases in insurance premiums, deductibles and other out-of-pocket costs which have impacted the ability, for some, to have access to affordable health care," he said. "Issues around the affordability of both Medicaid and benefit plans offered through the public exchanges must be addressed."

After ACA implementation, OSF experienced a spike in acutely ill patients who had put off care when they didn't have health insurance. "We do view this ultimately as a good thing because we were able to bring them into our continuum of care and establish a relationship that, hopefully, will improve their overall health and require less need for emergency care in the future," he said.

Meghan Woltman, Advocate Health Care vice president of government and community relations, said "We remain committed to working with our members of Congress to support improvements to the law. Our top priorities continue to be to protect patients and maintain coverage for those insured through the Affordable Care Act and Medicaid and we are supporting efforts to quickly resolve the current impasse regarding cost-sharing reductions for exchange products."

Angie McLaughlin, executive director of the Community Health Care Clinic in Normal, McLean County's clinic that serves low-income uninsured and under-insured residents, said "The Affordable Care Act has increased health insurance access to millions of individuals across the country, with accountability measures for health care providers and systems to improve the quality of care."

The clinic, which treats 1,000 patients with chronic diseases each year, experienced a dip in patients in 2014 when the expanded Medicaid and online marketplace opened and more people got coverage.

But they have been replaced by patients who lost their jobs and health care coverage and then purchased low-premium, high-deductible insurance that they can afford. But when they can't afford to pay all their medical bills until they reach their deductible, or when their new policy covers only one doctor visit a year, they end up at the clinic, she said.

Some clinic patients have new, low-paying jobs that don't offer insurance, meaning they no longer quality for Medicaid, but still can't afford insurance on the exchange.

"I anticipate new patients looking for health insurance access for 2018 -- more than in the past couple years," said McLaughlin.

"The (political) back and forth is not the best way to get health care information to people," she said. "I would urge people to be proactive, to navigate the websites and talk with friends and family or a trusted local insurance broker because the help is not going to come to you."

Follow Paul Swiech on Twitter: @pg_swiech

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