Mark Bennett: Tis the enrollment season … ACA marketplace users face uncertainties

Ten percent of Vigo County adults under the age of 65 don’t have health insurance.

Seven percent of Vigo kids under 19 don’t have health insurance.

That’s about 4,000 adults and 1,600 kids in and around Terre Haute, based on that data from County Health Rankings and Roadmap from the University of Wisconsin Population Health Institute.

Those numbers could increase if Affordable Care Act’s enhanced subsidies — which help lower premiums for people purchasing health insurance through the ACA marketplace — are allowed to expire.

Nationwide, 4.8 million more Americans could be uninsured next year, according to a Urban Institute analysis cited by Georgetown University McCourt School of Public Policy’s Center for Children and Families.

Nationally, the enhancement of the ACA subsidies more than doubled marketplace enrollments between 2020 and 2024, according to the Georgetown report. That increase included coverage for more than one million children.

For folks who do buy insurance through the ACA (or Obamacare) marketplace, the cost could double, on average. About 24.3 million Americans enrolled in the ACA receive subsidies, according to Centers for Medicare and Medicaid Services data, cited by the Annenberg Public Policy Center’s FactCheck.org.

The enhanced subsidies took effect in 2021 during the pandemic. The American Rescue Plan Act boosted premium tax credits and extended those to people with incomes above the previous ACA threshold. The Inflation Reduction Act in 2022 extended the enhanced ACA subsidies through 2025.

Now, 2025 is almost over, and enrollment is underway for health insurance purchased through the ACA (or Obamacare) marketplace. The enrollment period runs from Nov. 1 to Jan. 15, but the deadline is Dec. 15 for coverage that would begin by Jan. 1.

The future of the enhanced ACA subsidies — and the cost of funding them — was the sticking point in Congress that sparked the 43-day government shutdown that ended Nov. 12. The subsidies weren’t renewed in the deal ending the standoff and are set to expire Dec. 31, barring a change in stance by the majority Republicans, who’ve generally opposed the ACA since its origin in 2010.

A hint of a breakthrough emerged Friday as a bipartisan foursome of U.S. House members pitched a two-year extension of the enhanced subsidies, with fraud protections to satisfy Republicans, Politico reported.

Time is elapsing, though, and this is the insurance-enrollment season through the ACA marketplace or elsewhere.

Guidance for Wabash Valley residents who’ve relied on ACA enhanced subsidies is available, including through a crew of community resource navigators at Valley Professionals Community Health Center outlets at eight locations, including three in Vigo County.

Those navigators can assist folks — free of charge — with questions about the ACA, as well as the Healthy Indiana Plan (or HIP), prescription assistance, Medicaid applications and other resources available in the community.

Valley Professionals is a FQHC (federally qualified health center) serving people with limited access to healthcare, including the low-income, uninsured or underinsured.

“We can look at all the available plans and show you what the options are,” said Aaron Evola, community resources manager for Valley Professionals. The nonprofit agency “is happy to work with anybody in the community,” he added.

The prime concern is the unknown for many folks covered through ACA marketplace insurance.

“They’re worried about what 2026 is going to look like,” Evola said.

“There’s a lot of uncertainty right now,” he said.

Evola has worked in social services for 20 years. Charlotte Fulk, a Valley Professionals community resources navigator, is in her 24th year of social service work. “Right now seems like the most uncertain time” in her career, Fulk said.

Anxieties are common for Wabash Valley residents seeking answers. “People are coming in really nervous,” Fulk said.

Evola suggests seeking guidance on those questions early.

Among the additional outlets providing ACA marketplace guidance is Covering Kids and Families of Indiana. The organization helps any Indiana resident to apply for and understand healthcare coverage programs, but doesn’t steer people to any particular insurer, explained Susan Jo Thomas, CKF’s executive director.

She sees lots of households having “kitchen-table discussions” about healthcare and insurance right now. Thomas urges people not to despair and to look for other options. Even with the likelihood of higher premiums through the marketplace or having to accept lesser coverage because of costs, that likelihood shouldn’t dissuade people from checking prices.

“What is the harm in going onto the marketplace and shopping?” Thomas said by phone last week.

Thomas also offered reminders about additional resources, including guidance through Seniors Health Insurance Program counselors in Terre Haute for the 65-and-over crowd, as well as disabled folks; the previously mentioned navigators; and local healthcare professionals. Help remains available for people facing decisions, Thomas emphasized.

“What I hope they do is make reasoned choices,” she said.

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