If a competitive health insurance market and stable premiums were all that mattered, local health care advocates say, then open enrollment that begins Friday for 2020 coverage under the Affordable Care Act would be smooth sailing.
But scant federal promotion of the six-week sign-up period is once again fueling concerns that some people will miss a chance to obtain health insurance simply because they're unaware of it.
In addition, an appeals court ruling in a major, Texas-led legal challenge to the Affordable Care Act -- also known as Obamacare -- is expected any day, meaning it could come on the eve of open enrollment that runs through Dec. 15, or during the middle of it.
"Once the decision comes out, that will probably have a dampening effect" on enrollment if the appeals court rules that the Affordable Care Act is unconstitutional, said Kori Hattemer, a health care advocate with local nonprofit Foundation Communities. "People may see the headline and think it's gone."
But Hattemer and others said consumers who want Affordable Care Act coverage for the coming year should sign up regardless of how the court rules. That's because the decision is expected to be put on hold pending an appeal by the losing side to the U.S. Supreme Court, so neither the upcoming enrollment period nor the 2020 insurance plans will be affected.
The United Way for Greater Austin, with backing from Travis County's taxpayer-supported health agency Central Health, is providing a call center for information and assistance during the upcoming enrollment period for people who want coverage. To access the service, area residents can dial 211 on their telephones.
A federal judge in Fort Worth ruled last December that the Affordable Care Act is unconstitutional in its entirety, siding in favor of a Texas-led coalition of 20 states that sued to overturn the law, a signature achievement of former President Barack Obama and a prime target of conservative foes ever since. A coalition of states that support the law, led by California, appealed.
Texas Gov. Greg Abbott, a long-time critic of the Affordable Care Act, said at the time of the initial ruling last December that Texas -- which has the highest rate of uninsured people in the country -- "will be ready with replacement health care insurance" if the law ultimately is thrown out.
But he and other leaders of Republican-controlled state government did little during this year's session of the Texas Legislature to address the issue. Abbott spokesman John Wittman didn't respond to a recent question from the American-Statesman regarding the governor's plans if the Affordable Care Act is overturned.
About 1.09 million Texans enrolled for 2019 coverage on the federal HealthCare.gov marketplace created by the Affordable Care Act, including a total of about 85,000 in Travis, Williamson, Hays, Bastrop, Caldwell and Burnet counties, according to the federal Centers for Medicare and Medicaid Services. Enrollment in Travis County came in at 53,309, while Williamson County sign-ups totaled 19,447.
Local health care advocates say they're optimistic heading into the open enrollment period for 2020.
"The marketplace for Austin is looking really good," said Hattemer, who is in charge of financial programs for Foundation Communities. "Everything we are doing on outreach right now is just to say: Here are the facts. It's all good news right now. The marketplace in Texas is stable (and) pre-existing protections still exist."
The same four insurance companies that offered plans in the region last year on the HealthCare.gov marketplace are expected to do so again this year. They include Blue Cross Blue Shield of Texas, Ambetter, Oscar Health and Sendero, a nonprofit offshoot of Travis County's Central Health agency.
In addition, an unsubsidized family of four in Travis County opting for the lowest-cost available coverage will pay an average of about 1% less in 2020 than in 2019, or $995 a month compared to $1,002, according to a recent analysis of local plans by the Centers for Medicare and Medicaid Services. Federal subsidies reduce those amounts significantly for consumers eligible to receive them, although people who aren't eligible for subsidies pay the full price.
"We are looking for it to be a pretty strong year," Sendero chief executive Wesley Durkalski said. "Hopefully, we'll do a little bit better" than last year, when Sendero, which offers plans in Travis and seven surrounding counties, had about 14,000 enrollees.
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