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The Affordable Care Act has survived several repeal attempts by congressional Republicans and the Trump administration, and while it is still the law of the land, there have been changes.
Open enrollment for the ACA began on Nov. 1 and will last for only six weeks, ending Dec. 15. This is a significantly shorter duration than the 13 weeks in the last several years.
People interested in enrolling are strongly urged to sign up as early as possible to avoid last-minute problems that could result in not getting health insurance.
Enrollment is for anyone who buys individual health insurance directly from an insurance company, through an insurance agent or on healthcare.gov. The phone number for HealthCare.gov is 800-318-2596
Approximately 500,000 people in North Carolina are expected to sign up. ACA open enrollment does not apply to those who buy health insurance through their employer or through a federal program like Medicare, Medicaid or Tricare. In past years, it was possible to buy an individual health insurance policy off the ACA exchange, offering additional options for people who made too much money to qualify for subsidies, but those plans will not be available in 2018.
North Carolinians can get assistance from a N.C. health care navigator who is trained to help consumers get affordable coverage on HealthCare.gov, which is the Health Insurance Marketplace established by the Affordable Care Act.
Navigators help consumers understand the details of the plans available on the Marketplace, apply for financial assistance and complete the enrollment process. All navigator appointments are free and confidential. The website is https://ncnavigator.net/.
The following is reprinted with permission from NC Health News
Insurance Enrollment Period Starts Amid Confusion, Sense of Urgency
By Rose Hoban
Wade Patrick didn’t think he could get insurance through the Affordable Care Act exchanges this year.
“I thought it was gone; I was hearing that it was gone,” said the 56-year-old electrician who had insurance last year through Blue Cross and Blue Shield of North Carolina. “Everybody is just confused; nobody really knows.”
But on Wednesday afternoon, Patrick’s wife saw something on television about an enrollment event and encouraged him to come down to Martin Street Baptist Church in southeast Raleigh to enroll.
In prior years, the airwaves were full of advertisements such as this one
encouraging people to enroll. But the Trump administration cut funding for ads
by 90 percent this year.
Patrick needed to sign up – again – since his insurance lapsed when he missed a couple of payments after he had surgery on his left hip earlier this year.
“During recovery, it slipped my mind and it got past me,” he said. By the time he realized he’d missed payments and started paying again, he’d been cut off.
And Patrick needs surgery on the other hip, which gives him constant pain.
He doesn’t have a lot of time. This year’s enrollment period is only six weeks, compared to 13 weeks in years past. Advertising dollars have been cut to the bone and federal officials say they’re taking the insurance website offline for 12 hours every weekend “for maintenance.”
Find help enrolling for ACA insurance: The NC Navigator Consortium website has a list of enrollment events if you scroll down.
You can call 1-855-733-3711 to get an appointment.
Or use the Connector App to find someone near you to help you sign up.
Sense of urgency
“People just don’t understand the state of play right now,” said Jennifer Simmons, from the North Carolina Navigator Consortium. She recounted doing a phone bank event at Raleigh television station WRAL where more than 700 consumers called in.
“The first phone call I got was from a woman who said, ‘I have coverage, through the marketplace, I’ve got a premium tax credit and I’ve heard that it’s going away,’” Simmons said. “This is exactly what I was afraid that people are thinking.”
She said a good crowd showed up first thing Wednesday morning.
“We had a lot of consumers signed up for 10 a.m. appointments and much higher show rate than other years on the first day of enrollment,” said Simmons, who said people seemed to display a sense of urgency.
“The biggest question I got was about financial assistance and whether the ACA was still around,” said Wilma Metcalfe from Advanced Community Health Center in Raleigh. “That kind of misinformation is our biggest obstacle at this point as well as the shortened time frame.”
Certified application counselor John Curran from Advanced worked with four people throughout the day Wednesday.
“It’s always a good thing to help people get health insurance,” he said. But two of them went away empty-handed because they were unable to meet the income thresholds to qualify for financial assistance.
“That can be a little downer,” he said. “But there are resources out there for them.”
In previous years, more than 90 percent of North Carolinians signing up for insurance under the ACA qualified for financial help, and the state was a success story for getting more than a half million people to sign up for coverage.
According to health care market analyst firm Avalere Health, premiums for a silver plan in North Carolina are, on average, 16 percent more expensive than last year, but the increase was lower than the average 34 percent uptick nationwide. Nonetheless, the cost of a benchmark plan in North Carolina is $871 per month, the seventh highest premium in the country.
According to BCBSNC, the increase in North Carolina would have only been in the single digits but for the recent Trump administration decision to not reimburse insurers for the costs of co-pays and deductibles for many of the working poor.
Researcher Mark Hall from Wake Forest University wrote in an analysis published earlier this year by the Brookings Institution that North Carolina’s insurance marketplace had gradually become more competitive over the first three years of open enrollment. By the end of 2016, two national insurers – Aetna and UnitedHealthcare – were selling ACA plans in the state alongside BCBSNC.
Hall surmised that had the Affordable Care Act not been undermined by the current administration, losses sustained by insurers in the first few years of enrollment would have evaporated and the market would have stabilized further.
This year, only one other carrier – Cigna – is selling plans in the state in only five counties.
In years past, Enroll America, an organization that promoted the insurance marketplaces across the state, had corralled interested consumers and had run a website connecting insurance navigators with clients using a ZIP code-based locator.
But Enroll America’s funding ran out in the past year. Now the ZIP code app is being maintained by a DC-based grassroots organization called Young Invincibles.
“We constantly work to update the app and keep it as accurate as possible,” said Maani Stewart, with the organization. He just returned from North Carolina where he was training navigators who assist people with their healthcare.gov applications.
He estimates that consumers can reach about 100 navigators and certified assisters in North Carolina through the app.