Enrollment in federal health care marketplace open

Enrollment in federal health care marketplace open

People can buy or change their health insurance plans on the federal government’s marketplace now through mid-December — although this is the second year with less time for people to sign up, and with fewer resources to make sure people know they can sign up.

Open enrollment started Nov. 1 for 2019 health insurance plans on healthcare.gov and will continue through Dec. 15.

“[People] only have 45 days to get signed up,” said Chantal Fields, executive director of West Virginians for Affordable Health Care. “So we are encouraging people to sign up early. The earlier you do this, the less likely you are to forget, and the less likely you are to crash the system when everybody is attempting to do it in December.”

Fields said her organization has been trying to get the word out about open enrollment. Last year, President Donald Trump’s administration cut the marketing budget for the health insurance marketplace and cut the enrollment period by half, she said. Those cuts remain in effect.

“There’s a lot of sabotage-type things happening,” she said. “So that’s why we’re trying to do the best we can with social media and traditional media to get the word out that open enrollment is here.”

Lots of people don’t realize that the Affordable Care Act is still the “law of the land,” Fields said.

The ACA — or “Obamacare,” as it’s often known — is still in effect. But the individual mandate that forces people to get health insurance or pay a penalty is going away beginning in 2019, as part of the GOP tax bill passed late last year.

Beginning with plans next year, people who don’t have health insurance will no longer be charged a penalty on their taxes.

Fields said she’s encouraging people to who do get plans on healthcare.gov to see what plans are available before they decide. The plans change every year, she said.

“Folks that have been enrolled every year, even though you’ll automatically be re-enrolled, it’s still not a bad idea to go and look at those plans just to make sure,” Fields said. “Maybe something has changed, maybe there’s a better benefit. You might want to change your plan, so we’re encouraging people to really take a look at them.”

In West Virginia, two insurance companies are participating in the marketplace in 2019: CareSource and Highmark, said Ellen Potter, director of health policy for the West Virginia Offices of the Insurance Commissioner.

Potter said the average rate increase for Highmark marketplace customers in West Virginia is 9 percent. The average for CareSource customers on the West Virginia marketplace is 9.5.

Potter said 2019 will be the first year the marketplace has only a single-digital rate increase. The companies had requested higher rate increase than what they got, she said.

“So year six [of the Affordable Care Act], I’m glad we’re getting things to level out some,” Potter said.

Potter said she isn’t sure how much the individual mandate going away might affect rates in West Virginia in the future. Having fewer people, or only those who are aged or sick in an insurance pool, can lead to higher costs.

But Potter said about 86 percent of West Virginians who buy their plans on the marketplace qualify for income-based tax credits that lower the cost of their plans and make the cost “reasonable,” she said.

“So many people receive help already with it,” she said. “They’ve seen the benefit, and they see it’s not too expensive for them.”

People can also get one-on-one help signing up for a plan at no cost to the customer. A list of these “assisters” and “navigators” is available at the West Virginians for Affordable Health Care website, wvahc.org.

“You can actually go and sit down with a navigator, and they will help you do the sign-up, and they will also tell you if there are any … tax credits — which are based on your income — which will bring the cost of your plans down,” Fields said.

Fields has been warning people of the website’s “get contacted” button. Using that feature and filling out the form sends the customer’s contact information to insurance agents that try to sell them “short-term plans,” that don’t comply with Affordable Care Act regulations, she said.

As the name implies, short-term plans last only for a limited amount of time and limit the benefits covered. They’re designed for people who need temporary coverage between jobs or while they wait for other coverage to begin.

Fields said people can get into “trouble” buying short-term plans.

“They often have much higher premiums,” she said. “They don’t generally cover all of the things that [Affordable Care Act] plans. They don’t necessarily cover doctors’ visits or emergency care or prescriptions. They’re pretty much a catastrophic plan.”

Fields has also been warning people of a feature on the healthcare.gov site labeled “get contacted.” She said she was looking around healthcare.gov, accidentally clicked the button and sent her contact information to insurance agents.

She said she got 22 calls in two days from agents trying to sell her short-term plans.

“I cannot get them to stop calling me,” she said. “I’ve begged. I’ve pleaded, I’ve talked to these people.”

With the exception of Medicaid recipients, people have only until Dec. 15 to sign up for coverage on healthcare.gov.

“If you miss it, you won’t be able to sign up until this time next year,” she said. “You’ll have to go a year without the health care coverage.”