Stable premiums, more options as Obamacare 2019 enrollment opens

People have 6 weeks to sign up for insurance under Affordable Care Act


JACKSONVILLE, Fla. – The Affordable Care Act's sixth sign-up season opens Thursday amid stabilizing premiums and more choices for consumers. People have until Dec. 15 to enroll.

Nationally, some premiums are actually lower and consumers will have more options. In Florida, the state's largest insurer, Florida Blue, requested an increase of less than half of one percent. Other insurers requested larger increases, but the average hike is 5 percent.

Last year, experts said eight of 10 people in the ACA marketplace qualified for subsidies and found plans for $75 per month or less.

"Even if you love your plan and the price that you're currently paying, prices do change," said Joshua Peck, former Health and Human Services official in former President Barack Obama's administration. "So by going back to the marketplace, you may find a better plan or a plan that's cheaper that better meets your needs." 

A year ago, it wasn't even clear Obama's signature program would survive repeated efforts by President Donald Trump and Republicans to repeal it. Amid the uncertainty, Florida had 1.7 million people insured through the ACA marketplace -- the highest enrollment of any state in the nation.

This year, so-called Obamacare is still with us and health care ranks among voters' top concerns going into next week's midterm elections.

There have been changes. It might be more difficult finding help in enrolling after the Trump administration sharply scaled back funding for sign-up counselors known as "navigators." Even so, independent community groups still guide consumers through the paperwork.

And in a change that takes effect Jan. 1, those who decide to opt out of health insurance won't be penalized come tax time.

Consumers have until Dec. 15 to sign up through HealthCare.gov.

Mike Hewitt plans to re-enroll. "God bless Obamacare," said the self-employed remodeling contractor.

The first year he signed up under the ACA, Hewitt fell off a roof he was working on, shattering his left heel and tearing an arm muscle. "It allowed me to get good health insurance to fix my body," said Hewitt, who's in his 50s. He believes the coverage has been worth the $290 he pays monthly in premiums.

Income-based tax credits to help pay premiums remain available. The HealthCare.gov website and call center will be up and running. Coverage is available even if you don't qualify for financial help, but many cannot afford to pay full freight and self-pay customers have left the market in droves.

 The 2019 sign-up season begins days before Tuesday's midterm elections when voters will determine control of Congress.

Democrats have made preserving the ACA's protections for pre-existing medical conditions a major issue. Trump and Republicans have been hitting hard against Sen. Bernie Sanders' "Medicare for All" plan, saying Democrats are out to destroy Medicare. Republicans haven't backed off their vow to repeal "Obamacare."

After repeal failed last year, the Trump administration and GOP-led Congress continued to chip away, making changes that could lead to fewer people enrolling. If younger, healthier people stay out of the market, it will increase taxpayers' cost of covering those who remain.

Among the major changes:

  • Repeal of the unpopular requirement that Americans get health insurance or risk fines, gone as of Jan. 1. Experts agree that will reduce enrollment, but differ by how much. Some argue that the so-called "individual mandate" was never very effective, since the Obama administration issued numerous exemptions, and the Trump administration added more. "This is not the death blow for the market that was thought," said Chris Sloan of the consulting firm Avalere Health.
  • Greater availability of short-term health plans in most states. The Trump administration is allowing such plans to cover up to 364 days, and renewals up to 36 months. Premiums are much lower than for ACA plans, but pre-existing conditions are excluded and plans don't have to cover basics like prescription drugs. "It's uncertain how popular these cheaper and more bare-bones plans will be among the healthy people who will qualify for them," said Larry Levitt of the nonpartisan Kaiser Family Foundation.
  • Expansion of "association health plans" for small businesses and sole proprietors. These plans, which can be sold across state lines, are broadly similar to employer insurance. But it takes time to set up provider networks, and to gain approval from state regulators. It's unclear how widely available they'll be.

A new Kaiser Foundation study estimates that if not for the changes by Trump and Congress, premiums would have been substantially lower next year. Standard "silver" plans will cost about 16 percent more than they would have otherwise, the analysis found.

But no one is predicting "Obamacare" will collapse, as Trump repeatedly did last year.

"It will shrink maybe a little bit, but it doesn't fall off a cliff," said Standard & Poor's analyst Deep Banerjee.

About 11.8 million people signed up during last year's open enrollment, only about 3 percent fewer than the final season under Obama. It was a surprising result, and experts saw it as evidence of the program's value to consumers.

Although federal funding for the sign-up season has been slashed, independent groups are trying to get the message out.

At Foundation Communities, an Austin nonprofit that serves low-income workers, calls and emails have already been going out to clients with reminders about open enrollment. Kori Hattemer, director of financial programs, said the goal is to help enroll 5,000 people. The center had the same target for this year and exceeded it.

"There's a lot of confusion around whether the Affordable Care Act still exists," said Hattemer. "We're making sure people know financial help is available. There's just lots of mixed messages out there."

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