Not Repealed, Not Replaced - Open Enrollment For 'Obamacare' Begins November 1

Oct 27, 2017

Although votes to repeal and replace "Obamacare” have come and gone, the Affordable Care Act is still the law of the land, and open enrollment begins on Wednesday, November 1. 

This may be one of the few places you hear about the open enrollment period this year. That’s because the budget for advertising the plans available on HealthCare.gov has been cut nationally by 90 percent. That’s not the only change from past years. The enrollment period has been cut in half to only six weeks in the 42 states, including Florida, that have not established their own health insurance exchange. That means you only have until December 15 to sign up for health insurance this year. "The open enrollment used to be anywhere from [the first of] November through the end of January which would give us a full three months to enroll those people and that's been literally cut in half" said Cory Brown, the Benefits Program Manager at 90 Works and a health care navigator. Brown says they anticipate being extra busy this year and not only because of the shorter enrollment period. "[The navigators at 90 Works are] grant funded through the University of South Florida [and] we just received our grant and we have had budget cuts."

Brown says the cuts have cost them one full time navigator for this enrollment period. The University of South Florida had their grant cut by 15 percent. The other navigators in the Panhandle operate through the Epilepsy Foundation of Florida. Their funding grant was cut by over 58 percent this year. Cecily Chunderlek, the Epilepsy Foundations Regional manager for the navigator program says "We are grateful for doing this work again, but the cuts do hurt. Cuts mean non-profit sector jobs are lost. We've had to let hard working, dedicated people go. And cuts mean we'll help [fewer] people get coverage". 

Chunderlek says they will be doing all they can to stretch the dollars they do have. "We're going to be more creative with our vastly [reduced] resources. We're going to need stronger partnerships with other agencies, with other community organizations and health providers, and we're going to have to go deeper into where people are in their daily lives." Chuderlek says thy will be approaching local business leaders to try and sign up people for health insurance on site. She also says they will be doing a little multitasking. "November is also Epilepsy Awareness Month, so we're going to combine our awareness events with awareness events for open enrollment." And just a reminder that everyone can use the navigators from the Epilepsy Foundation, not just customers with epilepsy.

Prices for 2018 health insurance plans will be rising, but those increases will be offset by increases in tax credits from the government, meaning customers who qualify for tax credits and subsidies will see out of pocket expenses remain close to the same. But there have been some actions taken by the White House that has caused some late confusion about pricing and subsidies. The first was a decision by the president to stop making CSR, or Cost Sharing Reduction payments to insurance companies. Those cost sharing reductions have been attacked by the administration has a “bail-out” for insurance companies. "The reality is it's a subsidy for lower income individuals that purchase coverage on the exchange" said Todd Torgersen, the President of Combined Insurance Services in Pensacola. "So if your income is at a certain level, then not only would you qualify for a premium subsidy, but you would also qualify for a cost sharing reduction. So, the way that would work is that if the plan that you qualify for would normally have a $2,000 deductible, the deductible might be reduced to zero or $200, something like that." Under the Affordable Care Act, the insurance companies are required to offer those saving to customers. The executive order prevents the companies getting reimbursed, turning the CSRs into an unfunded mandate.

There was also another executive order concerning Association Health Plans. These are plans that let groups like a car dealers association for example to band together and negotiate for better insurance rates. It also allows purchasing health insurance across state lines. Todd Torgersen says that can be problematic. "For example, in Florida we have a wide range of mandated benefits that, on one end some people say might be expensive, but on the other end people say offer certain protections. And if you go to another state that has fewer mandates then, sure, the insurance premiums may be cheaper, but your insurance coverage would not be as comprehensive. And my experience with this is that a lot of the population does not pay much attention to what is covered until [they need the coverage]. Kind of like homeowners insurance after a hurricane."

There are other changes in those executive orders that get into the weeds of the insurance industry, and there is legislation being debated to shore up and/or tear down other parts of the ACA. We’ll just have to wait and see what happens from here. There is one part of the law that has not changed: everyone is still required to have health insurance or pay a tax penalty of $695 for each uninsured adult and half of that for each uninsured child in the household, or 2.5 percent of the household income, whichever figure is greater. The IRS recently announced that they will no longer accept tax returns that do not have the filer’s health insurance information filled in, whether they have health insurance or not. 

You can contact Cory Brown at 90 Works at 855-90WORKS Extension 5

You can contact Cecily Chunderlek at the Epilepsy Foundation of Florida at 850-433-1395