Health enrollment begins Wednesday

ST. PAUL, Minn. — The Trump administration’s Affordable Care Act efforts have health care advocates and insurers concerned that the open enrollment period will be one of chaos and confusion.

But, a dozen states operate their own health insurance marketplaces, maintaining control over advertising and the help they can offer consumers. That will create a striking difference when open enrollment begins Wednesday between those states and the others that rely on the federal marketplace, essentially creating a tale of two countries.

For the individual health insurance market in much of the country, the Trump administration has slashed spending on advertising by 90 percent and drastically reduced budgets for the groups that help consumers choose a plan.

It cut the open enrollment period in half, to six weeks. Shortening the sign-up window further, the federal government will shut down its online marketplace, healthcare.gov, for 12 hours of maintenance nearly every Sunday during open enrollment.

The 12 states with their own exchanges are free to chart their own course and make it easier on consumers.

Nine have extended open enrollment beyond Dec. 15 — by a week in some states and six weeks in others.

New Mexico’s exchange deadline is Dec. 15.

They can also make their own decisions about spending because their budgets are free from Washington politics. State-run exchanges typically pay for their operations through fees charged to insurers on plans sold through their marketplace.

Minnesota, Colorado and Washington will continue heavy advertising for their exchanges.