Health insurance open enrollment starts Wednesday

Arkansans looking to buy their own health insurance policies can renew or apply for coverage starting this week.

Open enrollment for the state’s health insurance marketplace begins Wednesday and runs through Dec. 15. People who have policies this year through the marketplace can renew or change them during that time. Those who have other coverage but want to switch to the marketplace

can jump in then as well.

The Affordable Care Act, often called Obamacare, allows for marketplaces like the one available in Arkansas. The program allows consumers to compare insurance plans from QualChoice Health Insurance, Centene and Arkansas Blue Cross and Blue Shield this year.

Customers also can apply for tax credits to help pay for coverage if their incomes are below certain levels.

More than 70,000 people in the state signed up for marketplace policies by the end of last year’s open enrollment. The number dropped to around 54,000 as of September, according to state figures.

President Donald Trump’s administration made this year’s enrollment period half as long as last year’s and has said it’s spending one-tenth of the advertising dollars to promote the event. The marketplace website also will be unavailable for several hours on most Sundays during open enrollment. Officials have said the public knows about the law and doesn’t need more time or advertising.

Trump and his fellow Republicans, including Arkansas’ Congressional delegation, attempted this year to repeal or alter much of Obamacare and other health policy in a bid to reduce federal spending on health coverage, but the law’s rules for health insurance remain and its marketplaces are still in business.

The tax penalty for lacking health insurance is also still law.

“I think a lot of people are worried they’re going to lose it,” said Deja Glover, a case manager with the 7 Hills Homeless Center in Fayetteville who helps new clients sign up for coverage. She said most people she works with have insurance these days because of Obamacare, but many of them are struggling to keep up with the repeated attempts to change the law.

“People don’t really know — even people in insurance don’t really know what’s going to happen,” Glover said.

Some plans will be more than 20 percent more expensive for 2018 than they were this year, which insurance companies said was partly because of Trump’s decision to end some Obamacare subsidies that lower out-of-pocket costs for low-income people who receive health care. The increase will mostly affect some of the most expensive plans in the marketplace.

Gov. Asa Hutchinson and other Arkansas officials have said they support proposals to restore those subsidies.

SPREADING THE WORD

Lucy Capelle, director for the Arkansas Coalition of Marshallese in Springdale, said she and three others with the coalition would be working around the clock to help people renew or sign up for coverage.

Marshall Islanders can travel and work freely in the United States but don’t qualify for Medicaid as adults. Many rely on the marketplace because of the community’s relatively low incomes and high rates of diabetes, high blood pressure and other ailments. Capelle’s friend Marina Wena, who’s in her 50s, uses the coverage for dialysis, for instance. Others use it for insulin and minor surgeries.

“The time frame is really short — it looks like we’ll be working on Saturdays,” Capelle said Thursday, adding several dozen people had made appointments. Coalition staff members will go through the necessary paperwork with individuals and families.

Capelle also gets coverage through the marketplace, though she let it lapse because she pays for Wena’s coverage and couldn’t afford her own monthly premiums. The Marshallese community tends to be tightly woven, with close bonds among extended family members and a custom of caring for elders, community leaders and members have said.

“She needed it more than I do,” Capelle said. “But I’ll try again and see if there are other plans that are more cheaper.”

Tax credits are generally available to individuals or families whose household incomes fall below 400 percent of the federal poverty line, or below roughly $80,000 for a family of three.

Those who make around the poverty line or below can qualify for Medicaid or the expanded, modified version called Arkansas Works, which stems from Obamacare. People with this coverage can change their plans during open enrollment but can sign up for the first time at any time of the year.

Other organizations will also work to spread the word during enrollment.

The Arkansas Health Insurance Marketplace, a state group that certifies the quality of the plans in the marketplace and does outreach for it, will do the same amount of advertising on social media, TV and radio as in previous years, just concentrated in a shorter time, spokeswoman Alicia McCoy said. Max Greenwood, government and media relations director for Arkansas Blue Cross and Blue Shield, said the same.

“Of course, a shorter window of time to enroll will be somewhat of a challenge, but our team is prepared to make every effort to provide the best service possible,” Greenwood wrote in an email. “We are always sensitive to how a change in process will impact consumers, but we’re optimistic that our outreach will produce positive results during this shortened enrollment period.”

The marketplace group contracts with about a dozen navigators to guide people through the sign-up process, and many health systems help patients sign up for coverage as well. Mercy Northwest Arkansas spokeswoman Jennifer Cook said the system has a team of specialists yearround to help uninsured patients enroll in the coverage they qualify for and will send notices in the mail to uninsured patients about how to sign up.

More than 70,000 people in the state signed up for marketplace policies by the end of last year’s open enrollment. The number dropped to around 54,000 as of September, according to state figures.

CHANGING DEMAND

Arkansas’ marketplace could face a heavier influx of people during enrollment this year. The state has asked for federal approval to restrict the number of people who qualify for Arkansas Works in a way that’s expected to trim about 60,000 people from its rolls. The change is meant to cut spending on the program to the level legislators originally expected when they started Arkansas Works’ predecessor in 2013. The governor last month in a statement said the program is unsustainable without the cut.

McCoy said the marketplace group expects around half to turn to the marketplace for coverage, though they should come in smaller waves of a few thousand at a time.

The need for coverage could also be higher. The number of people without insurance has fallen in recent years as Obamacare’s provisions took effect, with Arkansas’ drop one of the biggest in the country. But the national polling group Gallup and health care platform company Sharecare found this month the uninsured rate ticked back up to 12.3 percent, up 1.4 percentage points since Trump’s election.

It’s not clear if Arkansas has seen a similar rise. McCoy said the drop-off in people participating in the marketplace over the past several months has been about the same in the past few years. The Census Bureau estimates more than 200,000 Arkansans lacked insurance last year.

“We’re optimistic. We’re hoping that we’ll have a good open enrollment,” McCoy said.

Some Arkansans without employer-sponsored or taxpayer-funded health insurance still don’t use the marketplace to find coverage.

Jose Esparza, a Rogers real estate agent who works essentially as a contractor for RE/MAX, said his family’s policy is through a company called USHEALTH Group, where his brother works, because he and his husband make too much to qualify for the marketplace’s tax credits. His family has a high-deductible plan intended for expensive emergencies.

“I hope not to use it, but it’s there,” Esparza said.

He added he supports Obamacare and the help it provides lower-income people, especially for those with pre-existing health conditions that might have made insurance inaccessible before the law.

“I’m glad someone can buy it.”