Federal agency moves to shorten ACA enrollment time
NASHVILLE - The open enrollment season for individual health insurance will be significantly shorter this year under a new rule from the federal health agency.
Instead of running from Nov. 1 to Jan. 31, enrollment will span just six weeks, from Nov. 1 until Dec. 15. The change is one of several new regulations contained in a 139-page rule issued by the U.S. Department of Health and Human Services.
The change is eliciting a variety of responses from those who help people pick a plan. Some are concerned people will miss the deadline in the bustle of the holiday period, or that messaging will not be adequate to get the word out. Others are hopeful it cuts down on confusion.
“We know many consumers, particularly young, healthy consumers, have a tendency to wait until the last minute,” said Sandy Dimick, Get Covered TN program director at Family & Children’s Service. “Shortening the open enrollment by half, with a holiday within that time frame, will make it difficult for all who wish to enroll to receive in-person assistance.”
Tatum Allsep, executive director of Music Health Alliance, thinks the change is a move in the right direction. There is perennial confusion about the open enrollments for Medicare, which runs from Oct. 15 to Dec. 7, and the period for the federally run exchange. This puts the cycles closer together, although some experts said the timing will still likely lead to confusion.
The first six weeks of enrollment is the busiest time period for Music Health Alliance and other navigators. Dec. 15 has historically been the deadline for selecting a plan that starts on Jan. 1.
The shorter period will give shoppers less time to dig through the changes in insurance plans — which have been dramatic in Tennessee over the past couple of years.
Checking to make sure doctors and prescriptions are in-network is time consuming and sometimes daunting so shoppers will have to be prepared to make decisions faster. The individual health insurance options are changing more from year to year than what people see in Medicare supplement or employer-sponsored plans.
The changes from HHS range from tightening the ability to enroll in a plan throughout the year to making people pay outstanding premiums before getting new coverage to allowing insurers to define the actuarial value of coverage.
The changes don’t help with the deeper issues facing the market right now, said Jackie Shrago, who has been pivotal in the development of Tennessee’s enrollment outreach efforts.
Insurance companies and shoppers are on edge as President Donald Trump, Congress and HHS debate what to do about cost sharing reductions, a payment made to insurers to help people who make 100 to 250 percent of the federal poverty line afford deductibles and other out-of-pocket costs.
The Republicans in the House are bringing a federal lawsuit regarding the subsidies, while Trump and other federal officials have sent mixed signals about whether the cost sharing reductions will remain in place. Without the subsidy, many people would not be able to afford the out-of-pocket costs and insurers are expected to leave the exchange.
“Everything you do to make it difficult for ordinary people to register to be a part of it, you aren’t making (the exchange) work very well,” Shrago said. “The stated rule seems to be try to stabilize the market — the goal makes a lot of sense. But stabilizing the market probably has more to do with the risk pool than anything.”
Of the three insurers selling on the exchange right now in Tennessee, Humana has said it will leave next year, while BlueCross BlueShield of Tennessee and Cigna are undecided and will make decisions based on what happens in Washington, D.C.
“I’m more concerned about what’s happening right now than the 2018 exchange,” Shrago said. “If the president and Congress decide not to fund the subsidies or get rid of the cost sharing reductions, which they could do right now, people would lose (insurance) right now. Most of those people would end up in emergency rooms and many would go bankrupt. We’d be back to where we were in 2010.”