Uncertainty reigns ahead of sign-up time

DES MOINES, IOWA» Jason Sanford has heard so many rumors about the changing health care landscape that every few weeks he dials a local information desk, seeking a rough estimate of what his diabetes medication will soon cost him.

The answer is the same every time: It’s too early to say, even with the next open enrollment period under the Affordable Care Act beginning in two weeks.

“It’s just hearsay,” said the 55year-old sales representative from Davenport.

After several failed attempts in Congress to repeal and replace the 2010 health care law, Americans across the country are grappling with unanswered questions about how Obamacare will function during the six-week sign-up period beginning Nov. 1.

The authors of a bipartisan plan to calm health insurance markets said Wednesday they’ll push their proposal forward, even as President Donald Trump’s stance ricocheted from supportive to disdainful to arm’s-length and the plan’s fate teetered.

“If something can happen, that’s fine,” Trump told reporters at the White House. “But I won’t do anything to enrich the insurance companies because right now the insurance companies are being enriched. They’ve been enriched by Obamacare like nothing anybody has ever seen before.”

The agreement by Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., on a two-year extension of federal subsidies to insurers that Trump has blocked gained an important new foe. The anti-abortion National Right to Life said it opposed the measure because it lacked language barring people from using their federally subsidized coverage to buy policies covering abortion, said Jennifer Popik, the group’s top lobbyist.

Overall, it was a bad day for the bipartisan accord, with several Republicans conceding that it likely needed Trump’s backing to survive.

“Without the president supporting it, I don’t think you have the votes in the House or the Senate,” No. 3 Senate GOP leader John Thune of South Dakota told reporters, adding, “We’re stalled out.”

Adding to the confusion, 19 state attorneys general are asking a federal judge in California to force the Trump administration to make health care subsidy payments that the president abruptly cut off last week.

The monthly payments were scheduled to go out Friday. The states filed a request Wednesday for an emergency court order requiring that they be paid on schedule.

California Attorney General Xavier Becerra is leading the effort. He says Trump is trying to sabotage the Obama health care law.

Trump announced last week that his administration will cut off payments to insurance companies that allow for lower consumer costs under the Affordable Care Act.

All this has done little to alleviate the average American’s uncertainty that has mounted in recent days amid Trump’s push to allow the purchase of skimpier insurance plans than the ACA requires and a move by the president to cut off those federal payments that help keep consumer costs down. Critics say such moves could lead to premiums that are too expensive for individuals with high-cost medical needs.

Without federal payments, insurers would likely boost premiums by an average 20 percent, the nonpartisan Congressional Budget Office has projected.

Gail Orcutt, of the Des Moines suburb of Pleasant Hill, receives costly chemotherapy for lung cancer. Because she doesn’t know what her costs will be next year, she is considering putting off some periodic scans that help detect if her disease is spreading.

“I just might need to skip those until I’m on Medicare,” said the 64-year-old retired elementary school teacher, who will be eligible in May for the national health program for older Americans.

Reyma McCoy McDeid hears concerns like Orcutt’s almost every morning when she listens to voicemails from strangers who have called into the Central Iowa Center for Independent Living, a disabled-services center where she is executive director.

She tries to provide as much information as she can — which often is little more than the callers already know.

“I listen,” she said. “I think that’s something that people are needing right now. I think a lot of people are overwhelmed. Health care is an extremely important part of being alive, and people are feeling really vulnerable.”

Jennifer Busch, who typically answers Jason Sanford’s calls about his diabetes, is one of a small number of federally funded “navigators” in Iowa whose job is to help people enroll in the insurance marketplace. For now, she offers only general answers because she hasn’t received word from the state on what will happen during open enrollment.

“It’s difficult to reassure people because I don’t know what the picture looks like either,” said Busch, who works for Genesis Health System.

Meanwhile, Sanford is waiting. He said he pays about $350 a month for insurance under the ACA and has seen unverified estimates his bill could soon double.

“My health is the most personal thing in my life, and with the help of the ACA, I was able to manage it,” he said. “Now I have a big question mark.”