Health in­sur­ance signups drop as dead­line looms

The Hazleton Standard-Speaker - - STATE - BY SARAH GANTZ PHILLY.COM

En­roll­ment in the Af­ford­able Care Act mar­ket­places is down na­tion­ally, in­clud­ing in Penn­syl­va­nia, com­pared to this time last year, and time is run­ning out to sign up.

The dead­line to en­roll in cov­er­age for 2019 is Dec. 15.

The fi­nal weeks of en­roll­ment are no­to­ri­ously busy 2018 — last year, more than two-thirds of peo­ple who bought ACA mar­ket­place health plans in Penn­syl­va­nia signed up in the last two weeks. But ac­cord­ing to a new poll by the Kaiser Fam­ily Foun­da­tion, 70 per­cent of peo­ple don’t know when the dead­line to en­roll is.

In the fi­nal stretch, Penn­syl­va­nia In­sur­ance Com­mis­sioner Jes­sica Alt­man said her depart­ment will be im­plor­ing peo­ple to log on to health­ or seek out an in-per­son nav­i­ga­tor to get help sign­ing up.

As of Dec. 1, 123,918 Penn­syl­va­nia res­i­dents had signed up for cov­er­age through the ACA mar­ket­place, down 23 per­cent from the same point last year.

Na­tion­ally, just un­der 3.2 mil­lion peo­ple in the 39 states that use the health­ plat­form have bought ACA health plans, down 11 per­cent from the same time last year.

Re­cent ef­forts by Repub­li­cans and the Trump ad­min­is­tra­tion to undo key as­pects of the Af­ford­able Care Act may be partly to blame, Alt­man said.

Be­gin­ning in 2019, peo­ple who do not buy in­sur­ance will no longer pay a tax penalty. At the same time, the Trump ad­min­is­tra­tion loos­ened re­stric­tions on short­term health plans, which are much cheaper than the mar­ket­place plans be­cause they can deny cov­er­age for ser­vices such as ma­ter­nity care, pre­scrip­tion ben­e­fits, and pre-ex­ist­ing con­di­tions.

Peo­ple feel­ing pinched by high in­sur­ance prices may in­stead opt for a cheaper plan or skip cov­er­age en­tirely. Oth­ers may have gained in­sur­ance through an em­ployer, Alt­man said.

“Fe­bru­ary, March, April is when we’re go­ing to start to see ... what the im­pact is,” she said. “That’s when we start to get the calls from con­sumers who missed open en­roll­ment and have a health care need or signed up for a short-term plan and are re­al­iz­ing their pre-ex­ist­ing con­di­tion isn’t cov­ered at all.”

Shop­ping for health in­sur­ance is al­ways daunt­ing, but could be even tougher this year. Pre­mi­ums for 2019 plans are de­clin­ing com­pared to 2018, but many con­sumers in Philadel­phia, Bucks and Mont­gomery coun­ties are find­ing they will have to pay more to keep the same plan.

That’s be­cause with a new com­peti­tor in those coun­ties of­fer­ing lower-cost plans, tax sub­si­dies are also go­ing down.

“Fewer peo­ple are say­ing on the spot, ‘I def­i­nitely want to en­roll.’ More peo­ple are go­ing home, think­ing about how it fits into their bud­get and fig­ur­ing out what they want to do,” said An­toinette Kraus, di­rec­tor of Penn­syl­va­nia Health Ac­cess Net­work, an or­ga­ni­za­tion that helps peo­ple en­roll in cov­er­age.

Dif­fi­cult de­ci­sion

Per­sonal cir­cum­stances also can make this de­ci­sion dif­fi­cult.

Jessy Foster, an en­roll­ment spe­cial­ist with Penn­syl­va­nia Health Ac­cess Net­work, sat down in early De­cem­ber with a 62-year-old ad­junct pro­fes­sor who en­joyed a $0 de­ductible this year be­cause he qual­i­fied for an in­come-based tax credit. The Philadel­phia man will have to pay $388 a month next year to keep the same plan.

He could have switched to a lower-pre­mium plan, but the plan has a de­ductible of al­most $7,000, which would have hit him hard be­cause he takes sev­eral med­i­ca­tions.

“We fig­ured out the math, and it made more sense to opt for (the $0 de­ductible plan). It can be tricky if you don’t know what you’re look­ing for,” Foster said.

He was lucky enough to get to see an ACA ex­pert who could help him fig­ure all that out. Fund­ing for nav­i­ga­tor groups has been dec­i­mated un­der the Trump ad­min­is­tra­tion, which has also slashed the en­roll­ment pe­riod from three months to six weeks.

Penn­syl­va­nia Health Ac­cess Net­work didn’t re­ceive any fed­eral grants this year. The group has cob­bled to­gether about $75,000 in do­na­tions to keep three en­roll­ment spe­cial­ists work­ing in Philadel­phia, plus two oth­ers else­where in the state.

De­spite the chal­lenges, Alt­man urges con­sumers to get go­ing now to check out the health­ web­site and seek nav­i­ga­tor help if needed.


Jessy Foster, an en­roll­ment spe­cial­ist, meets with a client at an en­roll­ment cen­ter in Philadel­phia last month.

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