ACA open enrollment period nears

The Affordable Care Act’s open enrollment period, the only time of the year when most people are able to purchase health insurance through the legislation’s exchanges, starts on Wednesday. The period ends on Dec. 15.

Between significant hikes in premiums, a shorter period during which people can purchase plans and decreased funding for so-called “navigators” who educate consumers about various plans, the health insurance landscape looks far different this year than it did last — leading some people like Lance Courtright, an insurance agent in Woodstock, to believe that fewer people will receive health insurance through the Affordable Care Act than in the past.

“I think that’s inevitable,” Courtright said. “There’s going to be a number of people who are going to fall through the cracks who will not be able to afford the new rates.”

Premiums for the individual marketplace plans of Anthem, which is the only insurer in Shenandoah and Frederick counties and Winchester, will rise by an average of more than 56 percent, according to their final September rate filing. Cigna, which is the only insurer in Warren County, is set to increase its premiums by around 51 percent on average.

But Dan Sullivan, health care navigator for Blue Ridge Legal Services, isn’t convinced that enrollment numbers will drop.

“I think that enrollment will probably remain about the same, because most people are satisfied with their policies,” Sullivan said.

Sullivan also pointed out that the federal government will be paying for most of the premium hikes. Federal subsidies will be increasing alongside the premiums, meaning that people who are eligible for those subsidies will not be heavily impacted by the rising premiums.

“For the guy that’s signing up for the insurance, they’re not going to notice much of a change from last year,” Sullivan said.

But that will still leave a significant minority of people who are not eligible for the subsidies having to pay around $150 per month more on health insurance than they currently pay.

“[Premiums are] going to be very, very high for anybody who doesn’t qualify for a subsidy,” Courtright said.

Still, Sullivan said he is less worried about increases in premiums than he is by healthcare news from Washington over the last year.  In the past year, Republicans in Congress have tried and failed to pass a major piece of healthcare legislation.

Meanwhile, President Trump recently announced that he would cut cost-sharing reduction reimbursements to insurers. Insurers are required to pay cost-sharing reductions to lower copays, deductibles and other costs to low-income individuals who receive their insurance through the Affordable Care Act.

A bipartisan group of senators has been working on legislation that would guarantee funding for those payments, but it is not clear whether or not Trump would support such a law.

All of that action in Congress, Sullivan said, could be leaving potential consumers in a state of confusion.

“What I’m more concerned about is the confusion that’s been created based on the changes” in the healthcare landscape since last year, Sullivan said.

The Centers for Medicare and Medicaid Services is also cutting funding for the health care navigator program that funds educational efforts like the one Sullivan is involved with down to $10 million next year — one-tenth of what it was last year.

Sullivan said that this will affect Blue Ridge Legal Services, which receives the federal funds and which educates people in the Shenandoah Valley Region about various Affordable Care Act Plans.

“It has reduced the number of positions that are available and has also affected the period of employment for Affordable Care Act navigators,” Sullivan said.

But Sullivan said that despite a reduction of funds, Blue Ridge Legal Services is going to try to maintain the organization’s outreach efforts during the open enrollment period.

The biggest impact to consumers, he said, will come for people who lose their jobs, get married or have another major change in their lives, like moving to another state, that could affect what insurance they are eligible to receive. Those are the only people who can purchase insurance through the Affordable Care Act outside the open enrollment period.

With fewer resources, Sullivan said Blue Ridge Legal Services will have fewer people employed to help those consumers navigate complicated health insurance policies.