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More Texans May be Left Without Health Insurance After End of Open Enrollment

Open enrollment for health care under former President Barack Obama’s health care law ends Dec. 15, and while current Texas enrollment numbers are up from this time last year, new restrictions under the Trump administration may mean more uninsured Texans.

Under the Affordable Care Act, individuals who are not insured through an employer can buy plans through the federal government during the open enrollment period. In 2016, that period ran from Nov. 1 to Jan. 31 — but this year, it’s been cut in half to end Friday, Dec. 15.

While several states opted to extend the enrollment period, Texas, which runs its services through the federal healthcare.gov webpage, did not.

Texas has seen 437,919 enrollees for the 2018 plan year as of Dec. 2, according to the Centers for Medicare and Medicaid Services — a 38.8 percent increase in enrollment when compared to this time last year. But that’s not much of a comfort to organizations trying to get more people enrolled.

“We only have half as much time to enroll people,” said Melissa McChesney, an outreach coordinator at the Center for Public Policy Priorities, a left-leaning think tank. “So we would have to be doing significantly better than we are right now in order to avoid a dip in enrollment numbers overall.”

“There is concern that we will see fewer Texans enroll in the marketplace, and that’s primarily because of the shortened enrollment period, and that does mean we are likely to see a higher number of uninsured Texans for 2018,” McChesney added.

Last year, a total of 1.2 million Texans bought insurance during the enrollment period, about one-sixth of whom were automatically enrolled after not changing their coverage from the previous year, McChesney said.

Karen Pollitz, a senior fellow at the Kaiser Family Foundation, a health care nonprofit, said that in previous years enrollment has surged just before Dec. 15.

“Most people last year, in all the states, signed up by Dec. 15 even though open enrollment went all the way until the end of January because if you want coverage to begin on Jan. 1, that was the deadline,” Pollitz said.

However, shortening the window to enroll is not the only cut made by the Trump administration affecting Texans trying to buy health insurance.

The administration cut the budget for outreach and advertising by 90 percent and slashed funding to the navigator program, in which someone walks potential buyers through the process, by 60 percent. Supporters of the Affordable Care Act said these cuts have led to a decrease in awareness about the enrollment period.

Drew White, a health care policy expert at the conservative Texas Public Policy Foundation, said these restrictions were the administration’s attempts to roll back aspects of the law within their power.

“We don’t believe there is a whole lot they can do,” White said, referring to the president’s executive powers. “Congress is going to have to be the one to repeal the statutes when it comes to the regulations or to roll back the Medicaid expansion, that’s just going to be out of their purview.”

“Congress should have made good on its promise and repealed Obamacare this year as they have been promising for seven, eight years prior to that,” White said. “It’s just unfortunate because consumers are going to see their premiums and deductibles go up with fewer and fewer options as long as federal insurance regulations remain in statute.”

While it hasn’t been heavily publicized, Pollitz said there will be a special enrollment period through the end of December for people who are living in or have moved out of hurricane-affected areas. People wishing to enroll during this period will have to do so over the phone, she added.

“I think everybody, CMS [Centers for Medicare and Medicaid Services], the navigators, the other people who help folks sign up really, really want the message to be, ‘Sign up by Dec. 15. That is the best way to do it,’” Pollitz said. “Some people will need more time, or miss it, and will have this opportunity.”

In Congress, Republicans are promising to pass a new tax code by Christmas, and the current U.S. Senate plan includes a repeal of the portion of the ACA that requires all individuals to have health insurance.

The Congressional Budget Office, a nonpartisan congressional analysis organization, estimates that if the individual mandate is repealed, 13 million Americans will lose their health insurance in the next 10 years and that plans will have higher premiums as younger, healthier individuals opt to go without coverage.

McChesney said even if it’s repealed, the individual mandate would still be in effect until 2019.

“It’s important that people understand, who are considering purchasing ACA insurance right now, that they are still subject to the mandate and could potentially face a tax penalty if they go uninsured in 2018,” she said.

Disclosure: The Center for Public Policy Priorities, Kaiser Family Foundation and Texas Public Policy Foundation have been financial supporters of The Texas Tribune. A complete list of Tribune donors and sponsors is available here.

Read related Tribune coverage:

  • Texas is pushing the federal government for temporary funding for the Children’s Health Insurance Program while Congress fights over a permanent solution. [Full story]
  • Open enrollment for health insurance, which begins Nov. 1, will be shorter this year, and President Donald Trump has slashed funding for subsidies and outreach. [Full story]
  • Watch the video of our event in Houston on the health care landscape following Hurricane Harvey, or check out our recap below. [Full story]

Author: CLAIRE ALLBRIGHT – The Texas Tribune

Texas Residents Could Receive more Federal Aid to pay for Costly Health Plans

Texans signing up this year for health insurance under the federal Affordable Care Act may see higher costs but should also qualify for larger subsidies.

As Texas consumers prepare for the fourth open enrollment to sign-up for or renew health insurance coverage under the federal Affordable Care Act, they face rising costs but could also receive more financial assistance.

Beginning Nov. 1, Texas residents can go to Healthcare.gov, the federal health exchange website, to sign up for health plans available in their area. But the sign-up period comes after several health insurers — including Aetna, UnitedHealthcare, Scott and White and insurance start-up Oscar — have called it quits on the federal website. Texas consumers’ monthly health insurance bills could rise an average 25 percent, according to a federal Department of Health and Human Services report.

While Texas state leaders and legislators have relished not promoting anything related to President Barack Obama’s 2010 health law, 1.3 million residents signed up for coverage in 2016. The federal law requires everyone to have health insurance whether through the federal or state health exchange websites or through an employer, with some people qualifying for tax credits to help cover the cost. Those who forgo insurance face tax penalties in the spring.

Jamie Dudensing, CEO for the Texas Association of Health Plans, said the reason “health insurance premiums are expensive is because health care is expensive.” She said medical care from, drug prices to freestanding emergency rooms, is becoming more costly and consumers are feeling the brunt. Insurance companies have built pricing tools to help people understand what they are paying for.

Among Texas insurance policyholders, 74 percent could buy a plan for $75 or less per month after receiving a subsidy, while 80 percent could buy a plan for $100 or less after receiving financial help from the government, according to the HHS report.

“We are concerned about prices, but we’re not panicked about what’s happening because health insurance is available and it’s good coverage,” Dudensing said.

For insurers, a big concern is how people hop on and off plans throughout the year. Dudensing said uninsured people will sometimes become sick, get health insurance and cancel once they feel better. She said those tactics “completely negate” the point of health insurance and can affect prices.

But news reports over rising premiums and health insurance companies opting out of offering coverage in certain areas “shakes people out of complacency” to get more information, says Mimi Garcia, Texas director for Enroll America, a national organization that helps with sign-up efforts. She said some Texas navigators — trained people who help answer insurance application questions — have been receiving calls since September about the upcoming open enrollment, a sign that consumers are “actively engaged in their health coverage.”

Garcia also pointed out that while premiums are going up, consumers can expect more subsidies to help offset the cost. Eighty-four percent

of Texans who bought a health insurance plan in 2016 received tax credits, with the average amount being $257 per month. Texans paid an average of $87 per month after subsidies. But some residents make too much money to qualify for subsidy help, a key point from Republican lawmakers that has troubled the Obama administration.

“The important thing is subsidies are going up as well so we’re really encouraging everybody to talk with an in-person assister to find out what plans there are,” Garcia said. “It’s about their own personal situation, and the vast majority of people in the marketplace, particularly those in Texas, are getting help.”

Read related Tribune coverage:

Disclosure: The Texas Association of Health Plans has been a financial supporter of The Texas Tribune. A complete list of Tribune donors and sponsors can be viewed here

Author:  MARISSA EVANS – The Texas Tribune

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