by Kaiser Health News | Updated on 12.11.18
The woman arrived at the University of South Florida’s navigator office in Tampa a few weeks ago with a 40-page document describing a short-term health insurance plan she was considering. She was uncomfortable with what the broker had said about the coverage, she told Jodi Ray, a health insurance navigator who helps people enroll in coverage, and she wanted help understanding it.
The document was confusing, according to Ray, who oversees Covering Florida, the state’s navigator program. It was hard to decipher which services would be covered.
“It was like a bunch of puzzle pieces,” she said.
Encouraged by her wife, the woman eventually opted instead for a marketplace plan with comprehensive benefits.
The annual open-enrollment period for people who buy their own insurance on the Affordable Care Act’s marketplaces ends Dec. 15 in most states. Enrollment in states that use the federal healthcare.gov platform has been sluggish this year compared to last. From Nov. 1 through Dec. 1, about 3.2 million people had chosen plans for 2019. Compared with the previous year, that’s about 400,000 fewer, or a drop of just over 11 percent.
The wider availability of short-term plans is one big change that has set this year’s apart from past sign-up periods.
Another is the elimination of the penalty for not having health insurance starting next year. The Congressional Budget Office has estimated that as many as 3 million people who buy their own coverage may give it up when they don’t face a tax penalty. But experts who have studied health insurance enrollment say that surveys so far indicate that the penalty hasn’t typically been the pivotal factor in people’s decision on whether to buy insurance.
They also caution against reading too much into the preliminary enrollment totals.
“There typically is a surge in enrollment at the end,” said Sabrina Corlette, research professor at Georgetown University’s Center on Health Insurance Reforms. “It’s hard to know whether it will make up for the shortfall.”
If they don’t pick a new plan, people who are enrolled in a 2018 marketplace plan may be automatically re-enrolled in their current plan or another one that is similar when the open-enrollment period ends. About a quarter of people who have marketplace plans are reassigned in this way.
Another factor that may be affecting enrollment is tighter federal funding for the health insurance navigators, like Jodi Ray in Tampa, who guide consumers through the complicated process. With fewer experts available to answer questions and help fill out the enrollment forms, consumers may fall through the cracks.
Across the country, funding for navigators dropped from $36 million in 2017 to $10 million this year. In Florida, federal funding for the Covering Florida navigator program was slashed to $1.25 million this year from $4.9 million last year, Ray said. The program was the only one to receive federal funding in the state this year.
The Covering Florida program reduced the number of open-enrollment navigators to 59 this year, a nearly 61 percent drop, Ray said. Navigators this year are available in only half of Florida counties; the organization is offering telephone assistance and virtual visits to people in counties where they can’t offer in-person help.
“It’s all we can do,” Ray said. So far, the group’s navigators have enrolled about half the number of people this year as they had last year.
It’s unclear the extent to which the Trump administration’s efforts to reduce health care costs by expanding access to short-term plans is affecting marketplace plan enrollment.
These plans, originally designed to cover people who expected to be out of an insurance plan for a short time, such as when they change jobs, can be less expensive. Unlike marketplace plans, short-term plans don’t have to provide comprehensive benefits or guarantee coverage for people who have preexisting medical conditions.
The Obama administration limited short-term plans to a three-month term. But in August, the federal government issued a rule that allowed their sale with initial terms of up to a year, and the option of renewal for up to three years.
Ten states either ban short-term plans or restrict them to terms of less than three months, said Sarah Lueck, a senior policy analyst at the Center on Budget and Policy Priorities.
Many people are seemingly not focused on their options this open-enrollment season, however. According to a recent survey, about half of adults under age 65 who were uninsured or who buy their own coverage said they planned to buy a plan for 2019. But only 24 percent of people in that age group said they knew what the deadline was to enroll in health insurance, according to the Kaiser Family Foundation’s November health tracking poll.
Written by Kaiser Health News
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Can anyone afford it? UNIVERSAL SINGLE PAYER HEALTHCARE SYSTEM, CRADLE TO GRAVE.
Repeal obamacare, get the government out of healthcare.
I tried to buy insurance and it was going to cost about 1/3 of my income for the year. I signed out of the marketplace. Insurance shouldn’t cost more than housing. It is so so so sad what has happened to insurance. It cost me $450 for a 10 minute appointment to an ENT. At think at the very very least, a price list should be provided for customers of doctors and I say customers not patients because insurance and doctors are a for profit business. They are only in the business to help people for a price. We need more transparency as customers of medical care. We don’t give other businesses a blank check for service. We get prices before making a purchase. We need the same for medical purchases like seeing a doctor.
Yes. We need a single payer system in this country. We are 2nd class heading to third world while All of EU and England and Canada and Australia and New Zealand and Cuba have comprehensive healthcare. Nixon's making healthcare for profit has made this country a nightmare. Along with other areas of inequality.
Universal Healthcare!!!!! Get it done!! Stop taking money from pharma and insurance lobbyists and take care of the people
The health insurance I'm being offered feels I like I would be making monthly donations to a insurance company. All the plans I'm being offered for my family are more then our rent. The plans have a high deductible, while still having to pay full price for doctor, dentist, specialist, hospital visits & full price for medicine. All because we have conditions we were born with.
We need to fix our broken healthcare system. If we don't fix it soon the Medicare for All plan will take a hold and we will be on the way to socialism. We need to keep the free market system as everyone prospers not just a select few like socialism. Not to mention we don't have the money to pay for Medicare for All as it will just cause the debt to skyrocket and World War 3 will be at our doorstep.
We should look much more closely at the Single Payer System that our President sings the praises of, repeatedly. He truly loves what Scotland has.
The GOP has voted over 70 times to end Obamacare and do away with your pre-existing condition protection. Nothing is more important than your health care. Single Payer Insurance for all. STOP VOTING AGAINST YOUR OWN INTEREST.
Get it fixed once and for all!!
Single payer, universal health care for all. Now.
Reform, yes. Make the Affordable Care Act better or introduce measures to ensure all Americans have healthcare. No more inequality between the haves and have nots when it comes to health insurance.
You Democrats need to FIX the mess you made of healthcare. You are shameful idiots that created something so bad for Americans that you owe us a fix and then resign.
Single payer/Universal Healthcare/Medicare for all is not for the US. Europe cancelled 300,000 elective surgeries last January because their hospitals were full with flu patients. Open heart surgeries have a delay of 3 months, knee scopes and replacements and scopes is a 2 year wait. When you go to have a baby you are in a Ward with 10 other women, no steak and lobster or tranquil birthing experience. Then the government will take 40% more of your paycheck (if you are a taxpayer) to pay for it.
It was the liberal socialist hypocrites Democrats (progressives) that screwed it up to begin with.
Continue progress towards truly affordable healthcare