It’s a turbulent time for insurers and patients taking part in Affordable Care Act programs, but some experts see a silver lining.
Even in a year when the enrollment window is shorter and federal subsidies appear to be in jeopardy, officials and observers say some consumers may be able to find less expensive coverage this year.
Enrollment began Wednesday, Nov. 1 and runs through Dec. 15 for coverage that starts Jan. 1, 2018.
Below are some of the key things to know as the enrollment period gets underway.
Do your homework
Even before the enrollment period opened, the Trump administration announced this summer that it would be cutting the federal ACA advertising budget by 90 percent, Bloomberg reported, as well as “reducing spending on groups that help customers find the appropriate insurance plan.”
That means it is even more imperative for consumers to seek out information and understand the options.
Some insurers — like this one in New York — have stepped up their advertising.
States, including Pennsylvania, also are doing more to make sure consumers know where to turn for information.
The state Insurance Department created a list of 10 things to know for open enrollment in 2018, which can be found here, along with a plan-comparison tool.
Information on the various plans available in each area of Pennsylvania, along with videos on buying health insurance and how it works, also are available at www.insurance.pa.gov, under the Health tab.
Know who’s participating
Consumers should also be careful of where they shop for health insurance, acting Pennsylvania Insurance Commissioner Jessica Altman said.
While some companies and agents are offering plans they say are compliant with the ACA, they actually may not be, the insurance department explains. The federal marketplace’s website ends in .gov. Consumers not shopping on Healthcare.gov, are not shopping on the federal marketplace.
In addition, the department says, consumers buying an off-exchange plan directly should make sure they are on an official website for one of Pennsylvania’s five health insurers: Capital Blue Cross, Geisinger, Highmark, Independence Blue Cross, and UPMC Health Plan.
About those subsidies
Cost-sharing payments to insurers have been used to help lower-income individuals with co-pays, deductibles, and other out-of-pocket costs.
The Trump administration has moved to end the subsidies — a move being fought by several states, including Pennsylvania.
As a result, rates for certain “silver” level plans, on which the cost-sharing reduction payments were made, have gone up significantly this year.
(Plans are ranked by four “metals” — bronze, silver, gold and platinum, with silver being a “moderate” level. It’s also the level consumers must choose if they are eligible for the subsidies.)
There is good news, at least for now. Anticipating the potential loss of subsidies, many insurers planned ahead by offering plans that increased premiums — particularly in the case of silver-level coverage — while also absorbing some of the cost of the lost subsidies. NPR explained that and more in this overview of the issue.
And, Altman said, consumers who were not eligible for subsidies (or only for low subsidies) should check Healthcare.gov for cheaper gold, platinum or bronze plans, which may have risen less than for the silver plans, although some may be offered outside the exchange.
As LNP pointed out, some consumers may even find no-cost plans available to them for 2018.
For everyone, however, one key point remains: The clock is ticking.
“I strongly urge consumers who need coverage to visit these sites now, and shop around, to find the best available plan for them, at the best price,” Altman said.