Local health care providers expect challenges enrolling residents in ACA
Open enrollment for Affordable Care Act plans is set to start Nov. 1, but some are worried about challenges that might prevent consumers from signing up.
Earlier this year, President Donald Trump's administration cut the federal marketing budget for open enrollment by 90 percent, according to news reports. State officials said Illinois is providing $1 million for marketing this year compared with $5 million from the federal government last year.
Federal officials also reduced the open enrollment period from 12 weeks to six. So, this year, it will end Dec. 15 for coverage beginning Jan. 1, 2018.
"Marketing and outreach is going to be our No. 1 challenge," said Maria Borrayo, manager of health care plans and patient access at Aunt's Martha Health & Wellness, which assists south suburban residents.
Rep. Robin Kelly, chairwoman of the Congressional Black Caucus Health Braintrust, a task force on health care, said she is concerned about the federal government changes.
"I definitely have concerns just because of the barriers that this administration has put in the way," said Kelly, a Democrat from Matteson who represents the 2nd Congressional District, which includes many south suburbs. "Many people won't be reminded. New people may not sign up because they don't know, because of the shortened period of time and also the lack of advertisement about the program. (The Trump administration is) actively working to destabilize the program. They want it to fail."
She said about 70,000 people in her district have insurance due to the ACA.
Organizations that will be assisting consumers during the open enrollment period will need to be proactive to get the word out. Kelly concurs and said they plan to do likewise.
"If the White House won't do their part, we have to do their part for them," she said. "We will use all kind of strategies; calling, leveraging social media. At different events that I speak at, I will make sure that I raise the subject."
Aunt Martha's officials, who have more than 20 health clinics in Illinois, including nine in the south suburbs and southeast Chicago, said they've been reaching out to clients to remind them about open enrollment.
"We have fliers in all of our clinics, in every exam room, indicating that we have staff that can assist them in enrolling in the marketplace and Medicaid," Borrayo said.
Free one-on-one help with enrollments can be scheduled at Aunt Martha's clinics in South Holland, Hazel Crest, Chicago Heights, Roseland and southeast Chicago, Borrayo said.
Staff at Family Christian Health Center, which also will be among organizations assisting people for free in enrolling in the south suburbs, are putting up posters at its centers to notify consumers, said Sandra Clark, outreach and enrollment specialist.
She said Family Christian Health Center, which has health centers in Harvey, Dolton and Lynwood, also plans to call and send letters to patients and hold education workshops.
In the past three years, FCHC has helped enroll roughly 11,000 people in the ACA, Clark said.
Clark said she also is worried about the Trump administration's decision earlier this month to end cost-sharing subsidies for insurers that help low-income consumers defray health insurance costs.
"Our clients are nervous," Borrayo said. "They think they won't be able to afford the premiums."
In anticipation that the federal cost-sharing subsidies for insurers would be eliminated, the Illinois Department of Insurance took steps to lessen the pain for consumers, the agency's director Jennifer Hammer said.
The department prompted insurers to impose a surcharge on ACA silver plans, so-called mid-level insurance plans, which were the only plans for which the subsidies could be used. The surcharge averages 15 percent and has pushed up premium costs. But as premium costs rise, tax credits available for consumers also will rise. So, in effect, through the tax credits, the federal government will be absorbing the increased costs to consumers that result from the elimination of the subsidies, Hammer said.
But that only applies to consumers whose income level qualifies them for tax credits. More than 356,000 people in Illinois enrolled in ACA plans for 2017 — 229,000 of them bought silver plans and 197,000 of them received tax credits, Hammer said.
"We worked diligently to maneuver through some of the regulations to protect consumers this summer," she said. "We negotiated with insurance companies to ensure that the consumers would not feel the price increase but rather the federal government would cover the increased price as a result of the uncertainty in Washington."
On average, premium increases in Illinois are lower in 2018 than 2017 for all levels of ACA coverage, Hammer said.
The department will partner with community organizations and ACA helpers throughout the state to educate consumers about open enrollment, Hammer said.
"We advise consumers to shop early," Hammer said. "We hope that they will consider all of the factors in a plan, ranging from networks to price, and that anyone that is currently enrolled on a silver plan and not receiving a tax credit should absolutely shop on and off the exchange. Consumers can shop on GetCoveredIllinois.gov through the insurance companies or independent agents. We always invite consumers to call our consumer assistance hotline if they should have any questions."
For those seeking one-on-one counseling, make sure you're prepared with the required information, said Stephanie Lloyd, financial counselor with Cook County Health and Hospitals System Cottage Grove Health Center in Ford Heights. That information includes pay stubs, a social security card and W-2 forms, among other documents. Cook County Health Systems will have financial counselors available to provide help at the Cottage Grove Health Center, Robbins Health Center and Oak Forest Health Center in the south suburbs, Lloyd said.
Clark stressed this year more than ever, it's important not to procrastinate.
"People get in the habit of waiting until the last minute," she said. "In the past, even if you waited until the last day, there have been extensions. They would give people time because they were in line on the phone, on hold; they put an application in, but the system couldn't handle the overload. This is not something that people should bank on this year."