HARI SREENIVASAN: President Trump has made it clear he remains strongly opposed to the
Affordable Care Act, or what's been referred to as Obamacare.
And the president says he hopes to make another run at eventually repealing it.
But, for now, it remains the law.
And today is the opening of sign-up season for the insurance marketplaces.
Lisa Desjardins helps guide us through ways it is different this year.
LISA DESJARDINS: The president's feelings and beliefs about the Affordable Care Act
are more than just words.
There are significant changes in store for this enrollment period.
For one thing, there's a shorter amount of time to sign up for insurance through the
federal exchanges: Enrollment lasts six weeks, until December 15.
That is half of what it used to be.
While this marketplace accounts for only a fraction of overall health care coverage in
America, more than 10 million people signed up for their health care this way last year.
Mary Agnes Carey of Kaiser Health News is here to help fill in the picture.
Thank you for joining us.
MARY AGNES CAREY, Kaiser Health News: Thanks for having me.
LISA DESJARDINS: All right, let's start with, what changed?
MARY AGNES CAREY: Well, I think there's a lot of confusion this year, for the very fact
you mentioned.
Consumers have heard Obamacare is imploding, that it's exploding.
People are wondering, is it even here?
Is anyone participating?
Will I still get help on the exchanges?
And as we know, healthcare.gov is open for business as of today.
We have also seen some big drops in advertising.
The federal government is going to spend 90 percent this enrollment season on advertising.
They're spending about 40 percent less for these on-the-ground people who would help
you walk you through how to enroll in health insurance, the navigators and assisters.
We should still say that the insurance brokers and insurance agents are out there to help
you, but that reduction in the navigators and assisters is really causing some concern,
because they did a lot of community events all over the country.
LISA DESJARDINS: A lot of people watching to see if the number of insured Americans
drops because of this, but there are those who support the Affordable Care Act that are
trying to counteract this, including President Obama himself?
MARY AGNES CAREY: Right, exactly.
President Obama was on Facebook and Twitter today asking people to go to healthcare.gov
and see their options.
There's also a group called Get America Covered who are former Obama administration officials
who are out there trying to get the word out about enrollment.
And I think that, as we go into the enrollment period, a lot of advocates for the Affordable
Care Act are going to be doing the same thing.
LISA DESJARDINS: OK, let's talk about what the state of individual markets means for
individuals.
What we know from the Department of Health and Human Services is that they expect in
the next year the average monthly premium will go up 37 percent.
That's for the benchmark plan.
And they also believe that 29 percent of Americans, nearly a third, will have just one insurer
on the individual market in their county.
Now, tell me, exactly, Mary Agnes, who will be hardest hit, because we know individual
markets affect different people very differently.
MARY AGNES CAREY: Right.
The hardest people who will be hit are the people who buy insurance on the individual
market, but don't qualify for any financial assistance.
That's roughly about five million people.
So, when we hear about these premium jumps, they're getting it hit by 100 percent.
But one thing they can think of this year is to look for health care plans that are
not on the Affordable Care Act exchanges, because, for a variety of funding reasons,
formula funding reasons, those jumped up in price perhaps more than those not on the exchanges,
so that could be an alternative this year.
LISA DESJARDINS: Now, a reminder here.
The people who get subsidies for their health care are individuals who are making just about
$48,000 and for families of four $98,000.
So, it not just lower-income, but also middle-income folks.
And talk about how some of those people might actually see some benefits or some better
options this year?
MARY AGNES CAREY: Absolutely.
Due to some quirks in the marketplace, what might happen is the plan you had last year,
especially if it were a silver plan, might be more expensive than a gold plan.
You might be able to get a bronze plan for less money, perhaps even a zero premium.
So, that's why it's really important to go back, because your subsidy amount is likely
to rise this year, so you may be able to buy a better plan for that money.
LISA DESJARDINS: And this all has to do with the fact that we have a law in place that
the administration opposes, and those forces are leading to sort of situations that aren't
necessarily logical.
MARY AGNES CAREY: Well, there are also a lot of factors that added to the premium increases.
There were some concerns about perhaps people who got in who were really sick.
They were more costly.
The medical costs were higher in a certain area.
There was a particular subsidy that helped people with cost-sharing that went away, so
rates went up to accommodate for that.
But the bottom line is, what you had last year may not be what you -- is best for you
next year.
LISA DESJARDINS: That's the advice.
What do people need to do right now in this market?
MARY AGNES CAREY: Get help, if you can get it.
And remember to move early, because this year, as you noted, the open enrollment season is
done by December 15.
That's for about 39 states that use healthcare.gov.
If you're in California, for example, your state exchange may allow to you enroll all
the way -- will to January 31.
LISA DESJARDINS: So, in other words, people need to start looking now, they need to shop
around, and they need to realize they are not going to have as much time.
And one other thing, of course, the individual mandate is still the law of the land.
So, if people don't sign up for insurance, they could be risking a penalty.
MARY AGNES CAREY: That's absolutely right.
LISA DESJARDINS: All right, Mary Agnes Carey of Kaiser Health News, thank you so much.
MARY AGNES CAREY: Thank you.