Open enrollment for healthcare plans available through the federal marketplace will begin Nov. 1, but for 34 states, the programs aimed at helping applicants through the process will be severely decimated. Since 2015, navigator programs funded through the Centers for Medicare and Medicaid Services (CMS) play an important role in the annual open enrollment, assisting those seeking help in signing up for health plans through the healthcare exchange marketplaces.
Budgeted funds have been announced at the beginning of each year for the three-year agreement: $60 million in 2015 and $63 million in 2016. But funding was cut nearly in half for 2017, and that is expected to have a significant impact on ACA enrollment for the 2018 plan year.
An interactive map produced by the Henry J. Kaiser Family Foundation (KFF) shows the estimated number of 2017 enrollees in the Affordable Care Act (ACA) marketplace, with rollover information including the number of Medicaid enrollees from expansion states. For more information, including the methodology, visit KFF’s interactive map.
Budget Cuts Eviscerate Navigator Programs
In August, CMS announced a 40 percent budget cut would limit navigator programs’ abilities to provide the full range of services to the 34 states with navigator programs. Of those states, only three saw no reduction in funds: Delaware, Kansas and West Virginia.
A survey of the assistance programs across the affected states by KFF found that the lack of funds would limit the ability to:
- Provide information and guidance to rural applicants -- 55 percent of state programs and 72 percent of regional programs said they would not have the resources to assist applicants in far-flung areas.
- Offer experienced staff -- nearly 90 percent of the programs will have to lay off knowledgeable staff members and rely on inexperienced volunteers.
- Promote the ACA and its health care plans -- more than 80 percent of the assistance programs said they will reduce outreach and public education activities.
Vulnerable Groups Could Be Affected by Changes
Larger cities with more resources will be better equipped to assist residents looking to sign up for healthcare plans through individual health insurance markets, even with the cuts to navigator programs, but Americans located in smaller towns and rural areas may find help lacking.
This includes help for people looking to sign up for Medicaid, which was also offered by the programs as part of their “no wrong door” policy, allowing one application for either individual health plans, or Medicaid enrollment.
ACA Repeal Fails, But White House Chips Away with EOs
After a Sept. 30 deadline passed without a full or limited repeal of ACA by Congress, despite multiple attempts, the White House issued an executive order this week that diminishes certain aspects of the law.
An early morning tweet by President Trump announced his intention to circumvent the House and Senate’s failures on healthcare repeal through an executive order.
Since Congress can’t get its act together on HealthCare, I will be using the power of the pen to give great HealthCare to many people - FAST
— Donald J. Trump (@realDonaldTrump) October 10, 2017
The executive order (EO) would allow small businesses to buy health insurance through association plans, as well as removes restrictions on short-term health insurance plans. Without having to follow the ACA minimums in regards to benefits, they are cheaper options some refer to as “junk plans.”
Dozens of Health Organizations Warn of Consequences
A statement signed by 18 health organizations, including the American Heart Association, the American Cancer Society and the United Way Worldwide, warned of the burden Trump’s EO would have on those with pre-existing conditions, by allowing healthier patients to purchase cheaper, less beneficial plans, forcing higher premiums for sicker individuals.
This order has the potential to price millions of people with pre-existing conditions and serious illnesses out of the individual insurance market and put millions more at risk through the sale of insurance plans that won’t cover all the services patients want to stay healthy or the critical care they need when they get sick,” the statement read.American Medical Association President David O. Barbe said the President’s actions could weaken the stability of the individual health insurance market. American Hospital Association Executive Vice President Tom Nickels echoed his sentiments, and warned it could be disastrous for all Americans.
Today’s Executive Order will allow health insurance plans that cover fewer benefits and offer fewer consumer protections. No one can predict future health care needs with complete certainty and such plans could put patients at risk when care is needed most.”The president’s EO does not automatically make the changes it outlines; it instructs necessary cabinet members to create the guidelines and issue directions, and could take months to enact, according to The Hill.
How to Prepare for ACA Open Enrollment
- Start early: Enrollment runs from Nov. 1 to Dec. 15, and will not open again until November of 2018.
- Visit HealthCare.gov for information on how to search and purchase plans through the marketplace.
- Contact the Marketplace Call Center at 800-318-2596 to speak with someone who can help you.
- Find someone local who can assist you by using the HealthCare.gov location tool with your zip code.