With all the focus on health care this year, consumers can be forgiven for not knowing what options they still have, and how those options might have changed since Donald Trump took office as president.
But with the end of the year approaching, health experts want to be clear on at least one thing: Yes, Obamacare still exists, and you still can sign up.
Enrollment will open Wednesday for the fifth year on the state health exchanges set up by the Affordable Care Act. But experts are bracing for one of the rockier enrollment periods of the health-care law’s short existence.
“In some respects, consumers may face more uncertainty, confusion and misinformation than was the case before the first open enrollment back in 2013,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation, a non-profit that researches health-care issues.
This will be the first enrollment period since Trump was elected president on the promise to repeal Obamacare, a promise the Republican-led Congress spent much of the year trying — and failing — to keep.
Because of that failure, the 230,000 South Carolinians who bought coverage on the exchange last year – and received federal help in making their insurance premium payments – still will be able to sign up for 2018.
Premiums going up?
That doesn’t mean there have been no changes, however.
Earlier in October, Trump signed an executive order halting payments to insurance companies for lowering insurance premiums for low-income Americans.
In South Carolina, BlueCross BlueShield – the lone provider on the state exchange – will increase the premiums on some of its offered plans as a result. But consumers still will be eligible for federal assistance and tax credits to offset the rising costs, according to an analysis by the Kaiser Family Foundation.
“People who are eligible for the tax credit can stay at the (same) level and get the same out-of-pocket cost,” Pollitz said.
However, tax credits will not automatically renew for customers next year, so consumers are encouraged to talk to a local ACA navigator about their options. Customers can find one near them at SignUpSC.com.
Help is harder to find
But finding help may be harder.
That is because there will be fewer navigators available than during last year’s sign-up period. Federal grants to pay navigators have been cut by 41 percent nationwide this year. Money for S.C. navigators was slashed 66 percent, and federal advertising for this year’s enrollment was cut 90 percent.
Those cuts could make it harder for people who need help with their insurance to get help, worries Shelli Quenga, program director for the Palmetto Project.
“We still hear from people that our former Gov. Nikki Haley made sure the ACA didn’t work in South Carolina or the ACA rules don’t apply in South Carolina,” Quenga said. (Neither is true.)
The sign-up period also will be shortened by more than a month. Consumers only can sign up between Nov. 1 through Dec. 15.
In Columbia, the Richland Library is offering help signing up consumers during the enrollment period at all of its branches. However, library health specialist Lee Patterson encourages health-care shoppers to get to work sooner, rather than later.
“Don’t wait until the last minute,” she said. “Calls will be extremely busy.”
How has the ACA changed this year?
▪ Premiums will be higher on some plans. A Kaiser Family Foundation study found monthly premiums for a 30 year old, making 200 percent of the federal poverty level, will go up by more than $100. However, tax credits would keep out-of-pocket costs the same as in 2017.
▪ The enrollment period is shorter. ACA customers can sign up between Nov. 1 and Dec. 15. That is more than a month less time than last year, when enrollment ran through Jan. 31.
▪ Fewer navigators are available to help. Federal money for navigators, who help people sign up for insurance plans, has been cut 41 percent this year, and 66 percent for navigators in South Carolina. Search SignUpSC.com to find a navigator near you.