Open enrollment starts next week for ACA exchanges

Certified Navigator Azia Troutman, left, helps Jacqueline Foster of Dayton with a Medicaid application at the Helping Hands Community Center in 2014. Open enrollment starts Nov. 1. JIM WITMER / STAFF

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Certified Navigator Azia Troutman, left, helps Jacqueline Foster of Dayton with a Medicaid application at the Helping Hands Community Center in 2014. Open enrollment starts Nov. 1. JIM WITMER / STAFF

It will be a challenging open enrollment period for people that plan to buy health insurance through the Affordable Care Act.

This year's open enrollment from Nov. 1 to Dec. 15 will be hallmarked by high prices, less choices and less time to spend making a choice on which plans to get.

On average, premiums will cost about 34 percent more in Ohio next year and there will be half as many insurers selling plans. Around 243,000 people last year in Ohio signed up for insurance offered through the ACA, which is also referred to as Obamacare.

About 11 percent of the increase is because the Ohio Department of Insurance required insurance companies to assume that payments will end from the federal government to subsidize lower cost plans.

RELATED: Dayton company to restore ACA insurance coverage in last Ohio county

Costs had been rising before the 11 percent increase because insurance companies have been struggling to get enough young, healthy people to buy insurance in order to subsidize the high costs of health care for older and sicker enrollees.

The Affordable Care Act was signed into law in 2010 and created marketplaces where people can buy individual or small business plans and income qualified people can get subsidies that lower the cost of co-payments and premiums.

The weighted average premium for an individual market plan will be $5,798.83 in 2018. That is a 119 percent increase from 2013.

“I think it’s going to affect the younger generation. That 22 to 32 category. They’ve been a hard market to get involved anyway,” said Glenn Hughes, grant project director with Resolute Certified Navigators, which gives one-on-one help for people signing up for Affordable Care Act plans.

County enrollment 
Number of ACA enrollees by county during last year's open enrollment. 
CountyTotal enrollees
Butler County7,806
Champaign County587
Clark County2,074
Darke County1,005
Greene County3,015
Montgomery County10,486
Miami County2,162
Preble County764
Warren County5,359
Source: Centers for Medicare and Medicaid Services

Dayton-based CareSource remains primarily a Medicaid-managed care company but the nonprofit insurer has been growing the side of its business that sells plans on the Affordable Care Act exchanges.

While other insurance companies have lost money selling ACA plans and fled the exchanges, CareSource plans to sell insurance options in 60 counties in Ohio next year, up from 51 counties in 2017. It also will sell plans in 32 counties in West Virginia, 61 in Kentucky and 79 in Indiana.

RELATED: CareSource expanding amid uncertain times for Obamacare

Despite the uncertain political climate surrounding the health law, CareSource said in a statement that it remains committed to serving uninsured populations with access to affordable care.

“We understand how important health care is to individuals and their families and we’ve seen the impact health and well-being has on governmental dependency and economic stability. We remain committed to the Marketplace and those who have trusted us to provide them with health care coverage,” the company said.

CareSource officials recommended people with ACA insurance plans make sure that their insurer has not left the marketplace and that they research and shop around early to find the plan with the best value. People should assess their life circumstances when looking at what is the right coverage and the right premium, the nonprofit advised.

“CareSource remains committed to the Marketplace and the thousands of members we currently serve. It’s our mission to serve consumers and that has been our goal since we entered the Marketplace,” it stated.

Local insurers    
Four insurers will have Affordable Care Act plans for sale next year in the area.    
InsurerAvg. rate change Minimum rate changeMaximum rate changeOhio policy holders affected
CareSource36.5-6.17251,590
Buckeye Community Health Plan49.625.313911,497
Molina42.213.5142.915,709
Medical Health Insuring Corp.29.48.4132.214,948

RELATED: High Medicaid, Medicare use in Dayton increases health care costs

If residents want help signing up for insurance plans sold on the exchanges, they can get one-on-one help from programs with federally funded “navigators” that can walk through the available options to chose from.

However, outreach programs run by navigators are facing sharp budget cuts this enrollment season.

The Ohio Association of Foodbanks, which had been the biggest receiver of navigator funding in Ohio, dropped its navigator program after its funding was cut 71 percent, down from $1.7 million to about $486,000.

Resolute Certified Navigators is the local navigator service that serves a 15 county area in western Ohio, and it also got a 71 percent of its funding for regional outreach, knocking it down to a $39,000 budget, said Hughes.

RELATED: Is Obamacare dead? What’s really going on?

Hughes said he expects the insurance navigators will see people who are concerned about the news about the federal government ending subsidies to cover the cost of exchange plans.

President Donald Trump announced Oct. 12 that he would end the federal government's $7 billion in cost-sharing reduction payments that help insurance companies pay the costs for low-income people buying Affordable Care Act insurance plans.

While the insurance prices for exchange plans have already been set for 2018 and won’t change next year because of the announcement, Hughes said he expects the news will make people feel uncertain about signing up.


Affordable Care Act open enrollment

• The open enrollment period this year is shorter: Nov. 1 to Dec. 15.

• Make sure you are aware if your insurer has exited the marketplace. If you find yourself in this situation, take note of information you will receive in the mail about being reassigned an insurer.

• Do your research and shop the marketplace early. This is a consumer-based marketplace, so shopping and comparing plans is important to find the best value.

• Assess your coverage needs based on your life circumstances. This will help to determine the right coverage at the right premium.

Source: CareSource

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