The enrollment period for obtaining health insurance through the Affordable Care Act on the Illinois exchanges begins Nov. 1, but signing up might prove more daunting this year than in the past.
This time around, the Trump administration has cut the enrollment period in half to six weeks. It has slashed the advertising budget for this year’s signup campaign by 90 percent and has reduced funding to groups that helped consumers sign up.
Previously, residents of McLean County could get assistance in navigating the health care exchanges from local agencies such as the McLean County Health Department or LIFE Center for Independent Living. That is no longer the case.
People will largely have to fend for themselves by going to websites such as GetCoveredIllinois.gov and HealthCare.gov. The Trump administration also plans to take HealthCare.gov offline for a good portion of Sundays.
Chestnut Health Systems in Bloomington says it has one staff member to help people who qualify for their services and have questions about signing up for insurance. Others seeking seeking assistance can turn to private insurance agents for help.
“The process is still the same. However because of what is happening in Congress right now, people are afraid and confused,” said Pamela Deaton, a private insurance agent who works for Health Markets in Bloomington.
“They have cut down the time we can get on the exchange and register for next year,” Deaton said. “And the website still breaks down quite a bit, "she added.
“The best thing I would say is find an agent … and sit down with the agent face to face, or call somebody local instead of calling an 800 number and relying on that kind of service,” Deaton said.
Private agents cannot charge people who ask for information about coverage, Deaton said.
Agents are required by insurance industry ethics standards to provide customers with plans that best suit their needs, and not on the basis of the commission they would stand to gain, Deaton said.
"You have to steer enrollees to a plan that is best for them, and not that's best for you," she said.
Central Illinois is in better shape than some states. It currently has three major insurers, Health Alliance, Blue Cross-Blue Shield of Illinois and Humana, that are willing to provide coverage, Deaton said.
Deaton said private agents are generally more familiar about the market than staff members at government agencies.
"I can get into the nuts and bolts of a plan ... If you are in the middle of cancer treatment, we want to make sure where you go for treatment is going to continue. We don't want you to have to change your network,” she said.
The Trump administration announced recently that it is eliminating what are known as cost share reductions—subsidies the federal government had been paying insurance companies to help stabilize the market in the early years of the Affordable Care Act.
Those cuts don't apply to subsidies some consumers receive who buy insurance on the exchanges.
"For the consumer, it's business as usual, " Deaton said. "Consumers will still get a tax credit if they deserve it for their premiums and still get subsides for their deductibles and out of pockets if they deserve it."
Insurance companies are expected to increase premiums to compensate for the loss of federal subsidies. Deaton said many insurance companies already anticipated this loss.
"They forecast the future for premiums knowing they would lose that subsidy eventually from the federal government," she said.
Consumers whose income makes them eligible for tax credits or subsidies, however, should not see their out-of-pocket costs increase, she added.
"If it’s a family of two, say a husband and wife, that makes $60,000 a year, and if they anticipate they will make $60,000 next year, they ll get the same tax credit," she said.
"It will adjust to premiums because the percentage they have to pay is based on their family size and income. The rate might go up, but their tax credit will go up as well."
People who see greatest increase in premium rates are those whose income is too high to qualify for a tax credit, Deaton said.
She said just how high those premiums might go won't be known until the sign up period begins Nov. 1.
Predictions of rate increase have been "all over the board," she said. Rate increases in the range of 20 to 40 percent would not be unlikely.
The enrollment period will end Dec. 15, and Deaton said there will probably be heavy traffic on the websites for signup.
"I would suggest waiting a week or two, maybe going on to look at rates, but not trying to enroll the first or second week" because the websites might be overloaded, Deaton said.
"Or go on at midnight when there is less traffic and try to enter your application at that point."
You can also listen to GLT's full interview with Deaton:
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