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Battered but Still on the Books, the ACA Starts a New Round of Open Enrollment

Mary Caffrey
Whether consumers use or a state exchange, this year’s enrollment cycle—the first year of Obamacare without Barack Obama—promises to be different. Some consumers will see premiums soar, while others will pay next to nothing,
The first order of business for the insurers still offering coverage, either on or state exchanges, may be to convince consumers that the ACA is still the law of the land. Insurers are stepping up—they’re adding staff, working with community groups, and holding outreach and education sessions. As CMS pulls back funds for navigators, insurers are adding helpers, or working with insurance agents who can perform this task.

“This is a very important market segment for us with just under 1 million current ACA members,” Paul Kluding, senior director of public relations for Florida Blue wrote in an e-mail. The insurer is offering 12 new off-marketplace plans this year, “so those who do not qualify for subsidies will still have affordable options,” he said.

The insurer runs 20 Florida Blue Centers across the state that offer enrollment services, health coaching, and other services, and will play a crucial role in reaching consumers in all 67 counties.

“Over the years we have learned that a grassroots approach is the best way to reach this audience, so we are participating in more than 1000 events across the state, going to county fairs, churches, community events,” Kluding said. Florida Blue will add 700 seasonal and temporary workers, he said.

In New Jersey, Horizon Blue Cross Blue Shield (BCBSNJ) is taking a similar approach.

“We are putting unprecedented resources into this effort through community-based outreach, expanding our footprint in malls throughout the state, hosting regular grassroots education events and making agents available in person, on the phone or online to help people choose the plan that is right for them and see if they qualify for federal tax credits that have helped nearly 80% of the people who get health insurance through the individual market,” said Michael J. Considine, Horizon BCBSNJ vice president of consumer, small group and mid-size market units.

Horizon’s tactics include expanded digital outreach, paid advertising and social media, and 15 mobile vans to offer educational and on-the-spot enrollment services. Horizon also has specific outreach services for New Jersey’s Spanish-speaking community, which has been an area of growth for the insurer.

Pennsylvania was among the states where regulators required insurers to plan for a loss of CSRs in rates. As a result, Lisa Hartman, associate vice president of marketing at Geisinger, said the health plan will be contacting about 10,000 current customers to explain how a gold plan could offer richer benefits at a lower cost than their current silver plan.

It’s a challenging task to explain how it all works, and Geisinger had to wait until these customers received a renewal letter for their current silver plan that is required by CMS. “We know most people don’t understand what the CSR is," Hartman said. “We want to let them know there’s other options that might be better for them." 

A rule proposed late last week suggests the Trump administration takes a different view of the navigator role, and sees it as a service that can be taken on by an insurance agent. Specifically, the proposed CMS rule calls for eliminating requirements that a navigator in each exchange be a community or consumer group. “The requirement that one navigator grantee in each exchange must be a community and consumer-focused nonprofit group may unnecessarily limit an exchange’s ability to award grants to the strongest applicant,” the rule states.

Until this year, the chief difference among the states was whether they had expanded Medicaid. But now, whether a state has its own exchange will matter, as some that run their own are extending open enrollment well beyond December 15. Minnesota will sign up enrollees through January 14; Washington will go until January 15, and the deadline for California and New York is January 31. Besides extending the enrollment period, several state exchanges are also spending money on advertising to make up for CMS’ lack of outreach.

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