Those seeking health insurance for the upcoming year have a little over a month left to get their coverage lined up.
The open enrollment period for the federal health insurance marketplace opened Nov. 1, with various starting periods — for example, someone who enrolled before Dec. 15 would have insurance coverage starting Jan. 1. The last day of open enrollment is Jan. 31, for coverage starting March 1.
This year, so many people have been signing up that the federal government extended the first deadline to Dec. 19. Jessie Menkens, navigator program coordinator for the Alaska Primary Care Association, said the number of people enrolling nationwide is unprecedented.
People have a variety of reasons for coming to get health care, but one may be concern over the incoming presidential administration, she said.
“It’s fair to say that some of the dynamics that are happening with the upcoming administration have spurred some folks to take advantage of enrollment opportunities now,” Menkens said. “… Within this program, our sole focus is to support Alaskans to understand their information that’s out there for them to take advantage of, their opportunities, so they can make educated decisions for them and their families.”
During the first two weeks of November, more than 1 million people selected plans on Healthcare.gov, a quarter of them new consumers. The enrollment was up by 53,000 people compared the same period last year, according to a Nov. 11 news release from the Centers for Medicare and Medicaid Services.
Menkens is traveling around the state to work with the public and health insurance navigators during open enrollment. Navigators and certified application counselors, who are similar to navigators but have a different level of training and are funded through a different revenue stream, both help people sign up for health insurance on the private market and Medicaid, depending on the individual’s income level. On the central Kenai Peninsula, Peninsula Community Health Services in Soldotna has two navigators.
Kelly Whitmore is one of them. She answers people’s questions about signing up for health insurance and walks them through the process, both during the open enrollment period and when people experience a major life change, such as having a baby or losing a job, effecting a “special enrollment period” in which they can sign up for insurance outside the regular enrollment period. Whitmore said people have begun to get more comfortable with the process over the last two years. However, there are still some questions and confusions people have, she said.
“I’ve seen more people that have come forward because they have been hit with those tax penalties when they haven’t purchased insurance and they didn’t like that,” Whitmore said. “When they’ve tried to search on their own to see if there’s anything available through the marketplace, I just think they didn’t go to the correct places because they say, ‘I can’t afford this.’ But when you talk to them, see if there might be something available, they were surprised that there were actually ways to get help.”
Whitmore also helps people sign up for Medicaid, which is administered by the state. With the downturn in the job market, more people have qualified for Medicaid this year, some of whom may not have known the requirements, she said.
The state expanded Medicaid eligibility in 2015, opening enrollment under the new guidelines on Sept. 1, 2015. By the end of June 2016, approximately 153,409 people were enrolled in Medicaid, more than 33,000 more than the total enrollment at the end of July 2015, according to the Kaiser Family Foundation, a nonprofit tracking health care information. By the end of September 2016, nearly 165,300 people were enrolled in Medicaid, a 35 percent increase over the previous year.
Some studies have shown that when people have access to health care services through insurance, their health outcomes improve. Whitmore said she thinks PCHS, which is required to report some data measures to the federal government as part of its grant funding, is seeing better outcomes in some measures of health.
“And those that are using it, people that didn’t have Medicaid before now that do qualify, are going in and having certain things addressed that they just kind of pretended didn’t exist because they didn’t have health care and couldn’t afford those out-of-pocket expenses,” she said. “And they can afford to have simple things addressed or chronic illnesses that they have but haven’t been able to address.”
One of the challenges in Alaska, though, is the increase in premiums. After Moda Health announced in May it would withdraw from the individual insurance market effective Dec. 31, the state has had one insurer for individual plans for 2017 — Premera Blue Cross Blue Shield. Every year, insurers adjust their premiums, and Alaska has some of the most expensive in the nation. The average increase was 7.3 percent this year, though some individuals’ plans may have gone up more than 10 percent, according to an October fact sheet from the Alaska Department of Commerce, Community and Economic Development.
Though the threshold for Medicaid is now 138 percent of the federal poverty guidelines — $1,707 per month for a single adult or $2,303 for a two-person household — the gap between those who qualify for Medicaid and those who can afford private insurance is growing. Menkens said this is a concern for people in the state.
“We can look within the realm of support through the individual marketplace … up to a certain threshold, there are ways to reduce those costs through tax credits or subsidies,” she said. “That’s always one of the first things that we look at, to see if they qualify for that level of support. There are limits to that, and in some ways now, there are quite a few families that are priced out of that support. And that’s really an unfortunate circumstance.”
The Alaska Primary Care Association has a policy arm and discusses issues with its partners and with legislators at the national and state level, she said.
PCHS’s health navigator services are free, confidential and available to everyone. To reach the navigators, people can call the center at 262-3119 and ask for a navigator. They can also call 844-752-6725 or visit getcoveredalaska.org to get help.
Reach Elizabeth Earl at email@example.com.