Deep ACA outreach cuts: 5 ways it will impact area marketplace

A certified marketplace navigator uses a projector to make it easier for people to see important information on healthcare.gov during open enrollment in 2014. FILE
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A certified marketplace navigator uses a projector to make it easier for people to see important information on healthcare.gov during open enrollment in 2014. FILE

The Dayton office that locally handles marketing and one-on-one enrollment assistance for Affordable Care Act insurance has been suspended after the Trump administration slashed its outreach funding.

The four local staff members with Resolute Certified Navigators, a nonprofit headquartered near Kansas City which serves a 15 county area in western Ohio, were sent home while they await word on what kind of resources the local office will have to work with after its $245,000 federal grant didn’t come through last week.

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The decision by President Donald J. Trump’s administration to cut the marketing and advertising budget for plans sold under the ACA from $100 million to $10 million follows a series of setbacks and uncertainties related to the health law, also known as Obamacare.

As it gets closer to the start of open enrollment for 2018 health insurance plans through Obamacare, here’s what you need to know:

1. There will be less advertising urging people to sign up for plans.

The Trump administration cut the budget by 90 percent for marketing and advertising, citing the declining number of first-time enrollees in Affordable Care Act coverage, which fell by 42 percent this year compared with 2016. The federal government is also rolling back its support for groups that offer one-on-one support with support for buying plans on the marketplaces, with funding for these groups cut from $63 million to $36 million.

2. Insurers on the marketplaces need to attract more healthy people to keep plans affordable, which could be harder to do with less advertising.

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The health insurance marketplaces have struggled to keep costs down, in part because insurers have struggled to attract healthy

people to help subsidize the high cost of sicker policy holders. While a person with high medical bills might make it a priority to seek out a health insurance plan, healthy young people have needed some persuasion to purchase a coverage option.

The federal government’s $100 million marketing and outreach efforts are in part intended to help address these problems. Cuts to marketing for Obamacare plans could further hamper the effort to draw in more young policy buyers and put more pressure on insurers who sell in the marketplaces.

3. The cuts place pressure on Dayton-based CareSource, which expanded to counties in Ohio and out-of-state that otherwise wouldn’t have an option for marketplace plans.

CareSource, which primarily is a Medicaid managed care provider, also sells private health insurance plans on the marketplaces and made national news when it expanded in August to fill the last coverage hole under the Affordable Care Act, announcing it would sell plans under the health law in Paulding County.

CareSource said in a statement today that the cuts will pose new challenges.

“ACA coverage is still new to many consumers across the country,” the nonprofit stated. “The uncertainty around the near and long-term existence of the Marketplace, as well as whether the individual mandate will be continued are some of the reasons why enrollment outreach and education continues to be a priority. The federal government’s plan to reduce support of these efforts by 90% this year will pose new challenges for many health insurers, as we work to ensure low-income and working families’ have access to essential health care coverage”

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4. There’s less time to enroll this year.

If you want to enroll into an insurance policy through Obamacare, there’s a shorter open enrollment period this year. People will need to enroll by between Nov. 1 and Dec. 15, compared to last year’s enrollment period from Nov. 1 to Jan. 31.

5. Health insurers that sell on the marketplaces also don’t know if Trump will end cost-sharing payments.

Trump has been threatening to stop paying subsidies that currently help insurance companies offer plans at lower rates through the Affordable Care Act marketplaces. The payments from the federal government to insurers, known as cost-sharing reductions, go towards reducing deductibles, co-payments and other medical costs. Trump has been deciding on a month-by-month basis to keep making the payments, but the uncertainty about whether they will continue has spooked some insurers from selling on the marketplaces and threatened to shoot up premiums.

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