Affordable Care Act open enrollment starts today

Open enrollment for individual insurance starts today, and this year the average premiums will be a little cheaper for Ohioans for the first time since the Affordable Care Act created the marketplace.

Open enrollment runs Nov. 1 through Dec. 15. and last year about 207,000 Ohioans signed up for individual insurance through the marketplace.

The average premiums will be $5,690, down 7.7 percent from the year prior. However, prices have still soared since when the exchanges first started in 2013 when the average premium in Ohio was $2,650.

Many people who buy the insurance pay much less than the average premium since they qualify for subsidies.

MORE: New CareSource building built for future growth

Dayton-area consumers can get free help navigating open enrollment and understanding if they qualify for discounts by making an appointment at (937) 208-8585 with a specialist at any of the Five Rivers Health Centers locations, said Kim Bramlage, marketing and communications manager.

“The first step is to simply call our offices and make an appointment to come in and meet with our outreach and enrollment specialists,” Bramlage said. “You do not need to be a current patient of Five Rivers Health Centers to get this assistance.”

The marketplaces for individual health insurance plans were one of the signature parts of the Affordable Care Act intended to bring coverage to more people. Marketplace plans have to cover essential health benefits, pre-existing conditions and preventive care.

The exchanges created the option to comparison shop insurance plans with government-regulated consumer protections, and many shoppers qualify for help paying for these insurance plans. However, the Dayton Daily News has previously reported that middle-class consumers who don’t qualify for insurance subsidies could be struggling with the climbing cost of the premiums on top of other medical expenses.

Along with prices starting to stabilize, more options will be offered this year in Ohio.

Ohio Department of Insurance filings show only one county — Logan — will have just one insurer selling individual plans. Last year, 16 counties had only one option.

Based on those filings, 29 counties will have two insurers compared to 33 counties last year. All other Ohio counties will have at least three insurers selling exchange products in 2020.

Marketplace enrollment  
Local sign ups declined last open enrollment.  
Montgomery 10,1038,536
Warren 5,7455,264
Source: Centers for Medicare and Medicaid Services 

For 2020, 10 companies have filed to sell on the exchange.

Only a small number of Ohioans — 207,000 out of 8.8 million — sign up for marketplace insurance, and that number has been declining since 2016, when 243,715 selected a plan, according to the Kaiser Family Foundation.

One of the major changes since the exchanges started is that there’s no longer a penalty for being uninsured. The Trump administration also announced last year new rules that allowed for more loosely regulated short-term plans that are cheaper but have less coverage and typically don’t cover people with pre-existing conditions.

Dayton-based CareSource had about 250,000 marketplace enrollees across all markets this year, and the insurer is preparing for the upcoming open enrollment season, when it is expanding into Georgia as well.

The nonprofit insurer has sold marketplace plans from the beginning, including expanding to cover the last bare county in the U.S. when other insurers bolted from the marketplace for 2018.

The business line hasn’t always been profitable for CareSource. Ohio Department of Insurance reported that CareSource took a $19.5 million loss on its marketplace plans in 2017 but then turned around for a $9.5 million net gain in 2018.

“We are confident that Marketplace will continue to perform to our expectations in 2019 and beyond,” said Stephen Ringel, CareSource Ohio Market president. “As a leader who has been in the Marketplace from the beginning, we continue to listen and learn from our consumers to tailor our product to meet their needs.”

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