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WASHINGTON – When the annual open registration period begins in a few days, the country's consumers will have more choices under the Affordable Care Act, but fewer sources of unbiased advice and assistance for guide in the labyrinth of health insurance.
The Trump administration has opened the door to the aggressive marketing of short-term insurance plans, which are not required to cover pre-existing medical conditions. Insurers enter or re-enter the Affordable Care Act market, expand their service areas and offer new products. But the budget allocated to insurance advisors, called browsers, has been reduced by more than 80% and in almost one-third of the 2,400 counties served by HealthCare.gov, no browser has been funded by the federal government.
"There is probably a lot of confusion among consumers about the various plan options that may be available this year," said Sabrina Corlette, a research professor at the Institute of Health Policy at Georgetown University. "It will be a bit of a Wild West – buyer beware!"
The "Obamacare Health Plans", the short-term plans and the "Christian Health Sharing Plans" are all posted on the same page of commercial sites such as Affordable-Health-Insurance-Plans.org, which describes itself as a free referral service for insurance buyers. .
Consumers may have difficulty sorting through their options after the administration Reduced the budget last summer for insurance carriers to $ 10 million this year, up from 36 million in 2017 and nearly 63 million in 2016.
"Mariners play a vital role in helping consumers prepare applications to establish eligibility and enter markets," says the Ministry of Health and Social Services on its website.
But 797 counties served by HealthCare.gov will have no navigators this year, according to a federal data table prepared by the Kaiser Family Foundation. This is a sharp increase over 2016, when 127 countries did not receive such assistance.
"If you are confused and want help from someone to try to figure out what's right for you – what's legitimate and what's legitimate – there will be fewer people to help you in the process. most states, "said Corlette.
Federal officials said they were not providing funds to mariners in Iowa, Montana and New Hampshire, no organization having asked for money in those states.
Cleveland, Dallas and large areas of Michigan and other states will also be missing browsers.
Texas will be hit hard. The state has the largest number and the highest percentage of uninsured, with 4.8 million people, or 17 percent of the population, without coverage, according to the Census Bureau.
"North Texas remains one of the least secure regions in the country," said Dallas County General Manager Clay Lewis Jenkins. "The administration's decision to cut funding for all mariners in North Texas will hinder our ability to enroll people in health insurance and will make some families of workers lose coverage. Only 45 of the 254 counties in Texas have a browser cover. "
Seema Verma, the administrator for the Centers for Medicare and Medicaid Services, defended the cuts.
Five years later, "the public is more aware of the private coverage options" available on the market, so it is "appropriate to reduce the navigation program". In addition, information and assistance is available from other sources, including insurance agents and brokers.
Consumers can sign up for health insurance under the Affordable Care Act starting Thursday. Last year, 8.7 million people registered with HealthCare.gov and three million additional plans were selected for state-run insurance scholarships.
Consumers can opt out of insurance next year without fear of penalty, as Congress has repealed the unpopular supplement imposed on people not covered.
Many health policy experts say that federal financial assistance is more important than the individual mandate to encourage people to buy insurance. These grants will continue to be available to low- and middle-income individuals for insurance under the Affordable Care Act and purchased on the public market. Grants can not be used for short-term policies.
"The vast majority of the people we serve, over 90%, are motivated by insurance because they want protection for their family and for themselves," said Matthew Slonaker, executive director of the company. Utah Health Policy Project, a non-profit organization. "It's not because they'd otherwise have to pay a penalty."
The average premiums for the most popular types of insurance purchased by individuals and families will be relatively stable next year, and in some states will even drop, according to the government.
According to the new standards published by the administration, mariners are being asked this year to inform consumers of all coverage options, including short-term plans that do not provide all the benefits and consumer protections required by the Affordable Care Act.
President Trump outlined short-term policies as an inexpensive alternative to the Affordable Care Act. These plans would be "much more accessible" thanks to a decree signed last year to cancel the restrictions imposed by President Barack. Obama.
Democrats have made health care a major theme in mid-term election campaigns. According to them, the short-term policies show how the Trump administration threatens the protections afforded to people with pre-existing diseases.
Short-term contracts, which can last up to 364 days and then be renewed for another two years, often do not cover pre-existing medical conditions, prescription drugs, pregnancy, maternity care or treatment of mental disorders and addiction.
Indeed, said Mr. Trump, short-term plans cost less because they are "not subject to very extensive and expensive Obamacare mandates and rules".
But, said Kirsten A. Sloan, vice president of the Cancer Society's Cancer Action Network: "People may be attracted to short-term plans without understanding that the lowest premiums are less covered. These plans may not cover the doctors and hospitals and the medications you need if you get sick. "
In another challenge this year, consumers could be overwhelmed by automated calls offering cheap insurance.
Alex Quilici, managing director of YouMail, a company offering software to combat automated calls, said he was witnessing a huge increase in health insurance scams.
"The callers say" it's an open registration "or" we can find you a better deal by consulting all the health insurance plans, "Quilici said. "Callers ask for a lot of personal information and the consumer who does not know it often gives their date of birth, social security number and information to all family members, in order to benefit from many offers. In reality, it's identity theft or the payment theft, or both. "
Mr. Quilici's company has recorded hundreds of automated calls. A classic appeal indicates that, with the inscription "imminent", Mr. Trump has created short-term hedging options of up to three years, "so that you and your family can get a great deal of money." affordable insurance. "
It is difficult to identify the source of the automated calls, Quilici said, because callers often falsify the information displayed on their identity.
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