Obamacare 2018 enrollment opens Wed. with little federal mention, lower rates for some

By Jayne O'Donnell, October 31, 2017

Insurers, some states and former Obama administration officials are heavily promoting the Affordable Care Act (ACA) open enrollment that starts Wednesday to make up for the lack of marketing the law is getting by President Trump's administration. 

"We are as an industry doing everything we can," says Kelly Turek, an executive director with trade group America's Health Insurance Plans.

There is actually some good news to promote, says Andy Slavitt, who headed the Centers for Medicare and Medicaid Services under Obama. Buried in a recent Department of Health and Human Services report: For 2018, 80% of people can find a plan for under $75 each month, thanks to financial assistance. That's up from 71% last year.

CMS, which runs Healthcare.gov, the site consumers who buy their own insurance in 39 states use to buy plans, declined an interview request Tuesday. A spokeswoman referred to a release last week that laid out its plans for scaled back and more targeted publicity. 

The amount of marketing will be "similar to what is effective for other major programs, like Medicare," CMS says. 

ACA supporters say they are doing all they can to make up for the Trump administration's huge cuts to marketing and consumer assistance funding. States with Democratic governors that run their own exchanges are also more aggressively promoting enrollment. 

Trump administration officials questioned whether the millions spent marketing and assisting with open enrollment was making a difference. Conservative health policy expert Avik Roy, another critic of the law, agrees. 

"There’s not a lot of clear evidence to me that the marketing by CMS was having any effect," says Roy, a former Republican campaign adviser who is now president of the Foundation for Research on Equal Opportunity. "Anyone who reads the newspaper — or doesn't — and is eligible for coverage is aware of their coverage."

But Slavitt, one of the national co-chairs of Get America Covered, says the federal government's voice is both powerful and necessary.

"It's very hard to match what we’re giving up — the heft of the administration's platform and mouthpiece," he says. "It's not just the money and the advertising; it's also the messaging," which is now often negative about the law. 

What's different this year: 

That means people who don't receive financial help to buy their plans — the people Trump has said he wanted to help — are the ones most affected.  These people account for about 15% of those who buy individual insurance plans. 

In South Dakota, Kris Westerbeck's premium for her Blue Cross Blue Shield plan increased by 16% to $828 for 2018. Last year, the Westerbecks were bracing for the worst, but her premiums only went up about $30 a month. 

Westerbeck still has what's known as a "grandmothered" ACA plan — one that was purchased after the ACA passed but before the exchanges opened in the fall of 2013.  Her husband, Mike Westerbeck, who is on Medicare himself, describes himself as an independent who leans conservative but blames "the lack of leadership from Trump" for this year's premium increases. 

The Westerbecks are counting the months until Kris is also eligible for Medicare in June 2019: "Many others will not be as fortunate," he says. 

Slavitt looks at it another way: "It's going to be a better year for many people, notwithstanding the challenges."


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