Despite what certain politicians may say, the Affordable Care Act (ACA/“Obamacare”) is very much alive.
“Open enrollment is November 1 through December 15,” says Health Care Navigator Kayla Berkey of the Consumer Health Coalition. “People can sign up for health insurance for the following year. It’s been shortened to only six weeks. In the past, it’s been three months, which gave people more time to figure things out. It’s a really short time frame.”
That means the individual mandate — the requirement to have health care coverage — is also still in effect.
The Consumer Health Coalition, based on the North Side, is one of the many groups of “navigators,” entrusted with helping people access health care via the ACA.
“[The ACA] requires every state to have in-person navigators to help with the enrollment process, and how it applies to their lives,” says Berkey. “I’ve been doing it since 2014. We have five navigators. We do a lot of emphasis on providing people a resource where they can come in, in person, and say, ‘Well, this is the situation I’m in.’”
If you haven’t heard much about it this time around, there’s a reason for that. The Trump administration cut the ACA’s marketing budget by 90 percent, to $10 million.
“It’s pretty drastic,” says Berkey. “They cut the outreach budget, as far as putting out ads goes, letting people know it’s open enrollment. We’ve been trying to work on grassroots ways to get the word out. We’ve been holding informational sessions at libraries in Allegheny, Beaver and Washington counties.”
To find a health care plan, people can use the marketplace tools through healthcare.gov, or can call the Marketplace Call Center at 1-800-318-2596 for assistance. The Consumer Health Coalition is available for individualized help.
“Some of the rates have increased this year in Pennsylvania,” says Berkey. “That’s tied into the fact that President Trump said he’s ending the cost-sharing. Companies have raised their rates in response.”
“Most people in Pennsylvania qualify for cost-sharing assistance … It won’t change anything for 2018. They’ll still receive all the subsidies that they’ve had in the past. If they’re still eligible, they can still get that cost-sharing deduction, which lowers the deductibles and out-of-pocket costs for their insurance plans.”
If you get health care via the ACA and are satisfied with your plan, it’s a good idea to look again anyway, suggests Berkey.
“Generally we encourage people to be very proactive during open enrollment,” she says, adding, “Even if you’ve got a plan you like. Plans change from year to year. If the plan changes or gets canceled, you’ll get put in a similar plan. Go back into your account, see if anything has changed, see if maybe there’s something better.”