Republicans in Congress promised to repeal it. President Trump said it was crumbling. Blue Cross and Blue Shield of Kansas City got out of it.
But people in Kansas and Missouri have still been embracing Obamacare at a brisk pace this year.
According to federal data, almost 79,000 Missourians used healthcare.gov to sign up for Affordable Care Act plans in the first four weeks of open enrollment, compared to about 62,000 at this point last year. Kansans had chosen 31,000 plans this year compared to about 25,000 last year.
The region’s juiced-up early enrollment numbers reflect a national trend. With the Affordable Care Act, commonly called Obamacare, seemingly on the ropes, its approval numbers have climbed to new highs and consumers are signing up at about a 46 percent faster clip than last year. That’s despite hefty premium increases in some states.
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“It’s gone remarkably well, I would say,” said Scott Miniea, the program manager of Insurance Counseling Services in Columbia and coordinator of the central hub of the Cover Missouri Coalition. “We’re getting a little bit stronger response in terms of people coming in and getting their enrollments taken care of.”
But Sheldon Weisgrau, the director of the Health Reform Resource Project in Kansas, said total enrollment still might not top out above last year’s marks of about 99,000 in Kansas and about 244,000 in Missouri. That’s because the Trump Administration also opted to cut in half the open enrollment period.
It ends Dec. 15 this year, rather than Jan. 31.
“In the past anyway, a lot of folks who wait until the last minute have been the young, healthy folks,” Weisgrau said. “I’m hoping they’re coming back to the market this year, but if they believe the enrollment period runs until the end of January, we’re going to have a problem.”
Weisgrau said the health insurance market needs young, health consumers to avoid a “death spiral” in which the market is packed with high-cost consumers who need a lot of health care, which drives up premiums, which pushes more healthy people out of the market.
“I’m very concerned that’s going to be a problem going forward,” said Weisgrau, whose group helps Kansans sign up for Obamacare plans.
He said reports that Republicans are still trying to repeal Obamacare’s “individual mandate” that levies fines on people who don’t carry health insurance could also persuade people to stay out of the market, if the threat of the fines is their main motivation for purchasing a plan.
But Weisgrau said he’s encouraged by the early enrollment numbers, especially in light of Blue KC’s decision to exit Obamacare. That temporarily left Kansas City-area consumers with no insurers that covered the University of Kansas Health System, which includes the area’s largest hospital.
Weisgrau said that might have caused some consumers to wait to buy a plan and see if KU joined the new networks. The health system struck a deal to get into one of them, Ambetter, on Nov. 15.
“Hopefully word has gotten out that KU is now part of one of the networks,” Weisgrau said.
Other major hospital systems, like Shawnee Mission Health and Olathe Health, are still not in any of the insurance networks, but are in negotiations with the insurance companies. Consumers who choose a plan now can switch to another during open enrollment if it adds their providers.
Miniea said the Trump administration’s decision to shorten the open enrollment period may have unintentionally drawn attention to it and increased the urgency for consumers. He said that if enrollment continues as it has gone so far Missouri will “meet or exceed what we did last year.”
Weisgrau was less optimistic.
“I’m sure there will be a surge at the end; that’s always the case,” Weisgrau said. “But I think there’s a lot of people out there who don’t know enrollment is ending early and a lot of people who don’t even know Obamacare is still in effect.”