Last year’s Affordable Care Act open enrollment was tumultuous, with longtime insurers out of the marketplace, new players in and consumers scrambling to figure out who was covering what.
This year’s enrollment period, which begins Thursday, promises to be more mundane. Last year’s insurers are back, and Molly Moffett, who heads ACA enrollment efforts for the Community Health Council of Wyandotte County, said the premiums are relatively stable too.
“Prices are about the same,” Moffett said. “They went up on average about 6 or 7 percent (in Kansas), and in Missouri there were a couple plans that actually saw a decrease.”
But there are still a few changes people should be aware of before they log on to healthcare.gov to choose a plan for 2019.
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Consumers on the Kansas side can choose from plans offered by the same two insurers: Ambetter and Medica. But Ambetter is expanding into Leavenworth and Miami counties.
Minnesota-based Medica is expanding its Select plan to residents on the Missouri side of the metro for the first time, in Jackson, Clay, Cass and Platte counties. Ambetter and Cigna are back as well on the Missouri side. With the addition of Medica, some Kansas City area consumers have as many choices of insurers as they’ve had in years.
But the Medica Select plan still offers a narrow network that excludes most hospitals. Last year it covered only St. Luke’s Health System and Children’s Mercy Hospital. This year, Medica has expanded to the Topeka area and added Stormont Vail Health and Holton Community Hospital, but other Kansas City institutions are still excluded.
Kansas City small business owner Beth Partin said she chose Ambetter last year because she’s a breast cancer survivor and its network included the University of Kansas Cancer Center, where she goes for her annual check-ups to make sure the illness hasn’t returned.
But she said she would still take a look at the Medica Select plan, now that it’s available in her area.
“I might be willing to transfer to St. Luke’s,” Partin said, “because I think their cancer care reputation is pretty good.”
Ambetter has a broader network of providers but will not cover St. Luke’s next year because of the hospital’s exclusive deal with Medica.
Partin said she chose her Ambetter plan after Blue Cross and Blue Shield of Kansas City pulled out of the ACA last year, citing unsustainable financial losses.
But after years of premium increases, the subsidized Obamacare markets appear to be stabilizing in most states, and smaller players like Ambetter (a division of St. Louis area-based Centene) and Medica have been expanding their ACA offerings to more states even as insurance juggernauts like Aetna and UnitedHealthcare have been pulling back.
There’s evidence that some insurers that left the market are reconsidering. Overland Park resident Barbara Elliott said she recently got an email survey asking whether she would be interested in going back to Blue KC coverage if the company got back into the exchange.
Blue KC spokeswoman Kelly Cannon said the company will not be offering plans for 2019 but hasn’t ruled out returning in future years.
“We regularly conduct market research and will continue to keep a close eye on the market,” Cannon said.
Analysts say the newcomers have made the individual markets profitable in part by narrowing their networks and negotiating lower rates with the providers they do let in, in exchange for exclusivity. That has allowed them to offer plans at lower cost while still making money, but it remains to be seen whether those plans and prices will be appealing enough to young, healthy consumers after Republicans in Congress repealed the mandate that everyone carry insurance or pay a tax penalty.
As in past years, workers at Moffett’s organization and other nonprofits will be available to help people choose a plan before the Dec. 15 deadline. Appointments can be made online or by calling United Way 2-1-1.
Moffett said she thinks most of the people served by her organization will continue to purchase insurance from the ACA marketplace because they qualify for income-based federal subsidies.
But she said people who make too much to qualify for those subsidies might be tempted to go for short-term insurance plans allowed under new Trump administration rules because they can be very cheap.
Moffett said consumers should be wary of those “loose, skeleton plans” because the plans aren’t required to cover all of the things that ACA plans cover.
“They most times don’t cover preexisting conditions,” Moffett said.