On heels of Trump executive order, open enrollment arrives in Connecticut

With the future of Obamacare again in question after President Donald Trump’s executive order this week to create new avenues for people to obtain insurance, Connecticut’s state health exchange enters November with a tighter window for open enrollment but a widening number of ways for people to get help signing up.

On Thursday, Trump directed federal departments to find ways for association health plans to enroll more small businesses and individuals, with the goal of giving them sufficient membership numbers to leverage the purchasing power that large group plans are able to leverage, and to expand enrollment across state lines.

On Friday, state Attorney General George Jepsen signaled Connecticut would join a lawsuit attempting to block the Trump order. U.S. Sen. Chris Murphy, D-Conn., is among the critics of the executive order, stating those large group plans are spared an “essential benefits” stance under the Affordable Care Act that requires coverage of prescription drugs, maternity care and mental health among other benefits.

It amounts to another enrollment period with yet another round of confusion, coming off previous periods thrown into flux by court challenges and before that the overall newness of Obamacare.

“The bills that were introduced had some immediate ramifications, but as of right now, nothing has changed,” said Andrea Ravitz, director of marketing and sales in the Hartford office of Access Health CT. “There could be changes in the near future, and as soon as we know what those are and when they will come, we’ll let our consumers know. People should take some interest ... because it affects them and their families.”

Two carriers, one or zero

With the Affordable Care Act created in 2010, a central provision did not become reality until 2013 — state insurance exchanges meant to give residents an affordable option to comply with the law’s mandate on having insurance. For those who do not, tax penalties come into play starting this year at $695 and increasing depending on circumstances like income.

The mandate has been effective in its main goal — prodding more people into getting coverage, with attendant implications for getting checkups and other services to catch and treat serious ailments before they get to a stage where medical costs spiral out of control.

From 286,000 Connecticut residents lacking insurance in 2013 — roughly eight in every 100 — as of 2017 about 125,000 people did not have coverage. In some cases, those individuals are immigrants who lack awareness of the law or fluency in English; in others, they are people who are at a gap in coverage for whatever reason, whether between jobs, aging off their parent’s plans or experiencing a financial crisis that gives them no recourse.

The Trump executive order reportedly would also threaten subsidies some receive to help defray their premiums under the Affordable Care Act.

“As of last year, 75 percent of our total membership was getting some kind of financial help,” Ravitz said. “In some cases, it is dramatic.”

But the other key tenet of Obamacare — bringing insurance premiums into check — has not come to fruition, with Trump and like-minded Republicans attempting to dismantle the law on fears those costs are on an upward trajectory that is unsustainable.

Insurance carriers, which remain the keystone of the health system under the Affordable Care Act, have been pulling out of state exchanges. Just two, Anthem and ConnectiCare, remain in Access Health CT heading into 2018 — too few for a fully healthy exchange, Ravitz and others acknowledge.

“We were planning for the three scenarios: having two carriers, having one carrier or having zero,” Ravitz said. “We are really happy to have them back.”

Evidence of a flawed system

Heading into year five of Access Health CT, not all are happy with the service they have received under the exchange. This month on Access Health CT’s Facebook page, Putnam resident Tracie Lombardy Renshaw dubbed “a nightmare” dealing with the health exchange’s call agents, echoing complaints from others earlier in the year.

For her part, Windsor librarian Ann Binder called agents “sincere” but said there is continued evidence of a flawed system.

“The computer system keeps generating letters for proof even after we’ve submitted the documents,” Binder posted on Wednesday. “I have received so many of these requests from the computer it would take a whole filing cabinet drawer to hold them all.”

If it would take more than a few filing cabinets to hold all of the press clippings chronicling the Affordable Care Act’s creation and subsequent challenges, plenty more space will be required in the coming months as the Trump administration sets out to knock out the underpinnings of Obamacare and pour its own foundation for U.S. health care in the 21st Century.

For now, it is business as usual heading into open enrollment, with information and eligibility requirements online at www.accesshealthct.com or via phone at 1-855-909-2428, and enrollment centers open as of Nov. 1 at the Bridgeport Public Library, the CIFC Greater Danbury Community Health Center, and Ferguson Library in Stamford. On Saturday, Nov. 4, an open enrollment fair is scheduled at Fairfield University’s Faber Hall Dining Commons.

“With all the noise on the federal level, it’s all the more important for Connecticut residents to know that here in the state, nothing has changed,” Ravitz said. “The question that we usually get is, ‘what happens if something changes?’ And just like anything else, we will adjust to it.”