Enrollment in the Affordable Care Act reached 100,000 the day after the Presidential Election. “That’s the highest single day enrollment in its history,” said Dr. Janet Seabrook, commenting on campaign statements that promise to repeal the health insurance and health care law, popularly known as Obamacare.
Dr. Seabrook is the founder and executive director at Community HealthNet Gary, among the hundreds of community health centers across the nation given a major lifeline when President Obama signed legislation implementing the Patient Protection and Affordable Care Act in 2010. A key pledge of president-elect Donald Trump during his campaign was “… on my first day in office I will repeal Obamacare.”
Community health centers mainly serve low-income urban and rural areas. The promise of the ACA, to provide affordable health insurance to those who have been without is evidenced by the 20 million more Americans who are now covered.
Another part of the ACA created funding to help establish more health centers. Since 2010, 4 more health centers now carry the CHN nameplate, one in Gary and one each in Merrillville, Griffith, and Hammond.
Campaign rhetoric is not reality says Dr. Seabrook. “The fact is ACA is the law and laws can’t be changed easily; even attempts to keep parts of it.” After the election, Trump indicated he favored keeping some of the healthcare law – pre-existing conditions and children staying on their parents’ insurance policies until age 26.
Seabrook said the law can’t be peeled apart like an onion. “Who is going to be the person to turn off… pull the plug on a patient undergoing chemo- therapy for cancer? Who is going to be the person to tell them their treatment has to stop. People should know that when they enroll, it’s not a contract with the federal government. It’s a contract with an insurance company and it is good for 1 year.”
Felisha Brown, a certified ACA Navigator at Community HealthNet said campaign promises have not been a factor yet. “I’ve completed multiple ACA enrollments. No one has mentioned or asked me, how the election’s outcome may impact their coverage. Also, I haven’t had any questions from enrollees in the state’s Healthy Indiana Plan.” Brown’s job was created by the law to help enrollees complete eligibility and insurance application forms.
Notices of changes in insurance coverage and costs precede the start of each yearly ACA enrollment period, November 1 through January 31. The Indiana Dept. of Insurance announced in October that half of Indiana’s 8 insurers selling plans in the 2016 ACA marketplace wouldn’t offer plans in 2017.
“We can’t look at Indiana providers getting out as a bad thing,” Dr. Seabrook said. “Insurance is a business that’s looking at its bottom line – profits for the company and its shareholders. Some of those providers will pull up stakes in one state and move to another.” For Indiana residents, she said, there will be fewer choices, but “we are not like some states that have only one provider.”
The four insurers leaving in 2017 are IU Health Plans, Physicians Health Plan of Northern Indiana (PHP), All Savers (United Healthcare), and Southeastern Indiana Health Organization (SIHO). All cited high costs of insuring enrollees and their claims. Although IU Health will stop selling individual coverage, it will continue to offer group plans.
The four carriers remaining are Anthem, CareSource, Celtic (MHS) and MDwise Marketplace.
One reason insurers might pull up stakes, Brown said, is because consumers aren’t choosing their plans. “Consumers make their decisions on affordability and their current health needs. They look at deductibles, out-of-pocket costs, and prescription plans; they want to know which networks include their doctors.”
Brown and other navigators at CHN work with those seeking healthcare and those with existing coverage. Before the enrollment period started, Indiana sent letters to enrollees about changes, if any, in plans and costs. For those whose plans were discontinued, the navigators can help them explore others. Brown said she has worked with more people whose premiums decreased than those with premium increases.
The three-month enrollment period is especially busy for CHN navigators because they are out in the community hosting enrollment sessions. They will be at City Hall in Gary and libraries throughout Lake County offering assistance.
Brown has some advice for those with existing coverage who are considering letting their plans automatically renew, even when they see premium increases. “Don’t,” Brown said. “Examine the other plans available or talk to a navigator because there could be a plan offering the same benefits at a cheaper cost.”
