States Counter Trump with PPACA Enrollment Initiatives
By David Peel
Publisher and Editor
Healthcare News
Original Publish Date: November 7, 2017
“It’s dead. It’s gone. It’s no longer - you shouldn’t even mention (sic). It’s gone” -- President Donald Trump speaking to the current status of the PPACA (Obamacare)
Having failed to repeal and replace the Patient Protection Affordable Care Act (PPACA), congressional Republicans have moved on to tax reform. However, President Trump is not done with his version of health care reform. He eliminated cost-sharing payments to insurance companies, cut the enrollment period in half and reduced federal enrollment outreach advertising by 90%. Insurance companies have already submitted 2018 rates so these actions were designed to reduce their enrollment and income and, in general, destabilize the PPACA.
Several states anticipated the President’s actions and countered with their own initiatives to solidify PPACA enrollment. We publish the Healthcare News in AK, AZ, CA, IL, IN, OH, OR and WA and this article summarizes what each of these states have done, if anything, to protect their PPACA enrollment.
Alaska
Alaska enrollees use the federal Healthcare.gov web site so federal enrollment and outreach reductions would apply. Premera Blue Cross Blue Shield of Alaska is the only carrier.
Arizona
Arizona enrollees use the federal Healthcare.gov web site so federal enrollment and outreach reductions would apply. There are two carriers: Ambetter from Health Net and Blue Cross Blue Shield of AZ (BCBSAZ). BCBSAZ doesn’t offer PPACA coverage in Pima and Maricopa counties, the two most populated counties.
California
California has been proactive in countering President Trump’s actions.
- The open enrollment period is 11/01/17 through 01/31/18, 45 days longer than federal
- $111 million is being spent on marketing and outreach
- Their web site was upgraded
- A surcharge was imposed on carrier silver plans to offset the elimination of cost-sharing payments
There are multiple carrier options. According to Covered California, the entity responsible for operating the PPACA in California, most enrollees will have lower costs in 2018 than 2017.
Illinois
Illinois has a partnership with the federal government where they use the Healthcare.gov web site but everything else is run by the state. Federal enrollment and outreach reductions apply. There are multiple carrier options.
Indiana
Indiana enrollees use the federal Healthcare.gov web site so federal enrollment and outreach reductions would apply. There are two carriers: CareSource and Ambetter from MHS.
Ohio
Ohio enrollees use the federal Healthcare.gov web site so federal enrollment and outreach reductions would apply. There are multiple carrier options.
Oregon
Oregon enrollees use the federal Healthcare.gov web site so federal enrollment and outreach reductions would apply. There are multiple carrier options although some counties have only one carrier. Oregon ordered carriers to charge higher rates for silver plans to offset President Trump’s elimination of cost-sharing subsidies.
Washington
Washington is supportive of the PPACA and has done the following to strengthen their PPACA enrollment:
- The enrollment period is 11/01/17 through 01/15/18, 30 days longer than federal
- Washington carriers were notified to charge higher rates for silver plans to offset the eliminated cost-sharing subsidies
- $3 million is being spent on marketing and outreach
There are multiple carrier options although some counties have only one carrier.
Conclusion
For 2018, there are health insurance options for enrollees in all counties in these eight states. Some states, like California and Washington, have taken significant actions to stabilize their PPACA enrollment. Other states have relied on the federal government to administer the PPACA and are having various degrees of success with rates, carrier participation and enrollment levels. However, at least for 2018, the PPACA is not “dead” or “gone” and the health care industry should prepare for at least one more year of significant enrollment.