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Shortly after the November elections are over, open enrollment will begin again for those seeking health insurance or wishing to change their current plan. In the run up to the elections, ACA opponents (aka Republicans) will continue to tout one-liners of how Obamacare is hurting American families (it’s not), how they will repeal it (they’ve tried this more than 50 times), or how people are getting worse benefits (when in fact they are getting more – for less). They are doing this because in spite of everything they’ve tried, Obamacare is refusing to fail.
And it’s only going to get better – or worse if you’re a Republican politician.
Beginning with the new enrollment period, 43 states will see an increase in the number of choices for insurance providers. This will increase competition, providing more choices at lower costs. The ACA requires all plans to have the same basic coverage, including preventative care without co-pay. This means that an increasing number of plans could become more affordable to people that fell into the so-called “coverage gap” during the last enrollment period. These are people that did not qualify for increased Medicaid coverage (often due to their states not expanding it), but also could not qualify for federal subsidies.
In all, there will be an increase of 77 insurers this year.
The bulk of the new issuers will be available via the federally run health insurance exchange. This exchange is available to individuals that live in the 36 states that lack their own. They will have a choice between 248 insurers, an increase of 30 percent. All states in the federal exchange will gain at least one new insurer, with four of the states seeing the number double. Eight states that run their own exchanges will also see a 10 percent increase in companies to choose from.
Then there are the states that are expanding Medicaid, without really expanding Medicaid.
With the ACA refusing to fail, and more of the general public seeing tangible benefits from the reform, many states governments are feeling the pressure to provide coverage for low income people. Since most of the states that refused to expand Medicaid are led by Republicans who despise all things government (except for the paycheck they receive), they are trapped between political rhetoric and the real world reality of how their refusal to expand has hurt the people in their states. Some have tried to alter their existing low income coverage without expanding Medicaid, while others have chosen bailouts for failing public hospitals. Others have said they would look at ways to “improve” the program.
Any changes to Medicaid, however, require approval from the federal government.
Recently, Pennsylvania became the third state to get such approval. Like Arkansas and Iowa, Pennsylvania has “reformed” its Medicaid program to allow the purchase of private plans with Medicaid funds. The program funnels more money to private plans (just like the ACA) and allows the use of Medicaid to cover more people (just like the ACA). The state estimates that 600,000 Pennsylvanians will be eligible for coverage, with enrollment beginning December 1st.
Not to mention, the Affordable Care Act is still going to be, well, affordable.
Most will see some increase in premium, but the increases are much smaller than the double digit increases that were occurring in the years before reform. The national average increase is 7 percent, with many customers seeing their premium costs go down. More employers are shifting their plan options to the exchanges as well, lowering the costs for themselves and their employees.
The state of California is considered the most successful of the exchanges, yet is seeing the only decrease in insurers from 12 to 10. Still, California had the highest number of enrollees than any other state with 1.4 million, and signed up 42 percent of the eligible population – the second-highest in the nation. Even with the decrease in insurers, Californians will only see an average premium increase of 4.2 percent. Ninety percent of all Californians enrolled through Cover California are receiving federal subsidies.
Open enrollment begins on November 15 across the nation.
There is little doubt that the ACA has become a very important part of the health insurance marketplace. While there is much room for improvement, most Americans are already seeing the benefits, and the nation is seeing the lowest rate of uninsured individuals since the 1990s. Voters head to the polls a little over one week before open enrollment begins. Their vote will determine how much better Obamacare will get in the years to come.
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