Premiums rise amid health policy tumult, but some consumers stand to save 

Market madness

Nov. 1 is the first day of open enrollment for Obamacare, meaning those who don’t get health insurance through their employer or the government can now go shop for a plan through the state exchange, Connect for Health Colorado (connectforhealthco.com). In 2017, over 200,000 Coloradans, including some 13,400 in El Paso County, took that route to insurance. Enrollment has risen steadily since 2011, when state legislators first created the exchange under the Affordable Care Act (ACA), but this year, under a cloud of uncertainty, exchange officials are hoping enrollment will at least stay flat.

Luke Clarke, spokesperson for Connect for Health, says that ordinarily the website allows consumers to preview and compare the upcoming year’s plans to prepare for the open enrollment period. This year, though, he says, “We’re right down to the wire.”

The difference this year is attributable, at least in part, to the White House’s mid-October announcement of the end of cost sharing reduction payments. Those are payments from the federal government to health insurance companies to reimburse them for keeping out-of-pocket expenses affordable for low-income enrollees. This wasn’t a complete surprise, of course, since President Donald Trump had been flirting with the move long before the official announcement. State regulators had, in fact, already planned for the scenario by requiring insurance companies to submit two sets of rate filings — one assuming the payments would continue and one assuming they’d end. So, when they ended, the state exchange had to load the alternate set of plans into their site. At press time, however, it looked like consumers would be able to view available plans at connectforhealthco.com by Nov. 1.

According to Clarke, all seven insurance carriers have stayed in the Colorado market, but premiums for 2018 plans will be more expensive. On average, statewide, plan premiums are now 6 percent costlier than they would have been had cost-sharing continued, and 33 percent more expensive than 2017 plans. That’s because, as Clarke explains, eligible enrollees will maintain lower out-of-pocket expenses, as is required by the ACA, so insurers will have to recoup that discount through premiums paid by the whole insured pool. But, because federal tax credits will increase relative to this premium increase, qualified consumers, especially those living in areas served by multiple carriers, may actually see net savings in 2018.
All told, Clarke estimates that eligible enrollees could see their costs go down by 20 percent on average. But, in the past, relatively few Coloradans have applied for financial assistance, including tax credits and cost sharing reductions (just over 61 percent compared to over 80 percent in many other states). According to Connect for Health’s income guidelines, individuals making up to $48,000 and families of four making up to $98,000 qualify for some type of savings. Those just over those thresholds stand to lose the most according to Clarke who says, “To reduce the amount of the [premium] increase, what they can do is switch to a different plan in the same metal tier.”

No matter what, Clarke urges people to shop around, apply for financial assistance and make use of free, in-person help with enrollment. Local helpers include: Choice Enrollment, at 4707 N. Academy Blvd., and HealthMarkets, at 1255 Lake Plaza Drive, #250. (Or click here to consult with a broker.)

During this open enrollment period, the differences between Colorado’s exchange and the federal marketplace (healthcare.gov) — used by states that didn’t set up their own exchange — will be pronounced. Our sign-up window is longer: You have until Dec. 15 to sign up for plans that kick in Jan. 1 and until Jan. 12 for plans that kick in Feb. 1. (The federal marketplace cuts off on Dec. 15.) Colorado’s exchange will also maintain an advertising budget comparable to those in years past, whereas federal funding for that purpose was cut by 90 percent.

Adam Fox with the Colorado Consumer Health Initiative observes, “There’s a lot of consumer confusion as to what’s actually happening ... After so many attempts at repealing [the ACA], some people think it has actually happened when it hasn’t.”

Signature Obamacare provisions are still in place: Once you’re enrolled in a 2018 plan, it’s not subject to change; health insurance still must cover “essential health benefits,” including mental health, maternity and preventive care; and all Americans are still required to have health insurance or face a tax penalty.

Below, find 2018 plans available through the exchange in the Colorado Springs rating area, which covers El Paso and Teller counties. Note, no platinum plans are available.
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