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Hammer discusses upcoming ACA open enrollment period

Hammer discusses upcoming ACA open enrollment period

When Illinoisans go to pick Affordable Care Act plans next month, they will likely see little change in their premiums, and some will have an additional insurer to choose from.

Open enrollment for ACA plans starts Nov. 1 and ends Dec. 15.

In a recent interview, Department of Insurance Director Jennifer Hammer said she expects “very little movement” in rates and confirmed that Quartz is entering the state’s ACA market. The insurer will offer a plan in Winnebago, Boone, Ogle and Stephenson counties that features SwedishAmerican.

Hammer also talked about steps the department is taking to promote open enrollment and the potential impact of alternative options like short-term policies and association health plans.

Edited excerpts are below.

HNI: What role will the department play in the upcoming ACA open enrollment period?

JH: State funding has stayed the same for Get Covered Illinois. It’s the $1 million [appropriation] that’s been in place previously. We anticipate that we will be seeking some of the same mediums to get the message out to the young invincibles or the uninsured. We’re in a partnership state with the federal, and so we’re responsible for consumer education and protection.

We’re anticipating a majority will re-enroll and our messaging will be somewhat similar. We want people to shop around, make sure they get the best networks possible. You want to make sure your doctor’s in the network that you’re purchasing. We will have people answering questions. They can call our call center during business hours and get some sort of guidance, and we’ll be sure to answer all of those in a timely manner like we have in the past. Most importantly, last year we rolled out for the first time ever our 102-county tour. I felt like it was important to get to people where they are. People don’t traditionally think of, “We should call the Department of Insurance.” So we need to come to them where they are to make sure they’re getting the assistance they need.

HNI: Gov. Bruce Rauner has criticized the Affordable Care Act. Why is the department making such an effort to promote enrollment?

JH: There are major structural flaws in the ACA. I think we can all agree that it’s getting better, but getting better doesn’t mean good. And I think we’re at a point now that the sick and subsidized are becoming stabilized, but the unsubsidized still don’t have the product that they need at a price that they can afford. And so I am using every tool that I can to make sure that I fulfill the department’s mission. I take it very seriously that we are creating a competitive and robust insurance marketplace and that we’re protecting and educating consumers. And the Legislature was clear when they granted the appropriation of $1 million. It’s my duty to fulfill the mission of utilizing the $1 million for the taxpayers of Illinois in the best way possible. We are supposed to be good stewards of that funding and the intent was to make sure consumers are educated and protected, that the insurance industry is robust.

HNI: President Donald Trump has made it a priority to offer alternatives to ACA coverage in the individual market, expanding short-term policies and association health plans. What impact will this have on the stability of the market?

JH: I think that the unsubsidized is not stabilized. If the consumer is well informed, if they have that good education about what the product is they’re purchasing, that they’re complying with federal regs, it’s another option. If it’s limited to three months, that actually provides additional instability, right? They were learning their network with that product and what’s covered, what they contracted for and then they’re having to purchase something maybe on the exchange because they had a qualifying life event. And so a 12-month plan with possible renewals gets them to learning that product and what’s covered.

From a consumer education perspective, you want consistency in the product that the consumer’s purchasing. If that product is right for that consumer, which may be an unsubsidized consumer that otherwise wouldn’t be able to afford anything on the exchange because they’re not receiving [Advance Premium Tax Credits], that may be the right product for that person. And I don’t necessarily think that we’re in a scenario, with the ACA being far from perfect, that state regulators should be limiting the short-term, limited-duration plans down to three months. I think it provides choice.

I think the association health plans have the opportunity to provide choice just like large employer plans do. And so they still have to comply with state mandates and those things that the Legislature has identified as priorities for coverage here in Illinois. So if an association has a group of members, it has been established for some time, it meets the requirements and they want to offer coverage just like it would be offered to a large employer group, that’s another option for an unsubsidized person that otherwise wouldn’t be able to afford any coverage and would turn into charity care at a provider setting. You certainly don’t want that.

HNI: For the second year in a row, the Trump administration decreased funding for navigators. What impact do you expect that will have on enrollment?

JH: As we get further into the implementation of the Affordable Care Act, the re-enrollment percentages are going to continue to increase and you’re going to see people staying in a product they like or maybe transitioning to something else. I think initially in the first few years of the ACA, you were trying to find the woodworker, the people that never had coverage. You’re really doing a community-based outreach approach to finding people that have never purchased coverage, don’t understand what coverage is, trying to get them educated to purchase the right plan. Now we have a core group of several hundred thousand people that have been purchasing coverage for several years. We’re hoping that the enrollment will remain stabilized.

Health News Illinois is a nonpartisan, independent news service covering the Illinois healthcare beat. Sign up for a free trial to the newsletter here.

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