By the numbers
The number of Tennesseans who signed up for individual health plans during open enrollment for next year’s coverage under the Affordable Care Act declined by 3 percent from the previous year and was down 4.7 percent from two years ago.2019: 223,3202018: 230,4932017: 234,222Source: Centers for Medicare and Medicaid Services. Tennessee Department of Commerce and Insurance
Although the individual mandate for buying health insurance was dropped this year and a federal judge this month ruled that provisions of the Affordable Care Act were unconstitutional, the number of Tennesseans enrolling in individual health plans under ACA or ObamaCare declined only 3 percent from a year ago.
A surge of persons signing up for so-called ObamaCare plans in the final week of open enrollment this month pushed individual enrollment under Obamacare plans in Tennessee to 223,320, or 7,173 fewer than the previous year. In the final week of signups ahead of the Dec. 15 deadline, enrollment for 2019 coverage more than doubled in Tennessee, according to figures released by the Centers for Medicare and Medicaid Services.
About one of every 30 residents in Tennessee signed up for individual coverage in one of the individual plans offered by five health insurance companies in Tennessee for those who don't have health insurance through any employer, Medicare, VA or Tenncare plan. With more than 60,000 additional Tennesseans on the job compared with a year ago and more retirees in the state getting Medicare, the drop in Obamacare enrollment shouldn't have much impact on the share of uninsured persons in Tennessee.
Those signing up for individual coverage this year benefited by lower rates from the biggest insurers, including Chattanooga-based BlueCross BlueShield of Tennessee - the state's biggest insurer - which cut its rates by an average of 14.9 percent for 2019, with premiums for differing individual plans ranging from $175.12 and $2,971.6 per month. Cigna Healthcare, the state's second biggest health insurer, cut its rates for next year by an average of 12.9 percent, with premiums ranging from $243 to $2,966 per month for different individual plans.
But the individual mandate requiring all Americans to buy some health insurance if they are not otherwise covered or pay a tax penalty was repealed under the tax reform changes adopted by Congress a year ago. The Trump administration also cut at least $26 million, or 70 percent of the funding, from a key Affordable Care Act outreach program that helps people sign up for health insurance.
The federal agency that oversees the "navigator" program said that up to $10 million will be available for outreach organizations in 34 states that use the federal marketplace. Each state will receive a minimum of $100,000 for eligible groups that help people sign up for health insurance.
The Centers for Medicare and Medicaid Services said the marketplace navigator groups should be able to "stretch their funding further" than in the past as ObamaCare enters its fifth year of operation in 2019.
"We were happy to see the final numbers coming in close to similiar numbers as last year," said Bobby Huffaker, CEO of American Exchange, an online insurance broker in Chattanooga. "With a historically low unemployment rate and the funding for advertising and navigator and assisters being slashed dramatically by the Trump administration, the federal and state marketplaces have become a place individuals and families continue to rely on to gain access to healthcare in America. It provides protection to many that would be unable to seek care without the creation of the state and federal marketplaces, especially those with pre-existing conditions."
The drop in enrollment in Tennessee was even less than the nationwide decline of 4 percent, according to CMS figures. Nationwide, about 8.5 million people signed up for individual plans under Obamcare for 2019, down from the 8.8 million who enrolled last year.
The actual number that pay their premiums and enroll usually declines, however. Last year, the final count nationwide was 8.7 million enrollees, including 199,114 enrollees in Tennessee.
On the final day of the enrollment period, a federal judge in Texas ruled ObamaCare was "invalid" since the tax law adopted by Congress a year ago eliminated the penalty for not having health insurance coverage. The decision by U.S. District Judge Reed O'Connor is being appealed and the Trump administration has agreed to keep the law in place while the appeals proceed.
CMS said it sent more than 3.2 million outreach emails to help Navigators, agents, and brokers who assist HealthCare.gov consumers with enrollment. The Call Center received a total of 5.6 million calls and is still working to get those consumers who left their contact information at our Call Center enrolled.
Marketplace plans in Tennessee
Five health insurers are offering a variety of individual health plans in Tennessee, but the options differ in each major marketChattanooga: Ambetter, BlueCross BlueShield of TennesseeKnoxville: BlueCross BlueShield of Tennessee, Cigna, Bright HealthNashville: Bright Health, Oscar Health, CignaTri-Cities: BlueCross BlueShield of Tennessee, CignaMemphis: Bright Health, Ambetter, Cigna, Oscar HealthSource: Tennessee Department of Commerce and Insurance
CMS also is returning calls this month to 200,000 people who left their information to receive a call back and enroll but didn't complete their applications by the Dec. 15 deadline.
In a year-end report on the enrollment, CMS also bragged that the open enrollment period was "a seamless experience for consumers" and lacked the online signup problems in previous years or the long delays in phone calls to the signup for one of the available plans.
"This Administration has taken strong steps to promote a more competitive, stable health insurance market and these steady enrollment numbers are yet another sign that the Administration's efforts are working," Administrator Seema Verma said in a statement. "With the lowest unemployment rate in 50 years, it's possible that more Americans have employer based coverage, and don't need exchange plans.".
Verma blamed some of the lower enrollment this year on consumers being priced out of the market.
"While enrollment remained steady through HealthCare.gov, many Americans don't qualify for subsidies on HealthCare.gov and remain priced out of the insurance market," she said. "At the end of the day, lower premiums will lead to increased enrollment."
Jaycee Wooley, executive director of the Tennessee Health Care Coalition - a nonprofit group that has supported Obamacare - said Tennessee attracted more health insurers into the individual market this year and "that is going to be a good thing for these communities with more competition and more choices.
"We still want Tennessee to join with what other states have done to expand coverage through Medicaid," she said. "But we think these new additions to the market are encouraging and show that despite all of the challenges, ACA (the Affordable Care Act) is still working and needed in our state."
Contact Dave Flessner at dflessner@timesfreepress.com or at 757-6340.