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Shopping has begun for health insurance plans on the Affordable Care Act exchange market.

This year's exchange has finally turned stable: Prices are flat, or even lower by some Tennessee plans, and more insurers are covering more areas of both Tennessee and Georgia next year. Political fights over Obamacare may come and go, but for the seventh year in a row, signups will begin Nov. 1.

A new study shows that two thirds of all Tennesseans signing up for individual coverage through the health exchanges being offered for next year can get coverage for $10 or less a month and more than three fourths can get coverage for $75 a month or less out of their own pocket.

Tax subsidies are available to about 90% of those seeking individual plans through the health exchange.

"Affordability is the number one concern for consumers shopping for coverage," said Joshua Peck, co-founder of Get America Covered, which surveyed 300 adults currently insured and 400 uninsured individuals about the Affordable Care Act plans. "This data shows that the overwhelming majority of marketplace consumers will be able to find comprehensive coverage that is very affordable."

(Read more: Stable costs but more uninsured as 'Obamacare' sign-ups open)

Nonetheless, Peck said surveys showed many don't think they can afford health insurance and fail to even apply for individual coverage.

"Our survey provides concrete new evidence of how the gap between perception and reality is undermining Open Enrollment," he said.

The number of Tennesseans with no health insurance climbed this year to its highest level in six years, according to a new University of Tennessee report. Affordability is cited as a key factor for the now-estimated 468,096 uninsured adults and children without health coverage in the annual survey conducted by UT at Knoxville's Boyd Center for Business and Economic Research for the state's TennCare health insurance program.

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What

— Open enrollment is the only time each year when people can sign up for Obamacare plans. The enrollment period lasts six weeks. You sign up in the fall and the plans start Jan. 1. People can “shop” beginning today, seeing on healthcare.gov what type of plan is available under their circumstances and how much they’d actually pay, if given discounts for their income and the number of people in their household.

When

— Open enrollment on the ACA exchange runs through Dec. 15. If you wait for winter break you’ve waited too long. Some people who’ve gone through a life-changing event, like a divorce, can get a “special enrollment period” allowing them to enroll outside the open enrollment window. But those rules are very strict and most people don’t qualify.

How

— Start with the federal ACA sign-up website, healthcare.gov. In Chattanooga, a local online company, American Exchange, offers assistance and recommendations at www.americanexchange.com. But experts caution to beware of some of the websites that come up on an internet search for “Obamacare” or “ACA,” because they may dupe people into thinking they’re the real Obamacare or ACA website. Unscrupulous sites might promote alternative plans that get a higher commission for the website or insurance agent, but can be more expensive for the client or deliver less protection than they thought. Healthcare.gov also has a phone number with helpers, 1-800-318-2596. For Spanish speakers, the website is cuidadodesalud.gov.

 

Those Tennesseans now account for 6.9% of the state's total population of 6.77 million, according to the study.

Nationwide, the Census Bureau reported that 27.5 million people nationwide were uninsured in 2018, an increase of nearly 1.9 million from the previous year, and the first increase in a decade.

But in Tennessee, consumers have more options for next year from more carriers and most rates are flat, or even down in some instances, which could lead to more signups.

"It's really exciting that rates have settled down and are decreasing in some instances with more competition coming into the market," said Bobby Huffaker, CEO of American Exchange, a Chattanooga-based online insurance broker which has added 25 employees to handle the busy six-week sign-up season that starts today. "These individual markets have really become a good place to purchase insurance and it looks like there should be an uptick in the number of individuals signing up this year, which would great."

The past couple of years, enrollment has dropped in the individual marketplace after the mandate for individual coverage was dropped.

The Chattanooga-based BlueCross BlueShield of Tennessee, the state's biggest health insurer, is expanding its marketplace coverage to Nashville and Memphis next year and will raise its rates for individual plans next year by only 1.4%. The modest rate increase next year follows a 14.8% cut in premium charges in 2019 by BlueCross.

Cigna Healthcare also plans to expand its coverage next year into the Chattanooga and Jackson markets and will cut its average premium for individual plans on the Obamacare exchange by 5.7% in 2020, Oscar Health, which entered the Tennessee market last year with pans in Nashville and Memphis, is proposing an even bigger 8.3% cut in rates in 2020.

(Read more: Chattanooga-based BlueCross BlueShield of Tennessee refunds $22.6 million to policy holders)

The rate changes show most carriers are pricing their plans relatively close to their rivals and are being more aggressive in their premium charges with greater competition and more certainty about the future of Obamacare.

"This range of around 11% (between the highest and lowest priced plans) is the tightest we have seen," Tennessee Insurance Commissioner Carter Lawrence said. "This tighter range and the proposed filings showing carriers continuing to grow their business into new markets suggests a stabilizing marketplace."

To entice more enrollment to its plans, BlueCross is also offering an enhanced telehealth benefit and a new member rewards program for individual plans in 2020.

"Our individual members have told us they like the convenience of telehealth services, so we're reducing the co-pay for EPO plans to $0 for the first visit and $10 for each additional visit, on most plans," BlueCross spokesman John Hawbaker said. "We're also introducing a member reward program to help encourage healthy choices. Members can earn points by getting preventive health services like an annual wellness exam and flu shot, and then convert those points into gift cards."

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