President Trump campaigned four years ago on repealing the Affordable Care Act and, with GOP support in the Congress, he did succeed in ending the mandate for Americans to buy health insurance.
But as Trump prepares to leave the White House next month, the so-called Obamacare program not only remains largely in place; it is gaining enrollment this fall.
Tuesday is the last day for individuals to sign up for one of the health exchange plans being offered under the Affordable Care Act for those who don't have health insurance either from their employer or a government program like Medicare or the Veterans Administration.
Spurred by the greater need for such coverage due to both economic and health problems created by the coronavirus pandemic, enrollment in health exchange plans is up from last year. At the same time as the market has matured and stabilized, more health insurers are offering plans and rate increases have moderated this year. At least three health insurers actually cut their premium rates for 2021 compared with the current levels.
"Premiums are more affordable this year; more people have lost their jobs and need their own coverage, and health care is something that rises on the to-do list in the midst of a pandemic," said Michele Johnson, executive director and co-founder of the Tennessee Justice Center. "We're seeing an increased focus on health insurance as people watch their loved ones get sick and, oftentimes without insurance, lose most everything. For all of its political opposition and efforts to weaken it, the Affordable Care Act remains resilient because people need the coverage it provides."
Enrollment in Tennessee's health exchanges offered through the Affordable Care Act peaked in 2016 when persons were still required under the federal law to buy health insurance. Without such a mandate, enrollment dropped in each of the next three years as the economy improved.
But early indications are that signups for the health exchange plans may be up this year, even with less advertising of the plans by the federal government and a shorter window for signups than in some previous years.
More than 3.8 million Americans selected plans through December 5 with daily signups averaging about 14% more than a year ago, according to the most recent federal data. The total number of people who ultimately choose coverage on the Affordable Care Act exchanges won't be known until early 2021, but for those in the 36 states under the federal exchange programs, including Tennessee, Georgia and Alabama, Tuesday will be the last day to sign up for coverage in 2021, barring a change in an individual's status next year.
The Kaiser Family Foundation estimates that roughly 2 to 3 million Americans lost work-based insurance between March and September and many of those may now be signing up for individual plans under the health care exchanges.
Bobby Huffaker, president of the health insurance brokerage firm American Exchange in Chattanooga, said the insurance options for consumers have broadened and prices have improved. With more choices, Huffaker said using a broker like his company helps persons match their health care needs and providers with the best plans for their area. American Exchange has grown to serve persons in 46 states.
"Insurance rates went up a lot in the early years of the program as many sicker people signed up for coverage, but the market has stabilized and gotten more competitive - and even cheaper in some places," Huffaker said.
Tennessee's biggest health insurer, BlueCross BlueShield of Tennessee, is the only insurer to offer health exchange plans in all 95 of Tennessee's counties. So far, BlueCross communications manager Dalya Qualls said enrollment in BlueCross plans "is consistent with what we saw in 2019.
"We've seen fewer new members, which we expected with more competitors offering plans across the state, but we've also seen a slight decrease in the number of our members switching to another insurer," she said.
Although BlueCross premiums will be higher next year, the company has reduced member costs for telehealth visits.
"Many of our members have enjoyed the convenience of telehealth this year, and we expect that trend to continue," Qualls said.
At Bright Health, which offers individual health care plans in parts of Tennessee, a company spokesperson said enrollments this fall have exceeded what was projected.
"We set ambitious enrollment goals for the 2021 plan year because we knew consumer interest in ACA plans would be strong," a Bright Health spokesman said. "We are thrilled to report that we've exceeded those goals and look forward to serving our new and returning members."
Contact Dave Flessner at dflessner@timesfreepress.com or at 423-757-6340.