Sign-up gets underway today for the Delaware’s Health Insurance Marketplace.
The sign-up period has been cut from 12 to six weeks under a series of moves by the Trump Administration that also include sharply cutting the program’s advertising budget.
Earlier, the Affordable Care Act (Obamacare) program ended saw the roster of providers go down to one in Delaware.
Deadline, Dec. 15
The deadline for signing up is Dec. 15. A release from the state stated that early enrollment is important because the federal government has announced planned maintenance shutdowns of HealthCare.gov on most Sundays during open enrollment.
Delaware currently has more than 27,000 people enrolled for coverage through its Health Insurance Marketplace, including 73 percent who re-enrolled for 2017 and 27 percent who were new enrollees. The number amounts to a small percentage of the state’s nearly 950,00 residents, many of whom get employer coverage or are part of the state’s Medicaid program.
The number amounts to a small percentage of the state’s nearly 950,00 residents, many of whom get employer coverage or are part of the state’s Medicaid program.
The Marketplace typically covers home-based businesspeople, contract employees, early retirees and those who can’t otherwise get coverage from a spouse. Many receive tax subsidies that reduce high premiums.
Earlier this year, Aetna announced it would not sell plans on Delaware’s Health Insurance Marketplace for 2018.
In October, Insurance Commissioner Trinidad Navarro announced that the Department of Insurance had approved an average rate increase of 25 percent for 2018.
25 percent increase
“With the uncertainty in Washington, many people may not realize that they can still get coverage through the Marketplace and that there’s still financial help available to help them pay for the plan they choose,” said Kara Odom Walker, secretary of the Delaware Department of Health and Social Services. “This year, more than 80 percent of Delawareans who have a Marketplace plan are receiving tax credits to lessen the costs of their premiums. It’s important that enrollees with a current Aetna plan go to HealthCare.gov or make an appointment with an assister who can help walk them through their enrollment options.
For 2018, Highmark Blue Cross Blue Shield of Delaware will offer seven plans for individuals – one gold plan, three silver, two bronze and one catastrophic. Two insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – will offer a collective 12 stand-alone dental plans.
All plans cover essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, and pediatric services.
Gold, silver and bronze
The three metal-level categories – bronze, silver and gold – are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums but high costs when you need care; gold plans have high premiums but lower costs when you need care.
Tax credits are especially beneficial to consumers who pick the second-lowest cost silver plan, since the credits adjust to match any changes in premium. In a silver plan, the insurer pays about 70 percent of medical costs and the consumer pays about 30 percent, up to a maximum annual out-of-pocket cap of $7,350 for an individual and $14,700 for a family.
Consumers who pick silver plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 45 percent of current enrollees qualify for cost-sharing reductions.
Penalties still in place
Individuals who can afford coverage but who choose not to buy are expected to pay a penalty equal to the higher of these amounts: 2.5% of your annual household income or $695 per person ($347.50 per child under 18). For 2017, the maximum penalty will not exceed $2,085 per household. In addition to the penalty, consumers will be responsible for the total cost of health expenses they incur.
Consumers can estimate their penalty using the penalty calculator available on ChooseHealthDE.com.
Since the marketplace was added and eligibility for Medicaid was broadened under the Affordable Care Act, Delaware’s uninsured population decreased from 10 percent in 2008 to 5.7 percent in 2016, according to a recent Census Bureau report.
Trump: System is broken
Health care costs have continued to rise. However, supporters of the Affordale Care Act say the increase came as people did not have insurance and neglected their health moved into the system for treatment.
That decline in the ranks of the uninsured includes Delawareans who could not get coverage before the Affordable Care Act because of pre-existing conditions. Increasing access to health care coverage is the first step toward a healthier Delaware, DHSS Secretary Walker said. She also pointed to the state’s efforts to better manage health care costs.
Others see sabotage
Critics have claimed the moves to shut down the system on Sundays, shorten the enrollment period and threaten to end subsidies amount to an effort to sabotage the system and come amid the failure of Congress to “repeal and replace” the Affordable Care Act. The effort led to confusion over whether the Care Act and whether penalties for not having coverage are still in place.
The Trump Administration has claimed the system is already broken. Trump and Congress have proposed reforms such as selling health insurance across state lines and low-cost plans that provide bare-bones coverage.
A bipartisan group of U.S. senators is working on a reform program for the Care Act, with Delaware’s congressional delegation, all Democrats, supporting the approach.
