The deadline to get health insurance using the federal marketplace is Saturday

5 steps to staying covered under Obamacare

The window for enrollment and renewal for marketplace coverage is Nov. 1-Dec. 15. Here are tips on how to stay covered.
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The window for enrollment and renewal for marketplace coverage is Nov. 1-Dec. 15. Here are tips on how to stay covered.

As the Dec. 15 deadline to enroll in health insurance via the federal marketplace approaches, officials are encouraging people who signed up in previous years to re-enroll, or to sign up for the first time.

Coverage bought during the enrollment period begins Jan. 1, and more than 80 percent of people who enroll using the marketplace qualify for subsidies and tax credits that save them money on their monthly premiums.

Plans bought during previous years will automatically roll over, but renewing the application can lead to more savings, said Edith Slone, director of the Division of Health Benefit Exchange in the Kentucky Office of Health and Data Analytics.

People who have not yet signed up via the federal exchange will not be able to enroll for 2019 coverage after Dec. 15 unless they qualify for a special enrollment period excemption, which includes getting married, having a baby or losing health coverage provided by an employer.

The latest figures show the number of people using the marketplace to enroll this year is down 16 percent from last year, Slone said.

“Our biggest issue right now is people don’t understand that there is that cutoff date,” Slone said of the deadline.

Because the Trump Administration cut the advertising budget for the marketplace by 90 percent, it’s been harder to reach people this year who may not know about the cutoff date, she said.

Congress’ elimination of the individual mandate tax penalty, along with the availability of short-term insurance, also likely contributed to the decline.

Nationally, enrollment figures for the marketplace are down 10 percent from last year, but those figures typically jump near the end of the year as automatic re-enrollments are counted.

For people or families requiring additional help finding health insurance, Kentucky has more than 600 assisters — at least one in every county — who can meet in-person to help people fill out the insurance application and find the best policies.

As the number of people using the federal marketplace lags behind last year, so has the number of Kentuckians enrolling in Medicaid.

According to a November report from the liberal-leaning Kentucky Center for Economic Policy, total Medicaid enrollment between January and September 2018 fell by more than 96,000 people, or 6.7 percent.

State officials estimate a more conservative drop of about 54,000 people.

“In any case, 54,000 or 97,000, it’s a lot of people, and for the most part it’s because people’s incomes are rising,” said Dustin Pugel, author of the Kentucky Center for Economic Policy report. “The economy’s not booming, but it’s certainly improving.”

Since the Medicaid expansion in 2014, the number of Kentuckians without insurance fell dramatically, from 14.9 percent in 2013 to 5.5 percent in 2016.

According to another report from the Kentucky Center for Economic Policy, the expansion has helped create jobs and improved the financial stability of hospitals — the uncompensated care rate in Kentucky dropped 65 percent between 2013 and 2015.

Still, some health care advocates have warned the Gov. Matt Bevin’s Medicaid work requirements, set to roll out April 1, could force many people to lose Medicaid coverage and reverse some of the progress made during the past five years.

The new rules require “able-bodied adults” to prove they have worked or volunteered 80 hours each month to continue receiving coverage.

Emily Beauregard, executive director of Kentucky Voices for Health, a coalition of healthcare advocates, said the proposed policies have had a chilling effect on people who would normally apply and qualify for Medicaid.

“We’re making it harder for people to access these benefits. We’re making it more complicated, more confusing,” Beauregard said. “We know that they’re worried, they’re confused, and a lot of people are probably considering whether it’s worth it.”

Governor Matt Bevin's decision to cut vision and dental care for some Kentucky Medicaid recipients is hurting Healthy Smiles Family and Cosmetic Dentistry in Prestonsburg, where office manager Jessica Clark-Boyd is turning away patients.