Shortened enrollment period likely to result in fewer N.H. signups

  • FILE - In this Oct. 6, 2015, file photo, the HealthCare.gov website, where people can buy health insurance, is displayed on a laptop screen in Washington. Worried that insurer exits from the health law’s markets may cause many people to lose coverage, the Obama administration plans to automatically pick a plan from a different carrier for affected consumers. But policyholders could get an unwelcome surprise if their government-recommended plan isn’t what they’re used to. The elaborate backstop was outlined in an administration document circulating among insurers and state regulators. It also calls for reaching affected consumers with a constant stream of reminders as the health law’s 2017 sign-up season goes into full swing. HealthCare.gov’s open enrollment for 2017 starts Nov. 1 and ends Jan. 31. A copy of the plan was provided to The Associated Press. (AP Photo/Andrew Harnik, File) Andrew Harnik

Monitor staff
Friday, December 15, 2017

Hours away from an enrollment deadline for the individual insurance market, New Hampshire community health organizations say interest is higher than ever. Daily signups are robust; navigators have been flooded with calls and appointment requests.

But a Trump administration decision to cut the signup window in half means even with strong engagement, overall enrollments in New Hampshire next year is likely to be reduced, organizers have said. Established with the state exchanges under the Affordable Care Act, the enrollment period, once three months, was reduced by the U.S. Department of Health and Human Services this year to six weeks.

The numbers paint a contrast. By late December 2016, the end of the enrollment period, New Hampshire had seen 35,000 people choose individual marketplace plans, according to figures by the Center for Medicare and Medicaid Services. As of Dec. 9 this year, a week before the deadline, that number hovered around 25,000.

Now, with the new midnight Dec. 15 deadline approaching, officials assisting with signup efforts say enthusiasm can only take the numbers so far.

“It has definitely been a problem,” Bhagirath Khatiwada, program director for the Manchester-based Building Community in New Hampshire (BCNH), said of the scheduling change. “We have seen much interest for people to get covered, but unfortunately because us having a short window, many people are not able to get the benefit of it.”

Khatiwada’s organization, formally the Bhutanese Community Community in New Hampshire, has employed navigators to help with individual marketplace signups for years, focusing on minorities and non-English speakers.

But this year, difficulties mounted. Beyond the reduced enrollment window, Khatiwada said his organization received fewer federal grants, forcing it to cut back on contractors that in past years have helped with sign-ups. And early on, confusion reigned over the status of the Affordable Care Act, with repeal attempts underway in Congress and consumers receiving misleading letters from insurance companies on premium costs. After the Administration’s discontinuation of cost-sharing reductions – a move that directly affected insurance companies – many consumers were under the false impression that they would lose their own subsidies.

Facing those challenges, BCNH made some changes to their strategy: They allowed walk-in appointments, and they expanded outreach and education efforts to much earlier in the year. In the end, that paid off, Khatiwada said: “Our navigators are extremely busy, particularly last week and this week.”

Still, the shortened window meant some who could have benefited from the insurance were unable to be served, Khatiwada said. Many people have work shifts that make signups in the day difficult, he said.

“Had there been a longer window, more people would have had opportunities,” he said.

The signup figures come against a troubled backdrop for New Hampshire’s individual market. An analysis by Gorman Actuarial found that premiums for those without subsidies are expected to rise 52 percent next year, a change the firm estimated could cause up to 13,000 to leave the market. Without a robust constituency of healthy people – and with a shorter period of time to convince them to enroll – some have worried that the market will be saddled with higher-cost patients that will drive up costs.

Amid the uncertainty, one official characterized the strong engagement as a positive sign.

Stephanie Pagliuca, director of the Bi-State Primary Care Association, which also assists with enrollments, said the organization had seen a consistent stream of signups this year. Navigators had kept their schedules full, and had seen the same proportions of people interested in signing up, despite the shorter window.

“In general we’ve found that it’s been busy, but it typically is busy,” she said.

She added: “I think we would count it as a success.”

(Ethan DeWitt can be reached at edewitt@cmonitor.com, or on Twitter at @edewittNH.)