Donald Trump pledged voters that he would repeal Obamacare “very, very soon” in June 2017. The law is still largely intact two-and-a half years later. However, Trump’s administration has succeeded in removing many of its core principles, including ending the requirement that all Americans be covered and allowing short-term plans. It also cut funding for navigators who assist consumers with signing up for insurance. Many consumers are confused as to what law is left, according to navigators Talley who work under a federal grant that allows people to sign up for insurance through a health care marketplace. Talley said that many people believed that Obamacare was over when the politicians tried to kill it and that the insurance penalty was cancelled. She said that short-term insurance plans are now allowed under the new rule changes. There is a lot of confusion when it comes to enrollment. People who enroll for the first time can’t distinguish between the official ACA Marketplace plans, private insurers piggybacking from the federal open enrollment period, or newly permitted short-term plans. She said that people don’t know how to ask questions about deductibles or premiums. This refers to monthly premium payments and out-of-pocket limits. “Some deductibles can be so high that the insurance is never going kick-in — some of these plans are short-term and others are just shams.” However, enrollment has not been affected by the Affordable Care Act changes. The numbers are rising this year, and Mississippi was among five states that saw enrollment growth last year. The enrollment figures for the first week of December were 37,576. This slightly exceeds the 35,445 who enrolled during the same period last year. Mike Chaney, Commissioner of Mississippi Insurance Department, stated that the federal Center for Medicare & Medicaid Services numbers frequently lag and placed Mississippi’s actual enrollment at 81,000 last week. “CMS is always behind. Chaney stated that it has been this way for many years. The main point is that enrollments through the federal exchange are likely to be higher than last year. This is because you can purchase an individual policy on exchange more easily than you can through private insurers Blue Cross and United. It is simpler to use the exchange.” However, it may prove difficult to get help from navigators to enroll and to get to the exchange. Enter “Obamacare plan Mississippi” and “Affordable care Act Mississippi” into an online search bar. Ads to sites promising “Obamacare coverage at $50/month” will fill the page. Many of these plans don’t comply with the ACA’s requirements for comprehensive coverage and the consumers will not be eligible for tax credits to pay for the coverage. The Trump Administration relaxed restrictions on short-term plans last year. This allowed them to cover consumers for a longer period of time, from three to twelve months. The ACA advocates had opposed this change for years. They argued that these plans are often cheaper than plans under the ACA, and offer less comprehensive coverage with higher deductibles. This could lead to consumers not realizing their limitations. Roy Mitchell, executive director of Mississippi Health Advocacy Program (a public health advocacy organization that advocates for Mississippians’ health rights), says the new short-term plans are concerning. He said that while they may be cheaper than plans under the ACA, they also offer less comprehensive coverage with higher deductibles and might mislead consumers. Mitchell also pointed out the case of a Tupelo resident who called MHAP to get help for $100,000 in unpaid medical bills. His bare-bones policy had denied him his claim for treatment. The ACA Marketplace plans must cover pre-existing conditions and meet other requirements. This is to ensure that insurance plans kick in when they are needed most. Chaney said that concerns about confusion are overblown. Chaney stated that although there are some cases in which the consumer might not be able to understand the product, most consumers in the state are well-informed. Mitchell points out the irony in the role of short-term plans as a temporary solution. Mitchell said that people seeking these plans during times of transition like when their parents or work are lost, or when they retire early, could be eligible for a tax credit and a special ACA enrollment to lower premium payments. The Trump administration’s recent changes to the ACA may cause instability in the market by stealing young, healthy people. Short-term plans put the Mississippi insurance market at risk and Mississippians who are looking for coverage. Mitchell stated that short-term plans will cause premiums for ACA-compliant coverage to rise as more healthy people choose them over long-term options. Mitchell said that Mississippi’s leaders are proud of their inability to expand health coverage. It is crucial for them to protect short-term health plans. Mitchell also stated that states have broad authority to regulate these plans. This includes a ban on short-term plans or limiting the plan duration. According to data he obtained from the insurance department, there were at least five short-term plan providers with nearly 1,500 participants in 2018. He’s pressed officials and the insurance department to ensure that consumers are protected when they sign up for these plans. However, he is concerned that not enough protections have been in place and that consumers will end up paying for them. These protections are good or bad for Mississippians, but it all depends on the overall support for ACA. U.S. Senator Cindy Hyde Smith, a Republican from Mississippi, voted last January to support the Trump Administration’s expansion in short-term plans. She said that the plans would increase competition for a state with few options on the exchange. “Mississippians require more options for health insurance. Only one insurer will offer coverage through Obamacare in 2018, which has repeatedly failed to provide affordable options for Mississippi families,” Chris Gallegos (Hyde-Smith’s director, communications) said last year in an email to Mississippi Today. Some Mississippians will now have another option for an insurance company this year. Molina joined Ambetter in the 19-county health insurance exchange — which includes the most populous parts of Mississippi, like the Coast and Jackson-metro countries. The new insurer has not attracted many consumers so far. Ambetter is still the cheaper option and offers comparable benefits. Chaney stated that Molina, the new insurer, had signed up just 1,000 of the 81,000 enrolled. Chaney stated that Ambetter has done a great job in improving coverage and networks for consumers, and the consumer is more confident in Ambetter. “… It’s clear that the tide has turned towards the Affordable Care Act.” The Navigators claim both old and new consumers favor Ambetter. Ambetter remains the most affordable option for new customers looking for affordable coverage. Barbara Davis, a returning customer who had previously enrolled with Ambetter, said that “if it’s not broken don’t fix it.” She reenrolled with Talley on December 15th. Davis, 59 years old, enjoys the perks Ambetter has to offer. Ambetter will reimburse her premium and copay if she exercises with them. She also said that the incentive keeps her healthy. The peace of mind that comes with knowing she is still a few years away from Medicare eligibility and that her custodian doesn’t provide benefits is a big plus. The “silver” plan, which has lower monthly premiums but higher deductibles, is a good choice for her. She doesn’t require many medical services, other than annual exams and asthma medication. Talley, who was the navigator that helped David re-enroll in the ACA, echoes her sentiment about peace of mind. She recommends to everyone without insurance that they at least consider enrolling through the ACA. To anyone who reaches out to her, she reiterates that most Mississippians will be eligible for at least some federal tax credit subsidy in order to cover their monthly premiums. CMS data shows that 92 percent Mississippi marketplace enrollees got a tax credit towards their premiums and averaged $42 per month out-of pocket. The market prices have remained stable this year. She said, “You never know what’s going to happen.” Enrollment is open through December 15. Access the marketplace at www.healthcare.gov to get help from navigators. To support this important work, you can make a regular donation to us today as part of the Spring Member Drive.