Questions surround Affordable Care Act’s future

Open enrollment continues through Dec. 15

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The Affordable Care Act has 33 percent more enrollees for health care coverage in 2018 than in the previous year.

“We have seen record enrollment so far during the first weeks of open enrollment,” U.S. Rep. G.K. Butterfield, D-Wilson, said during a Wednesday telephone town hall organized to answer questions about the federal health insurance program.

More than 3,000 people listened in to the town hall, with many asking questions about the ACA’s future.

“My message to you here today is that the Affordable Care Act is here and it is here to stay and I am encouraging all of our citizens who are qualified for benefits under the Affordable Care Act to use it and to take advantage of it,” Butterfield said.


More than a million people have gone to the website, which is more than a 33 percent jump over last year, according to Butterfield.

“When you look at the enrollment numbers for the 1st District, the basic health plan enrollees are now 30,000 people, 30,000 North Carolinians who live in my district are now enrolled in the Affordable Care Act who did not have health insurance previously,” Butterfield said.

The Affordable Care Act was introduced in 2009 by President Barack Obama and passed by Congress in 2010.

Despite many attempts to repeal the health care program commonly referred to as Obamacare since Republicans gained a congressional majority, the ACA remains in force.

Before the ACA became law, more than 50 million Americans were without health insurance.

President Donald Trump campaigned on a promise to repeal it immediately upon taking office, but could not get Congress to go along with the idea.

“Many of the proposals that have been put on the table during the Trump administration have been so far out there that they have not been able to build a 218-vote majority in the House of Representatives in order to get anything passed, so the act is still the law of the land,” Butterfield said. “They are still going to keep taking swipes at it.”

repeal and replace?

“I don’t President Trump realized how complex it was,” said Alan Winstead, a Farm Bureau insurance agent who sits on the North Carolina Department of Insurance Health Insurance Task Force.

The task force was assembled by N.C. Insurance Commissioner Mike Causey to bring together all the stakeholders in health insurance to plan how to respond in the event that the ACA is repealed.

Winstead said the task force is in a holding pattern while the federal government decides what its plans on health insurance will be.

“We will twiddle our thumbs. We will look and we will read, but there is nothing you can do because we are waiting for them to act,” Winstead said. “Without their action there is nothing for us to do. We can think about it. We can plan it, but there is only so much thinking and planning we can do because we have got to know what we’ve got to do. Once the federal government says ‘This is it,’ then we are going to react on how we are going to put it into force for our citizens in North Carolina and how we are going to make it work better for the state.”

Winstead acknowledges that there are no simple answers when it comes to health insurance.

“It is ultra-complex,” Winstead said.

RISING obamacare COSTS

Insurance companies have seen subsidies dwindle, making rates climb, and there has been widespread fraud with the special enrollment period.

Enrollees have seen rising costs of premiums with the Affordable Care Act.

“When this whole thing first started, I had a lot of people sit in my office and cry because they got health insurance for the first time,” Winstead said. “It was humbling when you’ve got people who sit in my office and bawl like babies because they have never had health insurance and they got it, and you felt like a hero. But now, I’ve got people sitting in my office crying again because they are losing it because they can’t afford it.”

Winstead cited his wife as an example.

“Her current cost is $554.46 (per month) in 2017,” Winstead said. “Now, to go to a plan that is not as good, we are being forced to the ACA for her, her premium is going to be $1,046.75 per month. That’s what we are dealing with.”

“People are getting outraged. When your insurance doubles, it hurts the economy. Then you’ve got to make the choice — health care or cable,” Winstead said.

Keeping rates low is, in part, accomplished by getting as many people as possible to enroll in the ACA

“The Affordable Care Act is based on broad participation and the more people who are in the insurance pool, the cheaper the premiums are and the better the coverage gets,” Butterfield said. “The Republicans for years have tried to eliminate the individual mandate so that people are not required to get insurance. Well, there is a reason for that. If people are not required to have insurance, that means that those who are healthy and young will not participate and pay the premium and those who are sick and older will participate and because of that, it will burden insurance premiums and cause insurance premiums to spike.”


On Thursday, Senate Republicans included a repeal of the individual mandate in a version of the tax reform legislation. Without the individual mandate, some say the ACA cannot survive.

“The Affordable Care Act is not in a death spiral as some would have you believe,” Butterfield said.

Butterfield said the Trump administration has taken actions to undermine the ACA by cutting the enrollment period in half, slashing the budget for navigators, people who go out into the community to try to get people to sign up, and cutting the budget for outreach efforts to educate citizens about the plan.

“They have tried to shut down HealthCare.gov for maintenance and they have done it for more than 60 hours during the open enrollment period including 12-hour maintenance blackouts on Sundays, on five consecutive Sundays,” Butterfield said.

Despite attempts to undermine the system, the ACA is still working, Butterfield said.

“It’s not perfect, as President Obama used to say, but it is working and many North Carolinians have insurance today who otherwise would not have it,” Butterfield said. “I am going to continue to defend the act and I am sure the Republicans will do everything they can to repeal it. If they can’t repeal it, they are going to try to damage it in some way and try to cut back in some way on some of the coverage, but I can promise you that I will continue to fight to keep it in full force and effect. If they were to repeal it and I cannot imagine that that would happen, but it the Republicans were to repeal it, it is estimated that the repeal of the Affordable Care Act would have a devastating impact on the American economy.”


Open enrollment began Nov. 1 and will continue through Dec. 15 for people who want to sign up for coverage through HealthCare.gov.

April Morgan, outreach and enrollment coordinator at the North Carolina Community Health Center Association, specializes in open enrollment.

“For people who select a plan on HealthCare.gov before Dec. 15, your coverage will start on Jan. 1 of next year. After Dec. 15, if you haven’t selected a plan, you will need to have certain qualifying life experiences in order to enroll in coverage. That would include things like getting married or having a child.”

Morgan said there are several ways that people can enroll in coverage.

“You can go to HealthCare.gov. You can call the marketplace, and the number for the marketplace is 1-800-318-2596. There are also assisters located throughout North Carolina who can actually sit down with you in person and walk you through the application process,” Morgan said. “You can do one of two things to schedule an appointment with them. You can call 1-855-733-3711, You can also visit ncnavigator.net to schedule an appointment online. Assisters throughout the state offer free, local and unbiased assistance. They will tell you if you qualify for any financial assistance. They will explain your options and they will help you understand the plans that are available to you.”

More than 90 percent of people who have a plan through HealthCare.gov are getting financial assistance to pay for their premiums and some two-thirds of North Carolinians who have an ACA plan get additional help which helps lower their deductibles, co-payments and other health care costs, Morgan said.

Morgan said that even if a person has a current plan through HealthCare.gov, it is beneficial to go back in to the website to see what options are available, because plans and networks change every year.

“Plans that are offered through HealthCare.gov offer a number of rights and protections, so plans offered through HealthCare.gov offer essential health benefits,” Morgan said. “These plans offer free preventive care so people can go in and get immunizations at no cost. They can get annual physicals at no cost, mammograms, colon cancer screenings and so forth. There are no annual and lifetime limits on coverage and people who have preexisting conditions are able to get coverage.”

More information on the ACA and applying for coverage can be found at www.ncgetcovered.org.