The period for signing up for the ACA for 2019 ended on December 15. Axios reports that this may be the worst season ever, certainly in part because of Trump administration policies, but also for other reasons. Sam Baker of Axios states that nation-wide, as of December 14, the number of people who had signed up through HealthCare.gov was down by 12% from the same time last year and down slightly from the year before.
On average, premiums are lower this year, and in many areas there are more plans to choose from. Axios attributes the decline in enrollment to the fact that although premiums have gone down, the coverage is still expensive and unemployment is low. The ACA program is primarily designed to provide access to health insurance to those who do not receive it through their jobs. Also contributing to the decline is the fact that the Department of Health and Human Services has severely cut the budget for advertising and enrollment outreach. It has also expanded short-term plans with minimal coverage that don’t have to cover pre-existing conditions, perhaps removing some healthy people from the ACA.
In our state, the Maryland Health Connection is the official health insurance marketplace. An article by Christina Acosta in the Kent County News on December 13 reports that enrollment in Maryland bucked the national trend and rose by 5% over last year. Acosta quotes Michele Eberle, the Executive Director of the Maryland Health Benefit Exchange stating that for the first time in 20 years premiums were lowered and, still, 9 out of 10 people who come to the system will receive financial assistance. During 2018 almost 154,000 Marylanders enrolled in qualified health plans. Those enrolling in 2019 are finding a 13% average price drop. The Democratic legislature and Governor Hogan took actions that partially negated or cancelled out the Trump administrations actions to undermine the ACA.
On the lower Eastern Shore, the Lower Shore Health Insurance Assistance Program acts as a partner for the Maryland Health Connection. All the qualified health plans sold through the Health Connection, except for catastrophic plans, provide the same benefits and offer free preventative services. The covered benefits are: (1) doctor visits; (2) hospitalization; (3) emergency care; (4) maternity and newborn care; (5) pediatric care, including dental and vision; (6) prescription drugs; (7) lab tests; (8) mental health care; (9) substance abuse treatment.
The uninsured rate on the Lower Shore is 5% in Worcester County, a decrease of 9% from 2013; 7% in Somerset County, a decrease of 11% from 2013; and 6% in Wicomico County, a decrease of 10% from 2013.
Meanwhile, just as the enrollment period ended, a Republican federal judge in Texas (appointed by George W. Bush) declared the ACA unconstitutional in response to a case brought by the Republican attorneys general of 20 states. Attorneys general in other states, including California, will be filing an appeal. The Department of Health and Human Services has stated that the ACA will continue undisturbed while the legal process proceeds. Maryland’s Attorney General Brian E. Frosh had already filed a lawsuit in the U.S. District Court for the District of Maryland against the Trump Administration, seeking a declaratory judgment that the Affordable Care Act (ACA) is constitutional and the federal government must stop taking actions to dismantle it, arguing that elimination of the ACA would imperil the health of millions of Marylanders, wreak havoc on our state budget, and destabilize Maryland’s health insurance markets and health care system.
Title image: Pond at Pickering Creek Audubon Center, Talbot Co. Photo: Jan Plotczyk