Access Health navigates 2018 challenges

BY Matt Pilon

HBJ Photo | Matt Pilon
HBJ Photo | Matt Pilon
Access Health’s Andrea Ravitz is promoting open enrollment this fall amid much uncertainty.
With President Donald Trump's and Congressional Republicans' near-constant attacks on Obamacare swirling, and the shortest-ever open enrollment period set to begin Nov. 1, Access Health CT Marketing Director Andrea Ravitz has been plenty busy communicating facts to potential customers.

People are perhaps as confused as ever about the status of the state's insurance exchange, which hosts two insurers — ConnectiCare and Anthem — that sell health coverage to individuals and small businesses.

"There's a lot of noise," Ravitz said. "Do I still need to do this? Are you still around? Did you close your doors?"

The answer: "Yes, the Affordable Care Act is still the law, there is still a penalty for not having healthcare coverage, and Access Health CT is still the only place people can get financial help," Ravitz said.

The open enrollment period to buy insurance through Access Health will run for eight weeks through Dec. 22. That's four weeks shorter than what's been allotted in previous years. Coverage starts Jan. 1.

Access Health officials weren't sure which coverage options would be sold on the exchange until mid-September. That's when Anthem and ConnectiCare confirmed they would continue offering exchange plans, despite uncertainty about the Affordable Care Act's future.

That short time frame made it more difficult for Ravitz to plan Access Health's ad campaign, which costs north of $4 million.

"I was planning three campaigns two months ago," she said. "Are we going to have two carriers, one carrier, zero carriers? And what do we do if that happens?"

Television, radio, print and other marketing launched in early September. The campaign focuses on the steep costs of health care without insurance. There is a $695 penalty for not having coverage, but that doesn't account for any major costs someone would incur if they suffered a medical emergency.

"The messaging we have right now is your past self talking to your future self about the decision they made when they signed up," she said. For example, one ad shows the $30,000 cost of a three-day hospital stay and the $800 cost of a year's worth of cholesterol medication.

Another hurdle to navigate this year has been Trump's threats — which he followed through on in September — to eliminate approximately $10 billion in federal payments to Obamacare insurers, which have helped keep premiums down.

The move spurred the Connecticut Insurance Department (CID) to ask Anthem and ConnectiCare to refile their 2018 health plan rates. Without the so-called "cost sharing reduction" (CSR) payments, premiums shot up. For 2018 plans, premiums on average will be 28 to 32 percent higher for individuals and 25.4 percent higher for small business exchange customers, according to CID. (There is a bipartisan plan being considered by Congress that would restore the CSR payments, but its fate is uncertain.)

While 2018 premiums will be steeper in Connecticut and other states, Ravitz said that federal subsidies for many customers will also be higher, helping to offset at least some of the impact. The majority of Access Health's nearly 100,000 customers on commercial health plans receive some level of federal subsidy, she said.

Trump ending CSR payments is a direct example of federal action impacting a state-run exchange. But not everything that's happened at the federal level will impact Connecticut, Ravitz said.

For example, marketing budgets have been gutted for the federally facilitated exchange, which is used by 27 states, but not Connecticut.