- Next Wednesday, November 1, the six-week enrollment period
begins for health care under the Affordable Care Act.
In tonight's look ahead, we talk with one of Wisconsin's
federally-certified navigators, who helps people looking
for care in the ACA marketplace.
Adam VanSpankeren is a health care navigator
for "Covering Wisconsin."
The agency is funded in part
by state and federal health agencies.
Thanks very much for being here.
- Thank you so much for having us.
- So how does this six-week enrollment period
compare to previous years?
- The six-week part, first of all, obviously,
so previous enrollment periods have gone from November 1
to the end of January and have even been, in some cases,
extended based on need that people still need to get
insurance for the following year.
This year it is cut down to six weeks.
It's just November 1 to December 15.
And we're expecting a lot of people to be struggling to make
those times work and then just to navigate the system.
So we are here to help with that.
- So why is that a struggle, that six-week period,
as opposed to a longer one? - Sure.
People have until December 15 to get insurance for January 1.
Making the time to go online, to call the marketplace,
whatever people are comfortable doing, it's not easy.
Insurance isn't easy.
So having to try and decipher that on your own is really hard.
- How do you help? - How do I help?
How do we help as navigators?
We sit down with people and we provide free,
in-person assistance.
We talk them through the website,
show them how to enroll and really help them.
We educate.
We make it easy.
We break down those tough insurance concepts and say.
"This is what this means for you and your family."
- How do people find a navigator?
- Anyone can find a navigator by calling 211.
Our website, CoveringWI.org, has a find local help feature.
Healthcare.gov has a find local help feature.
So searching online.
Just knowing it is a navigator you're looking for helps a lot.
- What kind of changes should enrollees expect
in premiums or coverage?
- So premiums go up every year.
That's true of health care universally.
And we're expecting premiums, even in Wisconsin,
I think to go up by as much as 50% in some cases.
That's a lot of money.
It was already a lot of money for people to paying.
But the important thing is the tax credit,
the discount that people see when they're lower-income,
and even people who do make kind of decent amount of money
can still get a discount.
That discount goes up when the premiums goes up.
So what people see at the end of the day and what they'll have to
pay month to month could still be very affordable
and probably will be for them.
- So is it expected that subsidies
will cover the increases?
- Maybe not 100%, but yes.
Those tax credits go up.
The discounts go up to manage those increases.
- Have you seen the effect of government spending on outreach
and ads being cut by 90% this year?
- I did see that.
- How so?
- We-- the federal government normally sends out
a lot of different alerts letting people know
that the marketplace is still there.
There has been obviously a veil of confusion over the whole
conversation with the different repeal and replace efforts.
It's important people know that Obamacare is there.
The CMS, HHS, Health and Human Services will normally help us
organize events and appear at those events
to help kick off open enrollment
and that has just been not forthcoming this year.
- And so navigators and places like "Covering Wisconsin"
have had to do that themselves?
- We do it ourselves anyway.
The outreach is important.
It's critical, actually.
But it seems more important than ever this year.
A shorter open enrollment period, increased confusion,
it's hard.
People need to know we're still here.
Tax credits are still here.
Affordable insurance is still an option.
Obamacare is still here.
- 250,000 people, we've just checked,
are currently enrolled in the ACA marketplace.
- In Wisconsin?
- In Wisconsin.
How many are out there that are not insured?
- Wisconsin still has about 300,
000 people who are still uninsured,
which is kind of staggering to think about.
We are doing our best to connect with those people,
get them on the programs they should be eligible for.
Children, families especially for BadgerCare,
we help with that as well.
That's our local Medicaid program, to connect them to it.
Most people are eligible for a tax credit on the marketplace.
We can sit down during open enrollment with anyone and show
them their options, show them how much they could save
and how affordable insurance is.
- Have health insurers stopped selling plans in Wisconsin
because of uncertainty
or the loss of these cost-sharing reduction subsidies?
- Sure.
Yes, a number of insurers have pulled out of different markets
in Wisconsin.
We still have 11 major insurers in the state participating.
In most areas there are two to three to four plans available
for people to choose from.
Not plans-- companies-- that is plans.
They have many different plans on the marketplace
to choose from.
We still have a really healthy market here in Wisconsin.
- What's the bottom line advice for people
seeking to enroll this year?
- The bottom line is do it sooner rather than later.
And if you need help, help is available.
So go online, call 211, look for "Covering Wisconsin,"
find a navigator.
If I -- insurance is never easy.
And people have questions.
I don't want those questions to stop them from seeking help,
because we're here.
We have the answers.
We want to get you enrolled.
- If one were to call 211, find a navigator and have an
in-person meeting, how long should they expect to take with
you or someone else?
- We tend to budget an hour and a half.
It usually takes a lot less.
We like to have that amount of time available to answer
questions and to really help people feel good about the
choice they're making, to understand the many insurance
things we talk about.
And also I should mention going online to CoveringWisconsin.org,
anyone can schedule an appointment with a navigator
just by clicking the link there.
We have our schedules up.
You can find the next available appointment
and book it yourself.
- Great information.
Adam VanSpankeren, thanks very much.
- Absolutely.
Thank you for having me.