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What Consumers Should Know When Purchasing Health Insurance


It's time once again to sign up for a health plan if you purchase insurance on the health care exchanges. Starting Wednesday, the federal exchange will be open in 39 states over the next six weeks. In other states and the District of Columbia, you'll have even longer. But you can be forgiven if you find all this confusing. The Trump administration has not been supportive of the health law and has slashed the Affordable Care Act's marketing budget. That, along with all the talk of repeal and replace, made us think this that this would be a good time to check in with health - Kaiser Health News' Julie Rovner to sort out what's true from what's fiction. So, Julie, welcome back. Thanks for joining us once again.

JULIE ROVNER: Thanks for having me.

MARTIN: So the Affordable Care Act, also known as Obamacare, is still the law of the land, correct?

ROVNER: Yes, it is. Despite the Republicans' best efforts, they were not successful in repealing it or replacing it. And it is the law going forward. People are - a lot of people are confused about that. Some people think it's been repealed. It has not - at least, not yet.

MARTIN: But what does that mean?

ROVNER: Well, it means that there - the things that people like are still there - things like protections for people who have preexisting conditions, subsidies, help for people with their premiums. And these controversial subsidies that the president canceled the payments to the insurers for - those are actually still in the law. So if you earn less than about $30,000, you'll get help not just with your premiums, but also with your deductibles and your other out-of-pocket costs. They are still there for consumers, even though the federal government is no longer paying the insurance companies back.

MARTIN: So what's changed?

ROVNER: Well, the biggest thing that's changed is there's a shorter enrollment period, as you mentioned. In most states, it will be only six weeks. There'd been, at least - there'd basically been three months before that. The Trump administration has, in fact, cut much of the advertising and much of the help. People could go to these assisters or navigators or people who can help them sign up. The budget for the - both of those things have been slashed.

And there's also, this year, a lot of strangeness with the premiums. Because of the cancellation of those payments to the subsidies, you've got states where gold plans, which are supposed to be more expensive, are less expensive. Some people might be able to buy bronze plans for free. You really have to look this year to see how much things cost and what they cover.

MARTIN: That is a lot for people to keep track of, especially if they aren't getting the help that they might have from some sort of a mediator or somebody to help them sign up. So what is the most important thing that a consumer should know?

ROVNER: Well, the most important thing is to shop and shop early. In the past, if you had a plan that you were happy with you, and you didn't do anything, you would be automatically re-enrolled in that plan. Well, this year, that re-enrollment's going to happen after the end of open enrollment. So if you get re-enrolled into a plan that you don't like, you won't be able to change it.

Also, as I mentioned, there's so much strangeness with the premiums this year, you might actually get re-enrolled into a plan that's not the best for you, or the plan you have now might not be the best for you. As I also mentioned, there are fewer people to help. There are some people to help. So that the best thing you can do is get on as soon as possible. Figure out what makes sense. If you need help, find it soon because there'll be a big crush at the end, as there always is.

MARTIN: So you are telling us that being a procrastinator is not a good thing this time around.

ROVNER: No, not this time around. In the past, they've kept things open a little bit extra for people who waited until the last minute. That may not happen. And as I mentioned, it's going to be harder to find help if you need it.

MARTIN: Thanks, Julie. That was Julie Rovner, senior Washington correspondent for Kaiser Health News. Julie, thanks so much for coming in.

ROVNER: You're so welcome. Transcript provided by NPR, Copyright NPR.