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ACA enrollment opens this week for the first time under President Trump. What’s changed?

Oct 30, 2017

This Wednesday marks the start of the open enrollment period for the Affordable Care Act (ACA), also known as Obamacare.

This fifth enrollment season is the first one under President Trump, and it’s marked by what critics call his efforts to undermine the ACA.

Marianne Udow-Phillips from the Center for Healthcare Research and Transformation joined Stateside to walk us through what to expect.

Listen above for the full conversation, or read highlights below.

On the likelihood of lower enrollment

The open enrollment period, which runs from November 1 to December 15, is considerably shorter than in previous years, when the period would end in March. Additionally, “there are days when the system will be down and there aren’t navigators to help, so it’s much more complicated for people to get into the system,” said Udow-Phillips.

“There are estimates out there that it will lower enrollment by 10 percent or more,” said Udow-Phillips. “People are really concerned about the complexity and, frankly, all of the press and all of the debates about the Affordable Care Act this summer … has left some people with the feeling that it has been repealed and that they’re not enforcing the mandate and there aren’t going to be choices of health plans.”

On health care plans in Michigan

The ACA “is not broken in Michigan,” said Udow-Phillips. “Michigan continues to have many choices of health plans. In fact we have eight health issuers in the state and every county has a choice of at least two health issuers.”

On rising prices in Michigan

The ACA was intended to provide for cost-sharing subsidies, so that the government would help pay for the co-pays and deductibles of those below a certain income, but “these cost-sharing subsidies were not paid, because the president said that they will not pay them, and Congress has not overruled that,” said Udow-Phillips. Because the law requires those lower prices for those in a certain income brackets, the insurance market in Michigan had to raise premiums for other plans to compensate for the government’s refusal to pay. The average price for an individual plan in Michigan has jumped nearly 27 percent.

On the Senate’s Murray-Alexander bill

The bipartisan bill sponsored by Senators Murray (D-WA) and Alexander (R-TN) “would help lower the costs,” said Udow-Phillips. “I think it could bring the costs down by 20 percent because it would pay for those cost-sharing reductions. It would allow flexibility in states. It would allow people to buy bronze plans who are older than 30.”

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