Enrollment for Affordable Care Act (ACA) health insurance plans in the coming year is down nationwide - and in Maine. Advocates for the health care law say that several factors may explain the downswing, including a drastic reduction in federal funding for outreach efforts.
In the first month of enrollment, around 18,000 Mainers signed up for health insurance on the Affordable Care Act marketplace. That compares to nearly 24,000 in the same timeframe last year. It's about a 27 percent decline. That’s steeper than national enrollment numbers, which have also dropped.
Cheryl Fish-Parcham of Families USA, a national health consumer advocacy group, says that one likely reason for the drop is less federal funding for outreach efforts.
"So there's less community based assistance,” says Fish-Parcham. “The government is not advertising as much on TV and on the radio."
The Trump administration has slashed funding for state-based insurance navigator programs. Maine's funding dropped from about $550,000 last year to $100,000 this year.
"We just do not have the same capacity that we had in the past," says Hillary Barter, a health navigator with Western Maine Community Action. Western Maine Community Action coordinates with 10 other community action agencies across the state to help consumers find their way into the marketplace.
"Many of the agencies, they've gone down from several navigators to one," says Barter.
Some organizations had to drop navigator services altogether. Andi Pelletier of the Maine Lobstermen's Association says that his organization started offering navigator services five years ago to help self-employed fishermen sign up for insurance that was previously unavailable.
"We've worked really hard, we have a good relationship, I think, with people,” says Pelletier. “And, certainly the last two years, people knew that we were here, and that we were a resource, and we were deluged with phone calls. So to lose our funding was a pretty big blow."
Another likely reason for the enrollment drop, says Kate Ende of Maine-based Consumers for Affordable Health Care, is the elimination next year of the individual mandate penalty that has required individuals to purchase insurance.
"That was an incentive for a lot of people to purchase insurance prior to that."
Ende says some consumers may also be enticed by short-term health plans. President Trump has expanded the availability of these plans, which tend to be cheaper than marketplace insurance. But Ende says they come with another price.
"These plans often don't cover what you don't think they're going to, and they often have limits as far as how much they'll pay out in a year for an individual to receive a certain type of benefit."
Additionally short term health insurance plans are not required to offer the same protections- for preexisting conditions, for example, that ACA marketplace plans do.
Ende says consumers who need assistance selecting health insurance plans can call Consumers for Affordable Health Care's helpline.
Open enrollment runs through December 15.
Updated Wednesday Nov. 28, 2018, 5:16 p.m.
