Diane Brown’s careful to steer clear of politics when giving her pitch on health care, but that can prove difficult when it’s basically the reason she’s speaking to a roomful of students at Mesa Community College.
“I am not going to talk about the good, the bad of the Affordable Care Act,” said Brown, executive director of Arizona Public Interest Research Group, part of a grassroots coalition trying to get people to sign up for insurance.
Wednesday marks the beginning of open enrollment when people can purchase plans on the ACA’s marketplace. That may come as a surprise to some in Arizona given all the attention on Republican efforts to scrap the law.
“Health insurance is affordable, and I think there are a lot of misnomers that are out there,” she said.
Some people believe the Affordable Care Act is dead or no insurance plans are available — neither is true.
These days Brown is spending a lot of time trying to cut through the confusion wrought by months of Congress and President Donald Trump attempting to repeal the law.
She ends with a final appeal for students “to help spread the word through your student organizations, through your personal networks.”
In fact, that may be one of the only ways people learn about their options, especially the coveted but difficult-to-reach Millennials.
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The Trump administration has slashed this year’s outreach budget for the ACA, including almost all the ad dollars. People like Brown are now trying to fill the void.
At the end of her presentation, one student asks Brown: “What happens to pre-existing conditions?
His name is Edward Willekens, 23 years old. He and his mother have coverage through the ACA and her recent cancer diagnosis has him worried about the law’s fate.
“I know insurance is going to be more expensive next year for sure,” Willekens said.
He then brings up the decision to cut off certain subsidies to insurers.
“I think I heard something ... Trump actually signed something about getting rid of that support,” he said.
Willkens is right. Much to the dismay of the health care industry, President Trump ended the “cost-sharing reduction” payments, which lower the price of care for low-income consumers. But that move is having a different impact depending on where you live.
In Arizona, premiums are virtually unchanged this year. Last year, the state saw triple-digit rate hikes and quickly became the poster child for the ACA’s failure.
“Arizona could be given the award for most improved right now,” said Marcus Johnson, who’s with Vitalyst Health Foundation, which is helping lead the effort to enroll people.
“We are actually seeing a significant stabilization of the marketplace,” he said.
Johnson admits making sure consumers, especially young people, know that is tricky.
“However, we are doing a lot of outreach efforts to schools, to colleges, to community colleges to make sure people are at least aware,” he said.
The stakes are ever higher because in Arizona and most states, enrollment only lasts for six weeks this year. Pressure to separate fact from fiction will be on people like Veronica Rivas, who works for Keogh Health Connection.
Rivas is training navigators like herself who give free help to consumers buying marketplace plans.
“Most of our clients listen and hear and watch a lot of things on the news. They are one confused. Many of them think they won’t have any options to enroll,” Rivas said.
Each county in Arizona only has one insurer on the marketplace, but there are multiple plans. Still, Republicans contend that high deductibles and few choices are forcing people to forgo insurance and instead pay the fine.
“This notion, that it’s all hunky dory. Keep with the plan elides the fact that 155,000 Arizonans wake up this morning and say we are paying a fine to the federal government because we can’t find affordable care,” Republican Sen. Jeff Flake argued in September on the Senate floor.
But that isn’t the full story according to Jim Hammond, an insurance expert who publishes the Hertel Report. Those who need the individual marketplace, people who aren’t covered by their employer or the government, Hammond said “seven years ago had no choices, they really couldn’t buy insurance anywhere, so it’s always been better than a lot of people have been saying.”
The networks for some plans are narrow, deductibles high and people who make too much to qualify for tax credits are feeling the impact of the rate increases in recent years. But most people will get a tax credit and ultimately pay less than 100 dollars a month.
If that message doesn’t get out, Hammond said the marketplace will be in trouble.
“This gloom and doom if you will, we worry that is going to scare out some healthy people,” he said, “the sicker people stay, that creates a downward spiral of cost and then next year the rates go up.”
It’s a reckoning supporters of the health care law are working to avoid. The next month and a half of open enrollment will determine if they are successful.
