Md. health exchange prepares for enrollment amid Trump orders

Dr. Howard Haft

The Maryland Health Benefit Exchange is on track for the November open enrollment period to begin despite significant changes at the federal level.

While President Donald Trump and his administration have cut subsidies to insurance companies, shortened the enrollment period and cut federal funds for Affordable Care Act marketing and navigator services, those changes will not significantly affect the state, officials on the exchange’s board of trustees said.

Because Maryland’s Health Connection runs separately from the federal government, it will not see reductions in funding for advertisement or other services. Just 1 percent of the exchange’s enrollees come from healthcare.gov, the federal health exchange website.

“It could,” create some confusion for people signing up for the exchanges, said Andy Ratner, the exchange’s chief marketing officer. But while some people have linked Maryland’s exchange to federal actions, others do not see the connection, according to exchange survey data.

For the most part, that’s because “Health care literacy in general is just at an abysmal level,” said Dr. Howard Haft, the interim executive director of the exchange.

Since the creation of the exchanges, Maryland’s uninsured rate has fallen to 6.1 percent, more than half of the pre-exchange rate.

The state hopes to keep that momentum going in this upcoming enrollment period, especially attracting rural and minority consumers. Last year, the exchange saw a 7.5 percent decline in enrollment among black consumers and only flat growth from Hispanic consumers.

It has put marketing efforts this year into black publications and radio stations and will be advertising at grocery stores in rural areas. The exchange will also play movie trailer ads at theaters during the 45-day enrollment period opening Nov. 1.

The ads played over the airwaves will focus on the peace of mind of having health insurance versus the anxiety of not having it. Exchange surveys found that consumers with insurance felt confident while those who did not felt anxious about the topic.

The biggest obstacle to obtaining health insurance remains cost. But Ratner said that cost comes from awareness of premium prices, up significantly this year, not the actual prices consumers pay.

For 25 percent of consumers, 2018’s premium increases will come without any kind of financial aid and they will feel the brunt of the hikes. But most consumers will receive tax credits or other subsidies. The price after reflecting those credits and subsidies will be seen by consumers while they browse for plans.

The board did not address Trump’s decision last week to cut off subsidies to insurance companies.

Already, 800 people a day are visiting the exchange’s website to view plans for next year. The exchange also has an app that has been downloaded by 155,000 people to help browse plans and send notifications reminding consumers to renew their plans.