AFFORDABLE CARE ACT ENROLLMENT REMAINS CONSTANT IN RURAL TEXAS

Brent Magers, CEO Texas Tech Physicians

• By Brent D. Magers, FACHE, FHFMA, CMPE
• November 15, 2017

Last week, I was contacted by a reporter from Austin wanting to know how the “rural” area was handling sign-up for the Affordable Care Act (ACA). In other words, what were we doing to encourage people to sign up for health insurance products for next year purchased through the online exchanges created by the ACA? I ignored the rural comment—I know we are in a sparsely populated area of the state that is clearly rural, but I don’t consider Lubbock, with its population of more than 250,000 (just in the city itself), to be rural.  

My opinion on the question the reporter posed is that we will have about the same number of people enroll this year as we’ve had before, at least in our region.  I don’t know about the rest of the nation—some predict that it is likely that one million to two million fewer people will choose ACA health plans for 2018, compared with 2017. This is said because advertising spending has been reduced, the open enrollment period has been cut in half to 45 days (Nov. 1-Dec. 15), and there are fewer navigators who help people sign up for insurance plans.

But, I know that we still have navigators available through the Larry Combest Center and Community Health Center of Lubbock.  I also personally know at least three insurance brokers who will take all the time needed to explain options to people.  They get paid a small commission by the two companies that offer insurance on the exchange serving this area and are therefore highly motivated. The insurance broker community is very helpful to folks needing assistance. 

It is true that premiums have increased; but, remember that about 80 percent of the people who sign up are expected to qualify for subsidies that will reduce the cost of insurance to $75 a month or less, according to government data. ACA provides subsidies to single people who make up to $48,000 a year and families of four earning up to $98,000. 

Recently, Jimmy Williams, Senior Director of Provider and Payor Relations, was able to obtain very specific data on the number of people Texas Tech Physicians served who were covered through the Blue Cross Blue Shield product purchased on the exchange.  It is the first time we had seen the data.  It was impressive in terms of the total number of people served. Regardless of what one thinks of the ACA and the philosophy behind it, there is no question that a number of people have benefited from the program.