Year two of Delaware’s health insurance marketplace

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 The second open enrollment period of Delaware's health insurance marketplace runs from Nov. 15 through Feb. 15 (Shirley Min/WHYY)

The second open enrollment period of Delaware's health insurance marketplace runs from Nov. 15 through Feb. 15 (Shirley Min/WHYY)

“I’m not going to go broke because I get sick,” said Felipe Hernandez, a machine operator from Wilmington. “I have health insurance, it saves money and it saves my life.”

Hernandez enrolled in Delaware’s health insurance marketplace last year and is one of 23,398 Delawareans who signed up for private health coverage or who enrolled through the state’s Medicaid expansion. 

The Spanish-speaker, who pays a monthly premium of about $73, gave his testimony during a kickoff event at Delaware Technical Community College’s Stanton campus on Friday. The event comes one day ahead of the official launch of the state’s second open enrollment period under the Affordable Care Act.

“Access to care is the first step in enabling consumers to take control of their health needs,” said Rita Landgraf, secretary of the Delaware Dept. of Health and Social Services.

Open enrollment for health coverage in 2015 runs from Nov. 15 through Feb. 15 on HealthCare.gov. However, individuals must sign up by Dec. 15 for coverage to be effective Jan. 1, 2015. Policies for all current enrollees will expire on Dec. 31. Consumers like Hernandez have the option to renew their current plan or sign up for different coverage in 2015.

‘It’ll be a whole lot better than last year’

The first year of open enrollment was mired down with computer glitches, website crashes, long wait times and frustration. 

U.S. Sen. Tom Carper, D-Delaware, attended today’s event. As a member of the Senate Finance Committee, he helped develop and pass the health care reform law. Carper, who enrolled in a marketplace plan last year and will re-enroll this year, is confident open enrollment this time around will be “a whole heck of a lot better.” 

“Last year was a near disaster,” he said. “When you change something as big as health care, it’s not easy and we have struggled. And frankly, we are going to continue to struggle a little bit, but it’ll be a whole lot better than last year.”

DHSS said HealthCare.gov has been streamlined to make it easier for enrollees to shop for and enroll in coverage. For example, the newcomer application now involves only 16 screens, down from 76 screens in the initial year.

State health leaders also broadened the network for in-person assistance with more than 70 locations statewide staffed by certified marketplace guides. The guides are trained to help shoppers through the application and enrollment process. 

The state’s free website, ChooseHealthDE.com, that was created to help people better understand the changes under Obamacare and to navigate the marketplace was also redesigned. The site now includes an interactive tool for consumers to connect with marketplace guides, a link to certified agents and brokers as well as a penalty calculator to determine what you would have to pay if you don’t have health insurance.

It’s the law

Landgraf reiterated that federal law requires those who are eligible for health insurance to buy coverage. Those who are not exempt and don’t buy insurance will face a higher penalty this year: $325 per adult plus $162.50 for each child, or 2 percent of their household income, whichever is higher.

While the state fell far short of its sign-up goal in the inaugural year, Landgraf said this year the state will make a more concerted effort to reach out to communities it didn’t reach last year. The “young invincibles,” or 18-34-year-olds who often go without coverage, and the Spanish-speaking population will be targeted to name a couple.

“We will remind Delawareans that 81 percent of our first year enrollees received financial assistance to make their coverage more affordable,” said Landgraf, who added the state’s Spanish language campaign was culturally fine-tuned to be more effective within that community. 

As far as premiums go, Delaware Insurance Commissioner Karen Weldin Stewart pointed out while rates in at least six other states are going up by 10 percent or more next year, Delaware’s rate is increasing 3.99 percent, down from a requested 5 percent from Highmark/Blue Cross Blue Shield. Insurer Aetna, Stewart said, submitted a request which reflected a small reduction in rates. 

“Delawareans who purchase their plans in the Delaware health insurance marketplace shouldn’t find any unwanted surprises for 2015,” Stewart said. 

The insurance commissioner also said the 2015 marketplace will offer 25 plans to choose from, four more than were available in 2014; small businesses will have 16 plans, up from 11 last year.

The next challenge for the ACA may come from Washington. With Republicans in control of both houses of Congress, it’s unclear at this time whether changes to Obamacare or a complete overhaul are in store.

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