Weeks into the sixth annual open enrollment period of the Affordable Care Act’s health insurance marketplace, some local customers are debating whether to forgo insurance next year because of higher monthly premiums.
Life before the Affordable Care Act was tough for Jennifer Neagle, 41, of Waco, and her family. She suffered from untreated bipolar disorder, depression, anxiety, diabetes and painful peripheral neuropathy. Often she would find herself huddled in a closet, crying uncontrollably in the throes of a panic attack, with anxiety so severe it left her unable to care for her three children.
“It was a nightmare for my family,” Neagle said. “I feel sorry for them at that time in my life.”
For the past three years, a healthier and happier Neagle was one of 12 million people in the United States who received health insurance through the ACA’s marketplace.
But premium increases now threaten the affordability of ACA plans. Stacey Pogue, a senior research analyst for the nonprofit Center for Public Policy Priorities, said decisions by Congress and President Donald Trump’s administration have exacerbated premium increases. The center was founded in Texas in 1985 with a goal of expanding access to health care.
A Republican tax cut last year passed in a bill that also repealed the individual mandate penalty which fined Americans who did not buy health insurance. In response, insurance companies raised health care premium prices in anticipation of the departure of young, healthy people from the market, leaving behind older, sicker people in need of care, Pogue said. Recent budget cuts to advertising and an ACA navigator program have not helped either, she said.
“All of these policy changes at the federal level all had the same effect of undermining the sustainability and affordability of this market over time,” Pogue said.
In McLennan County, monthly premiums for the two cheapest Silver insurance plans increased between 15 and 20 percent from 2018 to 2019.
After looking at her 2019 health care options, Neagle said her 2018 insurance plan will no longer cover her medical needs. She could switch to a Silver Blue Cross Blue Shield of Texas insurance plan if her family can afford the $200 monthly increase, but if not, they may go without insurance.
Neagle said she would rather not go back to life before health insurance. A college graduate, Neagle has been unsuccessful finding a job locally. Her husband is employed, but his employer does not offer health insurance.
“If I didn’t have so many medical conditions we probably wouldn’t have insurance,” she said.
Without health insurance, she would not be able to pay the thousands of dollars every month it would cost for the seven medications she desperately needs. Her mental health would rapidly decline without the medication, she said.
“They (my family) like me a lot better now,” Neagle said. “It’s sad to say that. It sounds like I’m joking, but it’s true.”
She recently became a grandmother after her daughter, Julie Ohde, gave birth to a baby boy this summer. Now, she said she worries how her daughter and her husband will be able to afford family health insurance.
“I don’t know what they’re going to do because I can’t afford to help them,” Neagle said.
She said she wants newly elected and re-elected politicians need to come up with health care solutions rather than continue cutting existing health care protections.
“Politicians are supposed to be in office to improve the lives of their constituents,” she said. “If they are trying to do that and trying to make this nation better then we have to have some kind of affordable health care in place.”
Texas legislators could lower insurance plan premiums by applying for reinsurance money through the federal government, and seven states have succeeded in decreasing premiums that way already, Pogue said. Reinsurance offers insurance providers reimbursement for individual claims above a certain threshold.
“At least one of the seven states said that it dropped premiums by 20 percent,” she said. “That would make a big difference. There’s actually state-level work that Texas could do to bring down premiums. We don’t have to wait for the feds. We just have to turn in an application to do what these sevens states have done.”
During the first week of marketplace open enrollment, Nov. 1-3, healthcare.gov received more than 1.5 million unique visitors to the website. About 800,000 people applied for individual or family insurance coverage and have yet to select or pay for a particular plan. More than 371,000 people have selected and paid for a marketplace health insurance plan for 2019.
Through Dec. 15, people can visit healthcare.gov to apply and select 2019 health insurance coverage through the ACA marketplace.