Marketplace enrollment for health insurance begins Nov. 1

While most people think of the upcoming holiday season in terms of Halloween, Thanksgiving, Christmas and New Year's Day, I have another term for it! This "holiday" time for me is otherwise known as the Marketplace Health Insurance Open Enrollment period through the Affordable Care Act (ACA). It's the six weeks of the year that I am most busy, most saddened by the stories of ailments and loss, and most blessed to have a job that helps people obtain affordable health coverage. In 2018, our four East Missouri Action Agency counselors helped about 1,100 consumers understand and/or enroll in health coverage. The tax subsidy calculation and insurance rate changes resulted in most all who enrolled to have lower payments than the prior year.

I do expect the 2019 plans and rates to look similar, if not better.

At a time when rumors are flying, cries for change are being made, and worry and confusion are the norm -- clients in Southeast Missouri have, for the most part, been extremely pleased with the Anthem Blue Cross Blue Shield policy choices that were offered in 2018. It is no exaggeration that some individuals and married couples paid nothing for their policies and still have all essential health benefits as the law intended -- preventative care, maternity care, ambulance services, hospital coverage, mental and behavioral health care, chiropractor visits, and prescription co-pays to name a few.

I hear all too often phrases like "I'm not going to have any more kids, it's not right to make me pay for contraception and maternity care." Or "You could just get rid of that behavioral health coverage. Why am I forced to pay higher premiums to include that? I'm not crazy?" If you are in my office, you will hear me respond, "Yep, I hear you. But, the flip side is that I don't need a free, preventative prostate exam every year either, but I sure am glad that my husband, my friends' husbands, my step-dad, and my three brothers can all get theirs." I usually hear crickets for a couple seconds as the consumer ponders that thought -- and hopefully is re-thinking their "me, me, me" attitude and shifting to a "what-is-best-for-the-whole" mentality.

While the ACA is still the law and discounts are still available to consumers if they qualify, there are few changes beginning in 2019. The tax penalty that individuals and families have paid in past years for NOT having health insurance is going away. What this means is that if a consumer chooses not to get health insurance, he/she will not be penalized on taxes when filing in early 2020. However, if a consumer did not get health insurance in 2018 (and didn't otherwise have a legitimate exemption reason), he/she will still get a penalty when filing taxes in early 2019.

Lastly, for those who have heard about short-term limited duration plans and think that those plans would be better, please note that these plans are not required to cover pre-existing health conditions or provide prescription coverage or offer preventative care for free -- among many other consumer guarantees that the ACA plans offer. Read the fine-print in these policies and ask questions of your insurance broker/agent.

Open enrollment for 2019 Marketplace insurance is Nov. 1 through Dec. 15, 2018. East Missouri Action Agency employs four counselors who have offices available in nine counties in Missouri (Bollinger, Cape Girardeau, Perry, Washington, Iron, Madison, Ste. Genevieve, Jefferson and St. Francois). Call 1-800-392-8663 to schedule an appointment to enroll or re-enroll for health insurance.

Gina Martin is Affordable Care Act Navigator for East Missouri Action Agency.