San Antonio Express-News: Deadline looms for enrolling in health insurance; San Antonio officials urge residents to get it done soon

As coronavirus cases spike across the nation, San Antonio officials are sending out another, but just as important, public health message: Enroll in health insurance.

Dec. 15 is the last day to choose a health plan on the federal health exchange known as healthcare.gov — a deadline many officials and experts believe will not be extended, despite the pandemic wreaking havoc on the U.S. economy and a strained health care system.

"I think with the repeated slander of the Affordable Care Act and the legal challenges after the many attempts to repeal it, there may be some people who feel this option isn't available to them or that it's an option that is so uncertain that they are reluctant to consider it," said U.S. Rep. Lloyd Doggett, D-Austin, whose congressional district includes San Antonio.

But Doggett said, speaking at a new conference with other public officials earlier this week, getting an ACA plan through the exchange is the "best alternative for many people in Bexar County and the surrounding areas to get access to a family doctor in the midst of a pandemic."

City Councilwoman Ana Sandoval said much the same in Spanish at the news conference, stressing there are free resources available to help navigate enrollment.

CentroMed leads a coalition called EnrollSA, which pools funds from local partners to help people enroll in healthcare.gov plans. Individuals also can sign up on their own.

There are two new insurance carriers on the exchange this time around for a total of five in Bexar County, offering a total of 72 plans. Experts say the difference between health plans could mean hundreds of dollars in savings, so it pays to check out the options.

EnrollSA is offering assistance in considering those choices with certified application counselors every day on EnrollSA.com or by calling 210-977-7997, said Ana Maria Garza Cortez, vice president and chief development officer at CentroMed.

Limited in-person services are available by appointment only because of physical distancing requirements.

As of Friday, EnrollSA had completed 1,405 appointments, which led to filing 1,140 marketplace applications. So far, 758 of those have enrolled in health plans on the exchange.

Last year, the organization enrolled 2,019 individuals with many scrambling to file just before the deadline.

Currently, more than 11 million Americans purchase their health plans through the ACA marketplace, including nearly 65,000 in the San Antonio area.

More than 80 percent of consumers are eligible for financial assistance, which can reduce the cost of monthly premiums, Bexar County Judge Nelson Wolff noted at the news conference earlier this week.

Mayor Ron Nirenberg talked about the peace of mind that comes with having comprehensive medical insurance — a real concern during COVID-19, which can lead to high medical bills even for those not hospitalized.

Even before the pandemic, outreach for this six-week open enrollment period was going to be harder than in previous years.

Methodist Healthcare Ministries CEO Jaime Wesolowski described massive cuts in federal funding for marketing and advertising, leaving the public to figure out coverage options on their own or skip it altogether.

San Antonio is the biggest city in Texas without any funding through the federally facilitated navigator program.

The Centers for Medicare and Medicaid Services previously funded a robust call center and placed navigators in communities across the country to assist people with enrollment on the ACA marketplace, but funding went from $63 million in 2016 for the entire country to $10 million this year under the Trump administration.

Local organizations have had to step in to try to fill in the gap and get the word out to the public.

Insurance broker Justin Holland says he's as busy as ever helping people weigh their health plan options for 2021.

For the past three weeks, his San Antonio-based practice, recently acquired by Spire Risk Management, has been assisting clients every 30 minutes from 8 a.m. to 8 p.m. mostly through phone appointments.

"There is no doubt that COVID has played a part in this increased urgency to enroll in 2021 coverage," he said, adding that he hopes the government extends the deadline to accommodate the bottleneck of individuals and families trying to enroll at the last minute, like they've seen most years.

Last year, there was a short extension because of major technology glitches on the healthcare.gov website.

Holland said despite the increased options, he's seeing clients stick with their previous companies to avoid searching for a new in-network primary care provider or specialist.

The five carriers in Bexar County are Ambetter from Superior Health Plan, Blue Cross and Blue Shield of Texas, Friday Health Plans, Molina Healthcare and Oscar.

Private insurers submitted rate filings for 2021 not knowing how the pandemic would affect the company's health costs, utilization and enrollment. As COVID-19 testing and deaths from foregone care have the potential to drive up costs, insurers also expected consumers would avoid routine care while waiting for a vaccine.

In Texas, Blue Cross Blue Shield increased its premiums by 2.9 percent, Molina Healthcare of Texas by 5.3 percent and Oscar Insurance Company by 9.9 percent, according to data collected from state regulators by the Kaiser Family Foundation.

Eric Lane, a health insurance agent with more than 30 years of experience, said he's noticed that those who want to stay on their present plans have had rate increases that seem a bit high. "I would recommend they shop around," he said.

Lane said one of the biggest mistakes he's seen is clients going to out-of-network providers as many plans will not cover those services unless it's an urgent care or emergency event.

"Everyone should take the time to find out if they can qualify and afford a comprehensive major medical plan like those offered on the ACA," he added. "It's worth their time."

Allison De Paoli, founder of local insurance and benefits firm Altiqe Consulting, said as far as employer-based plans go, she has seen rate changes all over the board — up, down and flat. Prescription drug costs continue to increase rapidly.

Most employers won't change medical benefits, she said, unless they absolutely must because people have had a lot of change already. Employers are also showing more of an interest in EAP or Employee Assistance Programs, which offers counseling services for personal and work-related concerns such as stress and financial issues.