Lessons From This Year's Open Enrollment Season

Imagine how many more could have gained access to health care if their president and the ruling party in Congress were not undermining them at every turn.
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On Dec.15, the 5th Affordable Care Act open enrollment season ended in Illinois and other states that use the federal exchange. The numbers came in – and they show that people really do want health insurance. Despite the many hurdles put in their way by the Trump administration, preliminary numbers show that 8.8 million Americans enrolled in those states – 96 percent of last year’s number.

In Illinois, those numbers are slightly lower but still higher than expected – first reports show 339,000 Illinoisans enrolled – 87 percent of last year’s enrollees. It’s clear that people in our state rely on the ACA. The tragedy is that many will be uninsured in 2019 and will go without the health care they need because, instead of working to make enrollment easier, the Trump Administration engaged in a persistent, dangerous campaign to throw up roadblocks and barriers.

The outreach budget was cut by 90 percent ― at the same time that health care consumers were confused by Republican repeal efforts. Navigators – those individuals who provide independent, cost-free information on available health care options – had their budgets cut by 42 percent. In many parts of the state and country, there simply were not enough people to help.

The enrollment period this year in Illinois was cut in half – a Trump directive. A Kaiser Family Foundation survey this fall found that more than 8 in 10 uninsured individuals and the majority of people who shop for their own coverage did not know when open enrollment started or ended.

When my office asked the regional HHS office to participate in an enrollment event – something they routinely have done for previous ACA and Medicare Part D enrollment ― they said no. They were prohibited from doing so ― under orders from the Trump Administration.

The Trump Administration refused to pay for cost-sharing reduction subsidies – a move the non-partisan Congressional Budget Office (CBO) said could raise premiums by 20 percent or more. Then they refused to work with Republicans and Democrats to solve the problem they had created in time for next year.

And, of course, they have supported a tax bill that not only provides 83 percent of its benefits to the richest 1 percent but repeals the ACA’s individual responsibility mandate. That move, again according to CBO, will result in 13 million more uninsured Americans. AARP estimates it will raise premiums for those 55 to 64 by an average of $1,469.

Americans firmly rejected Republican legislative efforts to repeal the ACA – only 17 percent supported it. Instead of working with Democrats to improve the law (by, for example, reducing premiums, lowering prescription drug prices or adding a public option), Republicans turned to Plan B – all out sabotage. They unilaterally changed rules, gagged federal employees, and slipped major health care policy changes into their already devastating tax bill.

This open enrollment period proved unequivocally that Americans want and need access to affordable health insurance. Just imagine how many more could have gained access to health care if their president and the ruling party in Congress were not undermining them at every turn.