What the Health? Brace Yourself for Huge Changes to the Affordable Care Act

A new healthcare bill has yet to be finalized and voted on in the Senate, but big changes are already happening to the existing Affordable Care Act. Congress may not have yet presented legislative text for what is to come, but Republicans have made their intentions for what will be set forth clear—rolling back Medicaid, eliminating subsidies for block grant systems, and putting the decision-making power back in the hands of private insurance companies on pricing and preexisting conditions. And beyond that, the ACA has yet to be replaced, but it has been by and large repealed, leaving room for alterations to be made without a full new law being written and passed. And a huge change has finally been announced, which is Open Enrollment for 2018 will be 45 days instead of three months.

That’s a big fucking deal. Since 2013 we have been using the same system to enroll in individual insurance, which is enrolling in regionally designed private plans through healthcare.gov during what’s called Open Enrollment, a three month period of time that is usually November 1-January 31st. They are literally cutting the amount of time we have to enroll in health insurance by half. Some people will of course say that a month and a half is plenty of time to find a spare moment to enroll in healthcare. That’s just not true, and for a very big reason. That reason being that healthcare.gov is plagued with glitches and goes down frequently with so many people using the site.

To top that off, their call center will also shut down with too much activity, forcing people to have to leave a call back number who never get a call back. With a great deal of the American people not having a clue about health insurance, or the intricacies in the system (which is not anyone’s fault. The government didn’t do their part to properly educate people on the new system, and the call center for healthcare.gov is not populated with insurance agents who are knowledgeable about insurance, or often time how the site even works).

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As someone who has previously worked in health insurance I can not emphasize enough how detrimental this truncating of enrollment time will be to the American people. In the announcement of the new enrollment time period the Centers for Medicare and Medicaid Services released they directly said the new rule was enacted to, “”improve the risk pool and promote stability in the individual insurance market.” That’s a loaded and coded statement. The “risk pool” is an insurance term that is thrown around in the insurance community and in legislative texts. It refers to people who have preexisting conditions who are high risk and therefore cost insurance companies more money. They are essentially saying that they are doing this to reduce the amount of high risk people signed up for insurance, which is another way of saying that they want fewer sick people in the system, the people who need insurance the most.

They are right, this implementation will increase stability in the individual market, but it will cause chaos in general society, creating an astronomically high population of sick people who won’t have health insurance and will die. What they really mean to say is that they want to decrease the obvious instability in their own system that is all over the media. By doing this, they will have an excuse to sound bite as we move into 2018, that it’s sick people’s own faults for not signing up in time. And that will be wrong and it will have devastating consequences.

The New York Times recently reported that it does look like the Senate’s new healthcare bill is careening towards disaster, as the Congressional Budget Office released their statement admitting that their proposed plan would leave 22 million people uninsured by 2026. It’s unlikely that moderates seeking reelection in 2018 are going to support that bill no matter what party unity politics swill Trump’s administration shoves down their throats. But regardless, the Open Enrollment rule is final, and people need to realize that just because the full repeal and replace action hasn’t been signed, sealed and delivered that detrimental change isn’t afoot. So do yourself a favor and be ready for November when you will need to enroll in health coverage, and be prepared to be on the phone and online for frustratingly long and tedious periods of time to do so. The only way to survive this administration’s ineptitude in protecting our health and well being will be staying vigilant with the facts and doing the work to stay covered.

Photo: Valeri Potapova/Shutterstock, CC-BY

Chloe Stillwell is a Nashville-based columnist focusing on politics, culture and feminism.