Jessie Menkens expects that this year's health insurance enrollment period under the Obama-era Affordable Care Act could be the toughest one yet in Alaska.
"There has been a lot of uncertainty in our state and a great deal of confusion," said Menkens, who works at the Alaska Primary Care Association and oversees the organization's effort to get Alaskans health insurance.
Starting Wednesday, Alaskans can begin signing up for 2018 individual health insurance plans through the federally run health insurance marketplace, HealthCare.gov, and they will see a drop in the cost of health insurance compared to 2017 plans, according to Premera Blue Cross Blue Shield, the only insurer left on Alaska's individual market.
It's the fifth enrollment period under the Affordable Care Act, the law also known as Obamacare.
Alaskans who don't have health care coverage through their jobs and who aren't covered by Medicaid or Medicare can enroll in the individual health insurance plans.
This year, the length of time people have to enroll in plans through the individual marketplace has shrunk from about three months to 45 days. The enrollment period ends Dec. 15, Menkens said.
The truncated timeline is just one of this year's challenges, she said. She said other obstacles include widespread misconceptions about the health care law. Fighting misinformation has become more difficult since the Trump administration cut funding for the organizations, including her own, that employ "navigators" to help people sign up for the health insurance plans, she said.
"There's just been a great deal of confusion and that has only grown over the past year with the repeal and replace efforts and with the various executive orders and administrative decisions," she said.
Some of the confusion has to do with the prices of the plans and whether Alaskans can still get help paying for their premiums. In some cases, she said, there's still uncertainty around whether the health care law exists at all.
According to news reports, the uncertainty exists across the country.
While President Donald Trump has repeatedly attacked the Affordable Care Act and Congress has tried to repeal it, the health care law remains in place. The federal subsidies to help people with certain incomes pay for premiums and the mandate that requires most people to have health insurance or pay a tax penalty also remain intact, said Joshua Weinstein, president of Northrim Benefits Group in Anchorage, which has a division to help people enroll in health insurance.
"It's all still there," Weinstein said of the law.
The biggest changes in Alaska, Menkens said, include the shorter enrollment time and the decreasing premiums.
"We're letting folks know that for the first time we're actually seeing a significant decrease in rates," she said. "This is fantastic news for Alaskans."
Melanie Coon, a Premera spokeswoman, said monthly premiums on the individual marketplace will decrease by an average of about 21 percent to 27 percent (depending on the plan) in 2018. That follows a 7 percent cost increase in 2017 and 40 percent increases in both 2015 and 2016.
Currently, there are about 16,000 Alaskans insured through the individual health insurance market, Coon said.
Kelly Whitmore, an enrollment navigator at Peninsula Community Health Services of Alaska, said those Alaskans who had 2017 plans through HealthCare.gov should log on again during the open enrollment period to check their information.
She advised Alaskans to shop around and sign up early.
"I'm just trying to remind everyone, please don't wait until the last minute," Whitmore said.
She said Alaskans who want help enrolling in in health insurance can view local resources at getcoveredalaska.org.