Health care sign-ups in Alaska dip just slightly despite shorter enrollment time and confusion

The number of Alaskans who signed up for health insurance under the Obama-era Affordable Care Act dropped just slightly this year despite a shorter enrollment period and efforts in Congress to repeal the federal health care law.

"We're very pleased with the outcome given the timeline being half as long this year," said Jessie Menkens, who works at the Alaska Primary Care Association and oversees the organization's effort to get Alaskans health insurance. "This clearly demonstrates that Alaskans needs this coverage and rely on it."

A total of 18,313 Alaskans signed up for 2018 health insurance plans under the Affordable Care Act, also called Obamacare, during this year's six-week enrollment window that ended Dec. 15, the Trump administration said Thursday. That's down about 4.5 percent from last year, when Alaskans had twice as long to enroll.

Across the country, about 8.7 million people signed up for the 2018 plans using the federal website HealthCare.gov, a drop from the 9.2 million who got coverage last year.

This year's enrollment total exceeded expectations, according to news reports, given repeal efforts and President Donald Trump's criticism of Obamacare that he has referred to as "dead" and said "is imploding." The Trump administration also halved the amount of time people had to sign up for the health plans this year and slashed funding for both advertising and in-person enrollment aides, like Menkens.

"By far, this was the most challenging open enrollment period," Menkens said. She said the repeal efforts left some Alaskans confused about what was law and what wasn't.

Despite the challenges, she said, "The pace of enrollment was far, far higher than it ever has been."

Premiums for the health plans on Alaska's individual marketplace are also dropping for the first time. The premiums will decrease by more than 26 percent on average in 2018 after increasing by about 7 percent in 2017 and by about 40 percent in both 2015 and 2016.

Jane Straight, director of health impact at United Way of Anchorage, said she was "pleasantly surprised" by the number of Alaskans who signed up for 2018 health plans on HealthCare.gov — available to Alaskans who don't have health care coverage through their jobs and who aren't covered by Medicare or Medicaid. United Way is another organization that helped Alaskans sign up for health care coverage.

"Overall we think it went really well," Straight said of sign-ups. "We were super busy this year."

The federal government has not released additional information about the Alaskans who signed up for 2018 health insurance plans, including how many qualified for a federal subsidy, which help people with certain incomes pay for premiums.

While the Affordable Care Act has not been repealed, Trump signed a sweeping tax bill last week that included the elimination of the law's individual mandate beginning in 2019. The mandate requires most Americans to have health insurance or pay a fine.

Jon Zasada, policy integration director at the Alaska Primary Care Association, said it's too soon to say how exactly the repeal will affect Alaska's health insurance marketplace.

Melanie Coon, Premera Blue Cross Blue Shield spokeswoman, said the insurance company has long advocated that the mandate is "important for the stability of the market." But Republicans have said it's an example of government overreach.

Premera is currently the only insurer left on Alaska's individual market.

Menkens said she hoped the number of Alaskans who enrolled in 2018 individual health plans underscored the need for the health plans in the state.

"In order for us to have any hope of increased competition in our market we needed to have strong participation in the pool this year," she said. "And, this is clearly signaling that there is a need here in Alaska and had we even had a longer duration to work with, we would have had an even larger pool."

The director of the Alaska Division of Insurance did not respond to a request for comment Thursday.

Menkens and Straight said people can still enroll in 2018 health plans though HealthCare.gov if they have a "qualifying life event" such as getting married or losing insurance coverage. For help, they encouraged Alaskans to visit getcoveredalaska.org.