NewsOK: Oklahoma City News, Sports, Weather & Entertainment

Oklahoma navigators report more people signing up for insurance under Obamacare

Oklahoma City — Barbie Davis, an insurance navigator in Oklahoma County, says widespread uncertainty over health reform hasn't kept people from coming for help — and they definitely need it.

Navigators assist customers looking to sign up through the exchange under the Affordable Care Act, also known as Obamacare. President Donald Trump's administration cut funding for navigators by 41 percent nationwide, and by 31 percent in Oklahoma, according to the Kaiser Family Foundation. Oklahoma Insurance Commissioner John Doak also announced he was looking into the navigator program, though he has yet to lay out specific allegations.

Davis, who works with Legal Aid Services, said the uncertainty hasn't stopped people from coming to enroll, and she's had more clients than this time last year. Most people who come to her aren't familiar with computers and need help using the website to determine how much they might have to pay for a plan that includes their doctors, she said.

“They don't have a clue (about their options) until they leave my office,” she said.

Tamya Cox, regional director of public policy and organizing at Planned Parenthood Great Plains, said the two navigators in Oklahoma City and Tulsa are seeing about seven or eight clients a day, which is more than this time last year. The uncertainty surrounding the ACA seems to have increased people's interest in the exchange, she said.

“There's an urgency,” she said. “We've seen a substantial increase in people enrolling.”

It isn't yet clear if more people will buy insurance on the exchange than did last year, or if they're just signing up earlier because of the shorter enrollment period. The last day to enroll is Dec. 15. People who don't sign up and don't have another form of insurance will have to a pay a tax penalty of $695 or 2.5 percent of their taxable income, whichever is higher.

Karen Pollitz, a senior fellow at the Kaiser Family Foundation, advised people who want to buy insurance through the exchange to start shopping early. It takes time to compare potential options, she said, and there's no guarantee that the Department of Health and Human Services will allow a grace period for people who tried to enroll on the last day as it did in the past.

“Waiting until 9 o'clock that evening is probably not a good idea,” she said.

Steve Goldman, a navigator with the Oklahoma Primary Care Association, said some people seem to have discovered by word of mouth that they are eligible for subsidies they didn't know about last year. For example, some contractors found that they qualified after subtracting their business expenses, which is legal, he said.

“We've noticed an uptick in calls from self-employed folks this month,” he said. “We're also seeing a lot of re-enrollments, which shows that Oklahomans are happy with the coverage they have.”

Cox said many of the clients their navigators work with still need extensive guidance, however.

“Our navigators are highly trained to have those conversations about what is a deductible, what is coinsurance,” she said.

Buying insurance may be even more confusing this year than in the past. The sticker price of silver plans has shot up, but they still may be the best option for people who qualify for subsidies to lower their out-of-pocket costs. Others may be able to get a gold plan, which usually was more expensive, for the same price as a silver plan because of the way tax credits are calculated.

People who earn too much to qualify for tax credits will have to pay sticker price for whatever plan they choose, however. Off-exchange plans are an option, but can decline to cover some types of care, particularly if you have a pre-existing condition. A single person qualifies for help with premiums if they earn between $12,060 and $48,240. A family of four qualifies with an income between $24,600 and $98,400.

Davis said too many people wrongly assume they'll have to pay the full price, however, and urged them to explore their options.

“A lot of people don't know, so they don't even try” to enroll, she said.

Meg Wingerter

Meg Wingerter has covered health at The Oklahoman since July 2017. Previously, she lived in Topeka, Kansas, and worked at Kansas News Service and The Topeka Capital-Journal, where she earned awards for business coverage. She graduated from... Read more ›