LAS VEGAS (AP) - Trump administration changes and Nevada’s falling unemployment rate may be the causes of lagging enrollment this year in Nevada’s online health insurance marketplace, which closes on Saturday.
The online health insurance markets, a signature element of the Obama-area Affordable Care Act, let people who do not receive health insurance from their employers shop for and enroll in insurance plans online at healthcare.gov.
Enrollment is down across the country this year, including in Nevada, where about 31,000 people signed up for plans through Dec. 1. That’s about 12 percent less than the same period in 2017.
Heather Korbulic, the executive director of the state’s marketplace, known as the Silver State Health Insurance Exchange, said that enrollment started off much slower this year but has been catching up to last year’s sign-up rates.
“I am deeply concerned about it. I don’t want to see any losses in the number of insured Nevadans,” Korbulic said.
She points to a number of factors behind the slow sign-ups, including fewer jobless Nevadans without other options for insurance and less public attention being paid to the Affordable Care Act than in 2017, when a Republican-controlled Congress was working on proposals to repeal the law.
Nevada’s unemployment rate is at 4.4 percent, down from 4.9 percent during the same period last year.
But Korbulic also points to the Trump administration’s moves to weaken the health law and a proposal that could jeopardize the legal status of immigrants if they use public benefits as reasons behind the drop off.
Chief among the changes was a 2017 Republican tax overhaul Trump signed that ended a requirement for most Americans to have insurance or face a tax penalty.
Some people, especially those who are younger and healthier, are choosing to forgo insurance because of the change, but Korbulic said the state is trying to encourage them to keep their coverage.
One millennial-targeted television ad’s Korbulic’s agency is running shows a young woman accidently fall into a fountain while walking and texting on her cellphone. As she falls, the ad lists the average health care costs for her potential injuries.
Nevada’s last-minute marketing and outreach also has to compete with increased promotion of short-term insurance plans, which Trump this year expanded, allowing them to last for up to three years instead of less than a year.
Democrats have branded them “junk insurance,” which offer lower cost plans with skimpier coverage and don’t require coverage for people with pre-existing conditions.
A separate Nevada law only allows those plans to last for about six months, but Korbulic said they’re being aggressively marketed to consumers right now and may be pulling away people who would otherwise buy insurance through Healthcare.gov.
Korbulic said it’s possible that some consumers may be staying away from the health insurance marketplace this year because they fear it could jeopardize their immigration status.
The Trump administration has proposed rules that could deny green cards to immigrants if they use Medicaid, food stamps and other forms of public assistance. The Affordable Care Act’s subsidies aren’t included, but Korbulic said people may not know that.
She’s hoping a final surge before the midnight deadline on Saturday, along with her agency’s aggressive promotion of the marketplace, will keep enrollment numbers on par with last year.
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