Georgia qualifies for Obamacare extension — a surprise to many brokers

The Affordable Care Act sign-up website contains bad information for Georgians trying to see whether they qualify for an extension to enroll. The entire state’s residents are actually eligible for an extension to Dec. 31, due to Hurricane Irma. But while the website contains prompts for extensions due to divorce, changing coverage areas and other factors, it ignores the Hurricane Irma extension. (Screenshot of healthcare.gov Dec. 20, 2017)

The Affordable Care Act sign-up website contains bad information for Georgians trying to see whether they qualify for an extension to enroll. The entire state’s residents are actually eligible for an extension to Dec. 31, due to Hurricane Irma. But while the website contains prompts for extensions due to divorce, changing coverage areas and other factors, it ignores the Hurricane Irma extension. (Screenshot of healthcare.gov Dec. 20, 2017)

Insurance brokers all over Georgia got a clear, helpful message from the federal government on Friday about the end of the window to sign up for Obamacare.

"Open Enrollment Ends Today at 11:59 PM (PST): This is the final day to enroll consumers for coverage all year!"

Only, it wasn’t true.

In fact, the federal Centers for Medicare and Medicaid Services, known as CMS, has confirmed to The Atlanta Journal-Constitution that the entire state of Georgia is eligible for a two-week emergency extension of the Dec. 15 open enrollment window because of the statewide emergency declaration for Hurricane Irma. The new deadline is Dec. 31.

Several insurance agents who sell Obamacare plans told the AJC that the reporter’s call was the first they’d heard of it. The federal agency has done little to publicize the reprieve to potential customers. The last time it told insurance agents about the extension was in September — in spite of weekly email alerts it sends about all manner of other subjects from sign-up website maintenance to date reminders.

When the AJC called the healthcare.gov sign-up help line this week, the first customer service representative who answered had no idea about it and countered that such extensions were instead for events such as divorce.

THE ALERT: Read the government’s September 28 ACA enrollment extension announcement here.

The extension is called a “Special Enrollment Period” or SEP. SEPs normally apply to people who had a life-changing event, such as moving to a new coverage area or getting a divorce. In this case, the hurricanes Harvey, Irma and Maria resulted in emergency or disaster declarations triggering enrollment extensions in those areas that were hit. The applicant has to be “affected” by the storm, but the government is considering them eligible “if they reside, or resided at the start of the incident period,” in the emergency area. For Georgia, that means the whole state.

Another catch: People have to sign up via the phone line, not on the website. The phone line is 1-800-318-2596. The website will likely tell a Georgia enrollee, incorrectly, that he or she is probably not eligible for an extension.

That’s an odd, missed opportunity to message about the extension, some agents said.

“It asks you to put in your state — I would have thought that there would be a notification pop up,” said Trent Cobble, a broker in the Atlanta area who sells exchange plans under the Affordable Care Act.

Cobble was one of several agents or brokers who said they had no idea about the statewide extension until contacted by an AJC reporter.

Atlanta broker Don Warren, said, “If they would or did (send out a message), brokers like myself would still be working.”

Some said they planned to rev back up and call back people they hadn’t reached. “I mean I’ve got a couple people that I think probably would buy if they had another opportunity,” agent Donald White said.

Dawit Gebremichael, an agent in Clarkston, knew about the extension — but he learned about it from an insurance company that’s hoping for increased sales, not the government.

“We have actually quite a number of people who came since yesterday (Dec. 18, the first Monday after the official close) to enroll,” Gebremichael said. He was glad he knew to help them. But as for the Dec. 15 date: “They didn’t know. They maybe thought they would have enough time, like they did before.”

The Trump administration has drawn fire this year for an array of decisions that undermined the Affordable Care Act's market exchange, where people at average income and below are offered affordable health insurance.

It canceled subsidies that help make the market work, and it gutted the budget for enrollment advertising. One of the most significant decisions was to cut the open enrollment period in half. Where it formerly ended Jan. 31, this year it ended Dec. 15.

Analysts said that that date change would likely decrease enrollment. Furthermore, they added, many of those who would be deterred from enrolling could be younger, healthier people who are on the fence about buying insurance and thus buy at the last minute. They are cheaper to insure and thus a critical economic ingredient to the customer pool.

CMS has not yet released final tallies for the Nov. 1-Dec. 15 sign-up period. But in periodic updates up to now, the numbers have been surprisingly high, given the short period and the steep reduction in advertising about it. Still, as analysts predicted, so far they haven't been high enough to match last year's.

Insure Georgia, a large nonprofit “navigator” organization whose main job is to help people sign up, saw the September notice from CMS and started to plan. It has enrolled more than a half-dozen new clients since the weekend. Its navigators shut down their community kiosks on Dec. 15, but the phone lines are still open (at 1-866-988-8246).

The gutted advertising budget for this year’s sign-ups was one of advocates’ biggest complaints.

The administration countered that enough people knew about Obamacare to make advertising insignificant, and that they would instead target advertising online.

Some agents thought the hushed messaging was politically motivated; others said it was typical government incompetence.

A spokeswoman for CMS noted the Sept. 28 memo about the hurricanes. The spokeswoman, April Washington, added: “We have shared a great deal of information about the SEP related to individuals affected by the hurricanes. We were extremely active in sharing this information with enrollment assisters, including agents and brokers.

“On our site, we provide links that provide clear guidance regarding the special enrollment period that runs through Dec. 31. The public, including agents and brokers, may access this information readily and freely via CMS.gov.”

In fact, CMS.gov linked to healthcare.gov, which told a Georgia applicant there was probably no SEP.

One agent shared a screen shot of the website upon the close of open enrollment and said there was nothing on the home page about it.

White, asked about the administration’s assertion it was was extremely active in sharing the information with people like him, said: “Right. Yeah. I disagree.”


CHANGE IN PLANS FOR OBAMACARE ENROLLMENT

  • Nationwide deadline was Dec. 15
  • Deadline for Georgia residents is Dec. 31
  • Do not use the healthcare.gov website
  • Call the help lines:

— 1-800-318-2596 to sign up directly

— 1-866-988-8246 for Insure Georgia to help

A NOTE ON NEW DEVELOPMENTS

  • President Donald Trump is likely to sign a GOP tax bill that also repeals the individual mandate requiring everyone to have health insurance.
  • But the mandate won't be repealed for this year's sign-ups. The mandate will be in effect for all of 2018, and so is the fine for not having insurance. The repeal won't go into effect until 2019.

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