Here & Now

Covering Wisconsin offers Helping Hand on Health Insurance

Frederica Freyberg:

The new enrollment period for the Federal Health Insurance Exchange, the insurance marketplace, starts today and runs through December 15. In tonight’s look ahead, what’s new for insurance plans? Who can enroll? And where can you get information? For those and other answers, we turn to Adam Van Spankeren, the Covering Wisconsin lead navigator. Thanks for being here.

Adam Van Spankeren:

Thank you for having me.

Frederica Freyberg:

So as to those questions, what can consumers expect to see in terms of plan options this year?

Adam Van Spankeren:

Sure. There are more plan options than ever in the state and they have, in general — the premiums have gone down by an average of 4%. In some cases, a lot more than that. You have more plan options than ever. I think 61 counties or something like that have three plans at least to choose from.

Frederica Freyberg:

And we were talking just a moment ago about how consumers have to be a little bit careful this year in looking at those plan options because the federal government has allowed a different kind of array.

Adam Van Spankeren:

Sure. So it’s really important that people go to healthcare.gov if they’re actually dealing with the marketplace. At the same time, the plans you’re talking about, the short-term plans are marketed at the same time and they tend to look appealing because they’re cheaper. But they don’t have the same coverage. They don’t necessarily cover pre-existing conditions. They often have a lot of limits. So they don’t adhere to the same ACA rules.

Frederica Freyberg:

And those plans will describe that’s the case?

Adam Van Spankeren:

In the fine print. So it’s important that people know what they’re doing and if they need assistance, they can come to an expert like a navigator, who will help them choose between different options.

Frederica Freyberg:

They can do that by phone, in person or online?

Adam Van Spankeren:

Yes. So they can definitely enroll by themselves at healthcare.gov or by calling, but to work with a person, we like to do it face-to-face because it’s the best outcome for the consumer. It’s the most educational. You get the best result that way. But we can do it over the phone and plan to do that for a lot of the more rural areas of the state.

Frederica Freyberg:

Who is eligible to enroll?

Adam Van Spankeren:

Anyone who is uninsured right now, honestly. Basically, anybody who needs insurance and is over the limit for BadgerCare. And the people who are under the limit for BadgerCare might be eligible for that and we would check for that as well.

Frederica Freyberg:

Who gets subsidies and how much do they offset the premiums?

Adam Van Spankeren:

Sure. The subsidies go up to 400% of the poverty level, which is kind of a useless number, so if you’re thinking, you know, one person I think like $50,000 or a little bit less than that would be 400% of the poverty level. You get help to pay your premium up to that level. Now the lower you are, the more help you get. In some cases, when you’re struggling to make ends meet and you’re not making a lot of money, those premiums can go down dramatically, even as low as like 15 cents.

Frederica Freyberg:

According to state officials, about 400,000 people in Wisconsin were uninsured at some point in 2018. Why has enrollment in the ACA plan slipped?

Adam Van Spankeren:

That’s a really good question. There are a number of factors. One of which is the enrollment period shortened in that time. It used to be three months and now it’s six weeks. And outreach and marketing has stopped. The federal government has stopped marketing the insurance marketplace. So it’s been a burden on a lot of partners and nonprofit groups, our group Covering Wisconsin to really spread the word about open enrollment.

Frederica Freyberg:

Where should people go if they want to get information?

Adam Van Spankeren:

The easiest thing to remember is to call 211 because that is a resource that anyone can do. Just dial 211 and get referred to an assister in your area, maybe a navigator, or call Covering Wisconsin. Go to our website where all our schedules are. Plus we have walk-in events in this area every Saturday and throughout the state.

Frederica Freyberg:

Wow. And also Healthcare.gov.

Adam Van Spankeren:

Always Healthcare.gov. Never dotcom, always Healthcare.gov.

Frederica Freyberg:

All right. Adam Van Spankeren, thanks very much.

Adam Van Spankeren:

Great. Thank you.