An Obamacare Surprise in the Mail: New Insurers and New Costs

Meg and Robert Holub were surprised to receive a letter last week welcoming them to a new health insurance plan and telling them to pay $3,483 by Jan. 8.

“We have received your application for individual and family coverage effective 1/1/2018,” the letter said. The only problem: They never applied for the coverage, did not want it and could not afford it.

“I worried, did someone hack my account to sign me up for this?” Mr. Holub said. “And I wondered, what are the implications if I don’t pay for this plan? Will I be hounded by a credit agency?”

With just a few days left to sign up for health insurance under the Affordable Care Act, hundreds of thousands of consumers like the Holubs are receiving bills for health plans they did not choose. Their current health plans will not be available in 2018, they did not return to the marketplace to pick a plan, and the federal government has assigned them to other plans offered, in many cases, by different insurance companies.

The Trump administration said the process, known as automatic re-enrollment, would help consumers avoid a gap in coverage. Consumers will not be uninsured on Jan. 1 if their current insurer leaves the marketplace and they do not select a new plan in the 45-day open enrollment period, which ends on Friday.

Aetna, Anthem, Cigna, Humana and smaller insurance companies have announced that they will be exiting the Affordable Care Act marketplace in many counties, forcing consumers to look for coverage with other insurers.

The Holubs and their 10-year-old son, who live in Virginia, have coverage this year from Anthem Blue Cross and Blue Shield of Virginia, which is pulling out of the marketplace in their area. They were assigned to a plan offered by Optima Health of Virginia Beach.

“Thank you for choosing Optima Health!” said the letter informing them of the change.

The letter was dated Nov. 10, but the Holubs said they received it last week, just nine days before the end of the open enrollment period. The monthly premium of $3,483 — nearly $41,800 a year — is more than three times what they have been paying Anthem. The letter did not provide any details of the new coverage, benefits, deductible or other out-of-pocket costs.

“Everything about the letter offended me,” Mr. Holub said. “It’s as if I went to a Ford dealer to buy a Ford car, and then I get a call from Chevy saying, ‘Your Chevy truck is ready, and we need the money.’ Well, I didn’t order a Chevy truck.“

As of Monday, more than 50,000 people have been assigned to Optima from insurers leaving the health law’s marketplace, said Kelsea Smith, a spokeswoman for Optima.

“We are seeing our highest enrollment numbers since 2014, the first year Affordable Care Act plans were offered,” she said.

She also acknowledged the confusion. “We are getting calls to our call center with the kind of concerns you’ve heard,” she said.

The days leading up to enrollment deadlines have been crucial in the past. Joshua Peck, who was the chief marketing officer for in the Obama administration, said that a majority of plan selections for coverage starting on Jan. 1 of this year occurred in the two weeks just before the mid-December cutoff.

About 3.6 million people had signed up for insurance in the federal marketplace as of Dec. 2 of this year, about 22 percent more than at the same point last year. But the enrollment period this year is only half as long as the last sign-up period, which continued through January.

In a conference call on Monday, former President Barack Obama urged several hundred enrollment counselors, religious leaders and volunteers to make a final push to get people covered. The pace of sign-ups to date, he said, “is incredible, given that there’s been so little advertising or outreach from some official quarters.”

Fred Ammons, the chief executive of Community Health Works in Georgia, said he and his team of insurance counselors were seeing a surge of activity.

“We are going to come out with enrollment nearly as high as last year’s total in just half the time,” Mr. Ammons said. “Our folks have really been hustling.”

But in the rush, many consumers have been puzzled and perplexed. In Maine, Anthem, one of the nation’s largest insurers, is pulling out of the Affordable Care Act marketplace, and its customers have been assigned to plans offered by Harvard Pilgrim Health Care or Community Health Options, a nonprofit insurance cooperative. Mainers may not know what to make of the letters they are receiving from the new insurers.

“I have Verizon cellphone service,” said Steve Butterfield, the policy director of Consumers for Affordable Health Care in Maine, by way of analogy. “If I get a letter from Sprint saying, ‘You must pay us or we’ll turn off your phone,’ what would I do? What should I do?”

Consumers, he said, may not even open the letters.

Blue Cross and Blue Shield of Georgia is pulling out of the Affordable Care Act marketplace in 74 of the 159 counties in the state, and many of its customers are being automatically assigned to other insurers. Premiums for the new plans are, in many cases, much higher, but so are the tax credits that help defray the cost.

“In many cases, consumers can find a cheaper plan,” said Sarah Sessoms of Insure Georgia, a nonprofit group that helps people enroll.

For that reason, insurance counselors and federal officials strongly suggest that consumers return to to shop for insurance, update their applications and see if they can find a better deal.

Describing the process of automatic re-enrollment, the Trump administration says on that “we’ll enroll you in a 2018 plan with similar pricing and coverage to your 2017 plan.” But as the Holubs discovered, the prices may be very different. And consumers have no guarantee that their preferred doctors will be in the provider network of the new plan.

Even though President Trump has repeatedly said that the Affordable Care Act is collapsing, the federal marketplace is sending emails urging people to sign up.

“Friday, Dec. 15 is the one and only deadline to pick a plan for next year,” says a typical message. “If you miss the deadline, you will not get marketplace coverage in 2018.”

Consumers in a plan that is being eliminated may qualify for extra time — a special enrollment period. In addition, in some states that run their own insurance exchanges, consumers will have more time to sign up. The deadline is Jan. 14 in Minnesota, Jan. 15 in Washington State and Jan. 31 in California and New York.

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