By Jill Penley
Medical insurance remains a thorn in the flesh for most Tennesseans. Whether it is the cost of coverage, confusion of what is and is not available, or lack of availability, many are wondering what needs to be done, if anything, during the federal marketplace’s “Open Enrollment Period,” which is set to expire in less than two weeks.
According to a recent study published by the University of Tennessee’s Boyd Center for Business and Economic Research, the statewide rate of uninsured
Tennesseans has risen in the past year, leaving additional state residents without any form of health insurance. Despite this rise, the uninsured rate remains lower than it was before the Affordable Care Act, also known as the ACA or Obamacare, took effect in 2014.
Although one of the least healthy states across the nation, Tennessee is among the states that have not yet expanded Medicaid to single, low-income adults ages between the ages of nineteen and twenty-four leaving approximately 451,000 Tennesseans uninsured. The new study, based on an annual phone survey of 5,000 households, found the reason most participants remain uninsured is economic.
TennCare, Tennessee’s expanded Medicaid program, provides health care coverage for approximately 1.2 million Tennesseans and the survey measured the overall satisfaction of TennCare members with 95 percent of respondents reporting satisfaction with the program and the services rendered from TennCare providers.
“I am pleased that TennCare continues to be recognized for providing access to high quality care for our members,” said TennCare director Wendy Long. “We collaborate with our health plans to promote the delivery of the right care in the right place at the right time, and those efforts are paying off.”
During the recent survey, those identifying as “uninsured” overwhelmingly reported remaining uninsured because they could not afford coverage, but did not qualify for TennCare, In many cases, children in these households were eligible for TennCare coverage, but their parents were not.
Tennessee’s Health Insurance Marketplace sells individual and family healthcare benefits that qualify as minimum essential coverage under the healthcare reform law. Plans sold through the Health Insurance Marketplace are also eligible for income-based financial assistance in the form of premium tax credits and cost-sharing subsidies.
Those who do not qualify for federal credits and subsidies or prefer to explore other coverage options may shop for minimum essential coverage in the private marketplace. These plans may differ from those in the Health Insurance Marketplace. HealthCare.org provides Tennessee health insurance quotes for ACA-compliant major medical plans and more and Tennessee employers with 50 or fewer full-time employees can offer healthcare benefits through the Small Business Health Options Program (SHOP).
Premiums in the Tennessee exchange started out as some of the lowest in the country in 2014 but have increased rapidly since then. The premium increases appear to have caught up to claims costs, however, and the average rates are lower for 2019 than they were for 2018. The premium subsidies are also smaller, though, so enrollees are encouraged to pay close attention and shop carefully.
Open enrollment for 2019 health plans runs from November 1, 2018 to December 15, 2018, with all plan selections and changes effective January 1, 2019. Existing 2018 plans expire on December 31, 2018. In order to avoid any gaps in coverage, it is highly recommended you sign-up by December 15, 2018.