If you buy insurance on your own and have been paying attention to the Affordable Care Act, you鈥檝e probably heard that open enrollment for 2018 plans has just started and the government is spending a lot less money this year to get the word out.
That鈥檚 true in the 39 states that rely on healthcare.gov. But circumstances are different in some of the聽聽that run their own ACA websites and marketplaces.
They鈥檙e in charge of their own marketing and enrollment assistance programs, so are somewhat immune from Trump administration actions 鈥� and inaction 鈥� that critics have warned will undermine 2018 individual market enrollment.
鈥淲e鈥檙e in a very different position than the federal government,鈥� said聽, who runs Minnesota鈥檚 exchange, MNsure. 鈥淚 see a lot of action coming out of Washington designed to destabilize the market and to hinder enrollment. I have the exact opposite goal in Minnesota.鈥�
In its first year of managing the sign-ups, the Trump administration聽聽most states rely on for the federally run insurance exchange by 90 percent. The open enrollment period is shorter and聽, the federal website, will curb its hours on all Sundays during the sign-up period, except the last one.
A recent analysis by the chief marketing officer of healthcare.gov under President Barack Obama estimated that the marketing cuts alone may聽聽by at least 1.1 million people.
In contrast, MNsure is planning another all-out annual enrollment push with ads on TV and social media. It will also pay other organizations to help spread the word; for example, MNSure gave $500,000 to聽, a nonprofit healthcare navigator group, for outreach.
The money helps a lot.
鈥淧ortico Healthnet was able to staff up 鈥� so we have more navigators on staff now to prepare ourselves to meet the needs of the open-enrollment demand,鈥� said Meghan Kimmel, president of the organization, which is based in St. Paul. 鈥淲e are anywhere we can be where we can talk with people about access to coverage.鈥�
罢丑别听, which relies on healthcare.gov, the federal exchange. Open enrollment in these states is shaping up to be much different under President Donald Trump than it was under President Obama.
鈥淲e鈥檙e still enrolling,鈥� said Ginni Tran, who works as an ACA navigator at Mercy Housing & Human Development in Gulfport, Miss., 鈥渂ut we鈥檙e not aggressively outreaching and educating鈥� because there isn鈥檛 enough money. Her office helps Gulf Coast seafood industry workers find health plans on healthcare.gov. Cuts to federal enrollment assistance translated to a 70 percent smaller budget for Mercy鈥檚 open enrollment activities.
Mississippi鈥檚 uninsured rate has fallen to 12 percent but remains tied for third-worst in the United States. Republican Gov. Phil Bryant has staunchly opposed the Affordable Care Act and聽.
Kimmel and others said what鈥檚 happening in states using healthcare.gov underscores the value of Minnesota having its own exchange.
At least one longtime MNsure critic, however, remains unconvinced. State Rep. Greg Davids, a Republican, dismissed the notion that cutting back on the open-enrollment period and slashing the promotional budget will discourage enrollment. He said he favors having the state turn to healthcare.gov, instead.
鈥淲e need to get rid of MNsure,鈥� Davids said. 鈥淭hey鈥檙e an unnecessary duplicate layer of government that hasn鈥檛 worked.鈥�
This story is part of a partnership that includes , and Kaiser Health News.