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It is time to start shopping for next year's health insurance plan - that is if you buy your policy through an Affordable Care Act exchange. The sixth annual open enrollment begins tomorrow. And NPR's Alison Kodjak reports on what shoppers can expect.
ALISON KODJAK, BYLINE: Peter Lee has this sort of marketing mantra that he repeats a lot.
PETER LEE: There's no question that insurance has to be sold. You've got to sell insurance.
KODJAK: Lee is the executive director of Covered California - that state's insurance exchange, where 2 1/2 million people get health care coverage each year. And this open enrollment season he has plans to put on the hard sell.
LEE: We're going to be hitting the airwaves with TV, radio - interrupting people's Pandora. That means that in California the average Californian will hear us, see us, be interrupted by us over 50 times this open enrollment season.
KODJAK: Lee himself is leading a bus tour all over the state, including stops in Sacramento, Fresno and San Diego, to talk up Covered California.
LEE: And what's that mean? It means healthier people sign up because they're reminded and encouraged. And that lowers premiums for everybody, including the federal government.
KODJAK: As open enrollment through healthcare.gov gets underway tomorrow, the differences in insurance markets from state to state are becoming more stark. In California, political leaders have always been supportive of the Affordable Care Act, and they've allocated $100 million for outreach. But in states that use the federal government's insurance exchange - mostly conservative states whose leaders oppose the ACA - there won't be as much outreach.
The Center for Medicare and Medicaid Services says it plans to spend about $10 million on marketing nationwide. The effort will include email and text messages to consumers and Youtube videos, according to the CMS website. The agency declined to talk to NPR about open enrollment. Lee says that, with all the political fighting around the ACA, many people believe insurance is now too expensive for them or don't realize they can get government help to pay their premiums.
LEE: Every place in America, no matter where you live, the subsidies are there today. And people should check and find out if they're eligible for them.
KODJAK: The Trump administration has made changes to the ACA's rules, like gutting the mandate that people buy insurance and making it easier to buy short-term policies that offer only limited coverage. And those changes have added to the cost of some ACA plans, according to Cynthia Cox of the Kaiser Family Foundation.
CYNTHIA COX: So insurance companies when they set their premiums for the coming year have to show their math. They have to justify each element of what is driving up premiums each year or driving them down.
KODJAK: Cox analyzed hundreds of filings. And she says insurers pointed to those very rules to justify their prices. Some companies even mention the reduced marketing as driving up premiums. In response, some states have made their own changes. New Jersey adopted its own individual mandate, and California banned short-term health plans. Maryland and Alaska have added other stabilization programs. So in those states, Cox says premiums are stable and even going down. Others aren't so lucky.
COX: Rural areas have been particularly hard hit by high premiums - not a lot of insurance market competition.
KODJAK: Katie Nicol helps people choose insurance plans at Whitman-Walker Health in Washington, D.C.
KATIE NICOL: Well, our biggest role as navigators is to really ensure that people understand that the ACA is still the law of the land - that the marketplace will be up and running come November 1.
KODJAK: The deadline to sign up for new insurance is December 15 for most of the country. But some states have extended enrollment period that lasts into January. Alison Kodjak, NPR News.
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