DEPARTMENT: Health
DEPARTMENT HEAD: Colleen M. Bridger, MPH, PhD
COUNCIL DISTRICTS IMPACTED: City Wide
SUBJECT:
A briefing on the status of the Affordable Care Act
SUMMARY:
The San Antonio Metropolitan Health District will provide a presentation, briefing the Community Health and Equity Committee on the status of the Affordable Care Act.
BACKGROUND INFORMATION:
The Affordable Care Act (ACA) was created in 2010 to make healthcare more affordable and accessible to a wider range of Americans. The law has three primary goals: 1) make health insurance more affordable through a Health Insurance Marketplace; 2) expand the Medicaid program for individuals with incomes below 138% of the federal poverty level; and, 3) support innovative medical care delivery methods to reduce costs. Locally, the EnrollSA Coalition has been a nationally recognized major force in educating, promoting and enrolling individuals in health insurance.
In 2010, the estimated number of uninsured in Bexar County was 330,000. The number of ACA enrollees grew from 76,000 in 2014 to 121,000 in 2016. Since the November 2016 election, the local number of ACA enrollees has declined to 113,612. Currently, the biggest concern across the nation and in San Antonio is the confusion about the status of the ACA given recent attempts by U.S. policy makers to repeal and replace the ACA. The upcoming open enrollment period has been shortened from three months to just six weeks (Nov. 1st - Dec. 15th). Federal funding for media promotion and insurance enrollers has been cut resulting in 50 less ACA enrollers in San Antonio. ACA enrollers are responsible for outreach and education as well as enrolling individuals on insurance plans. In addition, a recent presidential executive order has added to the confusion by ending cost-sharing reduction payments to insurance companies.
The October 12, 2017 presidential executive order would create lower cost health insurance options with less coverage; however, the Congressional Budget Office projects premium increases for ACA enrollees and more individuals would be uninsured.
ISSUE:
Unless the U.S. Congress acts to stabilize the ACA insurance marketplace, the number of uninsured will increase across the U.S., Texas and the San Antonio community. This would increase the burden among Bexar County tax payers as more uninsured residents would seek medical care through the county hospital system.
Despite efforts from the federal government to repeal and replace the ACA and defund efforts to encourage enrollment in the ACA insurance marketplace, Metro Health has proactively convened key organizations (ACA Stakeholders) since August 2017 to support the EnrollSA Coalition’s efforts to promote the upcoming open enrollment period. The stakeholders include Centro Med, Daughters of Charity, Methodist Healthcare Ministries, Young Invincibles, Bexar County, University Health System, SA Food Bank, University of the Incarnate Word-School of Medicine, Baptist Health System, and the United Way. The following City departments are also participating: San Antonio Public Library, Department of Human Services, 311, and Parks & Recreation.
The ACA Stakeholders are working on the following actions:
1. Conducting outreach and promoting the upcoming open enrollment period so that the remaining 30+ ACA enrollers can focus on enrolling individuals.
2. Training staff on the ACA and directing residents to ACA enrollers.
3. Using Social Media, media interviews, agency websites to promote open enrollment.
4. Engaging the faith-based community to volunteer (phone banks, determine eligibility, etc.)
5. Disseminate open enrollment information to delegate agencies (CoSA, United Way)
6. Support the EnrollSA Coalition by sharing their five key messages;
a. ACA is still the law of the land. Nothing has changed and open enrollment will still take place.
b. Open enrollment will take place November 1st through December 15th.
c. Financial help is still available for those who qualify.
d. Free in-person application assistance is available through the EnrollSA coalition.
e. Community members can schedule a free appointment by calling 211, 311, or (210) 977-7997 or by visiting www.EnrollSA.com
As, the EnrollSA Coalition continues to encourage local residents to find out if they are eligible to enroll in the ACA insurance marketplace during the upcoming open enrollment period, the City of San Antonio should continue to support the EnrollSA Coalition and direct residents to EnrollSA certified enrollers for the latest information and assistance.
ALTERNATIVES:
This item is for briefing purposes only.
FISCAL IMPACT:
There is no fiscal impact at this time.
RECOMMENDATION:
This item is currently for briefing purposes only.