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Utahns urged to review their options on federal health exchange as enrollment deadline approaches

Sign-ups so far pacing about 7 percent below last year

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SALT LAKE CITY — As the deadline approaches for Utahns to sign up for coverage through the federal health exchange, those who already have a plan are being cautioned to carefully consider their best options for 2019 rather than passively re-enrolling.

Each insurance plan's benefits and premium rates are subject to adjustments from year to year, and which plan is best may also vary over time depending on an enrollee's expected medical needs, explained Heidi Castaneda, director of small employer and individual plans for SelectHealth.

Saturday is the last day to buy a plan on the exchange as part of open enrollment.

"You want make sure you're going back and making sure what you had last year is what you're going to have the next year and really look into those details. But also, your circumstances can change as a consumer," Castaneda said.

For example, she said, "maybe you're planning on having a baby next year," which could make a different plan a better option.

"It's a really good idea to proactively take a second look at the health plan you're enrolled in and just make sure it's the right one."

There are also significantly more insurance plans available for Utahns to choose from for 2019 — 38, as compared to 26 options in 2018 — according to Jeff Hinson, regional administrator for Centers for Medicare and Medicaid.

"It's time to act and see what's available," said Hinson, who oversees the federal government's Medicaid and Medicare programs in Utah and nine other states.

Hinson said plans offered in Utah for next year include 22 options in the bronze tier, 11 silver plans, and five gold plans. Gold plans generally have more thorough benefits and higher premium costs, with bronze plans on the opposite end of that spectrum.

SelectHealth and University of Utah Health Plans are each offering insurance on the exchange to Utahns in all 29 counties. Molina Healthcare, which exited the federal health exchange in Utah in 2018, has re-entered the market and is selling 2019 plans in 10 of the state's 11 most populous counties.

State officials also say premiums on the exchange are set to increase just 1.6 percent on average in 2019, compared to a jump of 39 percent between 2017 and 2018.

The increased options and steady premiums tell Hinson that the exchange is working as intended in Utah, he said.

"As these programs mature and stabilize, it becomes routine. People get comfortable with how it works," Hinson told the Deseret News. "From where I sit, it's nice to see these programs mature."

Despite the generally rosier outlook in the Beehive State compared to a year earlier, though, enrollment numbers on the exchange are trending somewhat behind 2017.

Updated federal data released Wednesday showed 97,931 Utahns had been enrolled in a plan between Nov. 1, when the sign-up period started, and Dec. 8. That is about 6.7 percent lower than the 104,942 who had been signed up through Dec. 9 last year.

The slight discrepancy between those timeframes exists because Centers for Medicare and Medicaid always releases new data on a Wednesday, which falls one day later on the calendar this year.

Hinson said he isn't worried by Utah's slightly lower enrollment figures, and he believes they won't stay that way when the sign-up deadline has come and gone.

"The numbers are a little bit behind but … they're not far behind," he said. "We're real close, and the folks that we've been talking to on the ground think we're going to be at or above where we were last year."

Nationally, numbers are not tracking as closely to last year as they are in Utah. Just over 4.13 million have so far signed up according to the latest data release, while that number was just under 4.68 million at approximately the same time in 2017.

Health insurance experts generally view a large enrollment base as one important indicator of the sustainability of the federal health exchange, saying it signals that relatively healthy people are among those signing up, helping insurers keep premium rates reasonable.

Subsidies and tax credits are available for most enrollees to help manage the cost of their plans. Still, Castaneda said, many who are interested in signing up are unaware that such resources are accessible to them.

"We try to get the word out and remind people that even up to 400 percent of the Federal Poverty Level there are subsidies available," she told the Deseret News.

Castaneda said there are significant resources on healthcare.gov to help people figure out what kind of help they qualify for.

Castaneda added some SelectHealth professionals, in addition to health insurance navigators with the Take Care Utah network of nonprofits, can answer people's questions about their coverage options.

She said she hopes Utahns ambivalent about getting insured will sign up for a plan primarily because those with coverage are "much more likely to take advantage of … preventive care" and stay healthy. She also said it is the wisest move a person can make financially.

"We want you to live your life without worry … so if something does happen, you know you are not going to bankrupt your family or cause major financial stress," Castaneda said.

Considering the importance of the purchase, it is a bad idea to leave put off enrolling for too long and risk missing the Saturday deadline, Hinson warned.

"Don't wait until the last moment. The last moment is upon us," he said.