TAMPA — As Republicans in Congress and the White House have an on-again, off-again debate about repealing Obamacare, a couple of developments on the ground are expected to affect this winter's open enrollment period for coverage.
For one thing, Tampa is one of 18 cities nationwide affected by a Trump administration decision not to renew contracts with two companies that helped people sign up for health insurance through the Affordable Care Act.
Also, the next open enrollment period is being cut in half, from 90 days to 45.
Together those decisions have local signup advocates planning to hire more navigators than in the past to help people get covered.
Last year, for example, the nonprofit Family Healthcare Foundation in Tampa hired 16 navigators to work during the annual Obamacare open enrollment period. This year, it expects to have 24.
Previously, open enrollment for Obamacare ran for three months: November, December and January. Starting this year, it will go from Nov. 1 through Dec. 15.
"That's all the time they have to select a plan," said Jodi Ray, program director for Florida Covering Kids & Families at the University of South Florida. The program also plans to increase its staffing for this year's shortened open enrollment period. "We don't know what this open enrollment period is really going to look like."
Locally, 299,899 people in the Tampa Bay area and Sarasota signed up for coverage during the last open enrollment period, up from 284,753 the year before.
Officials with the federal Centers for Medicare and Medicaid Services have cited several reasons for shortening the enrollment period.
They say it should bring the insurance markets for Obamacare in line with those for employer-sponsored insurance and Medicare. Also, a shorter enrollment period already was planned beginning in late 2018.
Moreover, they hope it will lower premiums for Obamacare coverage.
How? By checking the tendency of younger, healthier people to wait as long as possible to buy insurance. Those delayed purchases can drive up premiums by skewing the customer base toward less healthy people who need more care. (Similarly, in an attempt to prevent some people from waiting until they get sick to seek coverage, federal officials have started requiring applicants to prove they're eligible to apply for coverage outside the annual open enrollment period because they moved, got married, had a baby, lost other coverage or had some other specified change in their lives.)
Until this year, people had to enroll by Dec. 15 for coverage that began Jan. 1. If they waited to the end of January to enroll coverage wouldn't start as soon. Locally, said Family Healthcare Foundation executive director Melanie Hall, most signups took place by Dec. 15.
"People very much want coverage," she said. "However, there are always people who wait until the last possible second to enroll."
The second development made news recently when community groups learned the Trump administration will end contracts this month with two Virginia-based companies — Cognosante LLC and CSRA Inc. — that brought sign-up assistance to libraries, businesses and urban neighborhoods in 18 cities, including Tampa, Miami and Orlando.
Together, federal officials have said, the two companies helped with 14,500 enrollments this year — much less than 1 percent of the 9.2 million people nationwide who signed up for insurance through HealthCare.gov.
The first year Obamacare went into effect, both companies worked in the Tampa Bay area, Hall said. After that, Cognosante focused on eastern Florida and Miami while CSRA worked in Tampa, where it provided navigators to work Tuesday nights at recreation centers opened by the city of Tampa to host enrollment activities.
"We were sad and disappointed that their contracts ended so soon," Hall said. "They provided a great service, and as we go into an shortened enrollment period, they will be missed."
The contracts, however, were never meant to be long-term, Centers for Medicare & Medicaid Services spokeswoman Jane Norris told the Associated Press last month.
"These contracts were intended to help provide temporary, in-person enrollment support during the early years," Norris said. The program remains robust, she said, and will have "the on-the-ground resources necessary" in key cities, including a year-round call center and grants for navigator programs.
Despite months of debate and maneuvering in Washington about repealing and maybe replacing the Affordable Care Act, Hall said her organization isn't hearing "too much anxiety" about the future of the law.
"Definitely we get questions, but I think people are really interested about getting accurate information about what's happening right now," she said.
Tampa Mayor Bob Buckhorn, an outspoken supporter of the existing federal law, said Republicans are making changes to undermine Obamacare whether or not they can muster the votes to repeal it.
"Obviously, they're doing everything that they can to negatively impact people's ability to sign up," said Buckhorn, a Democrat. "They don't hide that."
Over the past four years, Buckhorn has opened city recreation centers to Obamacare navigators to help facilitate signups, and he says he'll do so again this year. Access to good health care, he said, affects the city's economy and quality of life, so it shouldn't be a political volleyball.
"Our best response to their attack on the Affordable Care Act," he said, "is to get more people to sign up."
This report includes information from the Associated Press. Contact Richard Danielson at firstname.lastname@example.org or (813) 226-3403. Follow @Danielson_Times