Jack Kramer / ctnewsjunkie file photo
Access Health CT storefront in New Haven that is now closed. (Jack Kramer / ctnewsjunkie file photo)

HARTFORD, CT — With so much uncertainty over the future of health insurance officials are gearing up for what could be the toughest enrollment period they’ve faced in the history of the Affordable Care Act.

Connecticut’s insurance exchange which goes by the name, Access Health CT, is planning a comprehensive strategy to enroll as many eligible people as possible, according to Director of Marketing Andrea Ravitz.

The enrollment period begins Nov. 1 and lasts six weeks. Ravitz reminded the Access Health CT board last week that when Access Health first began five years ago the enrollment period was six months, and then three months.

The good news, Ravitz said, is that Access Health has “four years of data” in its hands, which allows officials to plot out a better strategy for enrolling as many people as possible.

That strategy, she said, will include holding enrollment fairs all over the state on Saturdays during the enrollment period.

She said that Access Health will also be opening 10 different storefront locations to enroll people during the enrollment period. She added that the locations would be announced shortly, though she added that two storefronts that have operated for past few years in New Haven and New Britain would not reopen this year.

She quickly added, however, that Access Health will come up with a strategy that will accommodate the New Haven and New Britain customers who were served by the storefronts in the past.

As far as where the enrollment stores will be located, Ravitz said that “was still being discussed” but that they would be strategically located throughout the state.

She added there would also be an extensive media and public relations campaign to get the word out to where the locations are and to ensure that people coming to sign up bring the proper materials with them.

The marketing campaign will likely be needed to alleviate fears that the marketplaces no longer exist under Republican President Donald Trump.

In each of the past four sign-up seasons, the Obama administration was a clear cheerleader for the marketplaces, engaging in widespread marketing efforts, supporting nonprofit “navigators” who helped with community-based enrollment and loudly proclaiming the availability of insurance plans—and federal subsidies—to just about anyone without employer-sponsored coverage, Medicare or Medicaid.

That hasn’t been the case with the Trump administration or Trump, himself, who has repeatedly said he’d like to see Obamacare “implode.”

When Anthem Health Plans and ConnectiCare Benefits submitted their double-digit rate requests to the Insurance Department in May of this year, they both warned that the rates assumed the cost-sharing reductions would continue.

Connecticut insurance carriers receive about $40 million to $50 million per year in cost-sharing reduction payments, James Wadleigh, CEO of Access Health CT, said.

“We are in unprecedented times for the healthcare industry,” Wadleigh said after the Access Health meeting last week, adding there “is a lot of uncertainty.”

Trump has yet to say whether he would end the cost-sharing reductions.

About 40,000 of the 98,000 individuals enrolled in Connecticut’s exchange qualify for cost-sharing reductions (CSR) and 25 percent are qualified for advanced premium tax credits. About 25 percent are receiving no financial assistance.

Insurance Department Commissioner Katharine Wade said if the CSR payments stopped they would ask the two carriers to submit their rates for review.

Wade said she hopes the CSR issue will be resolved in the next couple of weeks.

According to the New York Times, Paul Lombardo, a health actuary at the Connecticut Insurance Department, told officials at a conference in Philadelphia that if the CSR’s are discontinued, Connecticut might direct insurers to spread the cost across all of their health plans, both on and off the insurance exchange created under the Affordable Care Act.

Ideally, the Insurance Department would like to set the 2018 rates by Sept. 1, but would push that off until Sept. 30 if there wasn’t enough clarity around the issue to make a decision.

Wadleigh said there is a real chance that the two insurance companies currently participating through Access Health CT will leave the exchange’s individual marketplace.

The 2017 insurance enrollment period ended with 4,495 fewer Connecticut residents signing up for private plans through the exchange.

There were 111,524 residents who signed up for plans in 2017. In 2016, more than 116,019 signed up.

Residents had fewer insurance companies, just Anthem and Connecticare, and 21 fewer plans to choose from this year.

The same two companies have also submitted rate requests for 2018, but could still leave the marketplace based on decisions being made in Washington D.C. about the future of the ACA.