PHOENIX (AP) - Arizonans who don't get health insurance through their employers or qualify for Medicaid don't appear to be rushing to buy individual plans for 2019 despite a looming Dec. 15 open enrollment deadline.
Experts say the reasons for the nearly 20 percent drop in the first four weeks of the annual open enrollment period for Affordable Care Act plans aren't completely clear. But a major cut in outreach efforts and the elimination of a tax penalty for those who don't buy insurance next year probably are factors. And a growing economy likely means more people are getting employer-sponsored insurance.
"Those are all legit questions, unfortunately there's no answer, it's just total speculation as to why," Allen Gjersvig, who oversees enrollment outreach for the Arizona Alliance for Community Health Centers, said Thursday.
Enrollment surged last year just before the deadline. Many people who are covered and choose to automatically re-enroll won't get counted until open enrollment closes.
Enrollment figures released Wednesday by the federal Centers for Medicare and Medicaid Services show that since Nov. 1, only about 41,000 Arizonans have chosen a plan on the healthcare.gov website, compared with nearly 52,000 at that time last year.
That means more than 100,000 people who currently have plans haven't signed up for coverage that takes effect Jan. 1. Nationally, enrollment is down 13 percent compared to this point last year.
As of June 30, about 145,000 Arizonans had active individual marketplace plans, and 10.2 million people had them nationally. The vast majority of Arizonans with coverage get it either through their jobs or the state's Medicaid plan for low-income residents.
More insurers are selling individual plans in Pima and Maricopa counties for next year, and premiums are stable across the state. Maricopa County saw a big drop, with 21 percent lower premiums being offered for next year as three new insurers enter the market. Two new players begin selling in Pima County.
That's a big change from two years ago, when prices skyrocketed in Arizona. Premiums went up by an average of 116 percent in 2017 as insurers realized they were losing big money and many fled the federal marketplace in the state.
"For all intents and purposes, rates remain stable compared to last year and last year the rates were stable as well," Gjersvig said. "So essentially we've had now going on three years of relative stability."
Blue Cross Blue Shield of Arizona remains the only insurer in the 13 smaller counties. This year, only Ambetter offered plans in Maricopa and Pima counties. Next year, Cigna, Oscar and Bright Health join Ambetter in Maricopa. Ambetter, Blue Cross and Bright Health also will offer plans in Pima.
That increased competition is probably one of the reasons premiums for the average mid-coverage plan in Maricopa will drop by 21 percent next year, said Dr. Daniel Derksen, a University of Arizona health care policy expert who examined rates in all 15 counties. Other counties also saw drops or just small increases.
Nationally, the Congressional Budget Office predicted that 4 million people with coverage could drop it next year because of the tax penalty elimination and other changes enacted by the Trump administration, including big cuts to advertising and "navigator" programs that help people choose insurance plans.
National advertising was cut from about $100 million in 2016 to $10 million last year and this year. Grants to nonprofit groups that hire navigators in Arizona have gone from $1.1 million to $300,000 this year. Gjersvig's group was the only grant recipient this year.
Derksen said those services are important to consumers, because insurance is a complicated purchase that requires comparisons of premiums, co-pays, deductibles and other factors like premium tax credits, which nearly 90 percent of people buying on the marketplace receive.
"People need help with the nuances of the plans that they're choosing," Derksen said. "It's nice to see Arizona having more choices and, certainly in those counties where there's more choices, we've seen the prices for the most part go down by anywhere from eight to 20 percent."
Plans can be viewed at www.healthcare.gov . Help picking an Arizona plan is available by calling 800-377-3536 or going to www.CoverAZ.org