Healthcare on the Ballot
With one month to go until the midterm elections, healthcare affordability continues to be a major issue driving the national political discussion, based on KFF polling. Efforts by the Trump administration to address affordability have included sending $90 payments to Medicare beneficiaries, and a $500 check to certain ACA enrollees. These checks are expected to reach enrollees this October. In both cases, public funds are being sent to enrollees who had not previously received premium assistance. These efforts are not expected to cover the rising cost of premiums.
In the weeks ahead, you’ll want to remind your enrollees about the importance of comprehensive coverage, and the limits of non-ACA compliant plans. Options like short-term plans, fixed indemnity insurance, and health care sharing ministries often exclude essential health benefits, like:
- Prescription drug coverage
- Mental health and Substance use services
- Maternity Care
For people with disabilities and chronic health conditions, these plans are likely to charge more for enrollees depending on their health status. They might not even cover treatment at all for things that are considered a pre-existing condition.
Enrollment Assistance Prep
Here are some quick ways you can prepare for the coming ACA Open Enrollment season to support people with disabilities:
- Stay updated on health insurance enrollment concerns for the 2027 plan year, by signing up for CBPP’s Health Reform Beyond the Basics fall webinar series. Watch the recording of their September webinar on Work Requirements. Follow their YouTube channel for the recording of the October 6th webinar on premium tax credit eligibility rules and calculation, and catch the next webinar on verifying marketplace eligibility on October 15th. Later in October they’ll review immigration-related eligibility requirements for Medicaid, CHIP, and the ACA Marketplace. Their archive of past webinars is an additional resource with relevant information for this enrollment season.
2. Gather tools to support enrollees as they prepare to navigate the enrollment process. You might want to offer:
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- Plain Language Explainers to support health insurance usage and literacy:
- Health Insurance Language overview from the Patient Advocate Foundation
- Health Care Enrollment Glossary
- CMS Glossary on Health Coverage and Medical Terms
- Essential Health Insurance Selection Steps from gov, including an overview of the 4 “metal” categories
- ACA Subsidy Calculator to estimate 2026 premiums
- Explainer on the ACA Subsidy Cliff and recommendations on keeping Modified Adjusted Gross Income (MAGI) underneath it to retain subsidy eligibility.
- Plain Language Explainers to support health insurance usage and literacy:
3. Get familiar with some of the specific enrollment considerations of the people you serve. You can check out the Georgetown Center on Health Insurance Reforms (CHIR) overview recent webinar on supporting enrollees with diabetes. They also have fact sheets you can reference on what to expect during Marketplace Open Enrollment this year, and how to make sure people receive adequate coverage. They also compiled a list of resources on finding affordable health insurance and relevant services for diabetes care and treatment to make the most of your coverage.
4. For people who are concerned about using their insurance, educate enrollees about the availability of community health centers that might be nearby to meet their basic health needs. These providers offer low-cost primary care services to everyone, regardless of ability to pay.
5. Stay up-to-date on the Medicaid Home and Community-Based Services available in your state. Over 500 thousand individuals are on waiting lists for these essential services nationwide, and availability is likely to be impacted by the implementation of HR1.
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