- Associated Press - Monday, October 31, 2016

FRANKFORT, Ky. (AP) - State officials say Kentuckians shopping for health insurance on the federal government’s exchange should expect higher prices and fewer choices during the open enrollment period that begins Tuesday.

The exchange lets some people buy private health insurance plans at a discount, depending on their income level. It’s one of the key features of the federal Affordable Care Act. Since 2013, Kentucky was one of the few states that operated its own exchange, called kynect. Started by former Democratic Gov. Steve Beshear, the system was widely praised for avoiding many of the technical problems associated with the federal exchange.

Republican Gov. Matt Bevin ended kynect soon after he took office. Beginning Tuesday, Kentuckians purchasing health insurance on the exchange will do so through HealthCare.gov, the federal website that 39 other states also use. The Bevin administration says the change will cost taxpayers $4.8 million by 2018, compared to $19 million this year.

Fewer insurers will be selling plans on the exchange for 2017. Anthem Blue Cross and Blue Shield is the only company selling plans in all 120 counties. For 59 counties, they are the only option. Premium increases for all plans will average between 23 percent and 31 percent, according to Adam Meier, Bevin’s deputy chief of staff for policy.

Premiums are difficult to calculate because they are based on a person’s age, where they live and whether they smoke. Avalere, a health care consulting firm, estimates the average premium for a single, 50-year-old nonsmoking Kentucky resident for the second-lowest silver benchmark plan to be $389.

Not every company is downsizing.

CareSource, the only nonprofit offering plans on the exchange, has expanded to 15 additional counties. Scott Streator, senior vice president for market and product group, said the company will offer a “low premium plan” in Louisville that will average $178 a month for a 27-year-old. And that’s before federal subsidies are applied. The plan includes co-pays to offset the lower premiums.

“These are for folks who have not had coverage from either their employer or the rates were unaffordable,” Streator said. “We’re hearing a lot from millennials, students who just graduated and need coverage.”

Meier said the price hikes and limited options would have occurred regardless of Bevin’s decision to dismantle kynect. He noted Kentucky will continue to operate the kynect website , which will now direct people to HealthCare.gov. The state also will keep a call center open and employ enrollment assisters to help people navigate the process.

“There really is no wrong door,” Meier said.

But health advocates worry the switch will confuse consumers by inserting the federal government into the application process. Emily Beauregard, executive director of Kentucky Voices for Health, says other states that used this system reported delays in processing applications and, in some cases, losing applications altogether. The result could create gaps in insurance coverage for some of Kentucky’s poorest residents.

“I sometimes call it application purgatory,” Beauregard said. “I don’t think the sky necessarily is falling .. People have to adjust their expectations. I don’t think we’re ever going to have as simple and easy and customer friendly a system as we’ve had with kynect.”

Meier acknowledged delays will be possible. But he said state officials are trying to minimize delays by offering a pre-screening tool online so people can figure out their eligibility for certain programs. He also said the state sent letters to everyone currently enrolled to help them understand the best way to re-enroll.

Open enrollment begins Tuesday and runs through Jan. 31, 2017.

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