Does Obamacare still exist?

Yes, it does, though you might be confused by comments from President Donald Trump in recent months as he pushed for repeal of the Affordable Care Act. “Obamacare is death,” and “Let Obamacare fail,” he has said, among similar statements, tweets and direct actions, in some cases, aimed at undermining the law.

But the Affordable Care Act is still alive — and Utah health insurance companies and other organizations are scrambling to prepare for another open enrollment period, which begins this week. The state continues to add more people to its insured ranks via Obamacare’s marketplaces, which have grown by about 20 percent annually in Utah, with 175,000 residents enrolled last year.

Here’s what you need to know about the 2018 enrollment period in Utah:

1. Open enrollment begins Wednesday.

The enrollment period to buy insurance for 2018 runs from Wednesday to Dec. 15 — less than half the time period of previous years. The shortened window could be problematic, considering a majority of Americans eligible for Obamacare remain unaware of when open enrollment occurs, according to a recent Kaiser Health Tracking Poll.

Though you can’t enroll until Wednesday, you can preview plans on healthcare.gov by punching in basic information about your income and family.

“We don’t want people to wait too long to make those decisions [on coverage],” said Heidi Castaneda, director individual and small employer sales for Intermountain Healthcare SelectHealth, one of two remaining insurers offering Obamacare plans in Utah. “We want people to start shopping and looking now.”

2. Federal advertising and “navigator” funding were slashed this year.

A big reason people don’t know about open enrollment? Federal advertising for the program was cut by 90 percent by the Trump administration this year, from $100 million last year under President Barack Obama to just $10 million this year.

Federal funding for “navigators” — those who help people sort through the process of buying insurance — has also been trimmed under Trump. Funding for Take Care Utah, a group of nonprofits and insurance brokers that helps people enroll, sustained cuts of about 60 percent this year, said Jason Stevenson, with the Utah Health Policy Project, a nonprofit advocacy group.

The federal funding cut means insurance companies are spending “orders of magnitude” more on advertising and other outreach this year, said Chad Westover, CEO of University of Utah Health Plans, the other Obamacare insurer remaining in Utah.

“It’s harder to get the word out,” Westover said. “But we’re now in the fourth year of this, so hopefully people understand better how to enroll, where to enroll.”

3. Utah is down to just two providers, but everyone has a choice between them.

As recently as 2016, there were four insurance providers in the Utah exchange. But Humana departed last year, and then in August, Molina Healthcare announced it would pull the plug on offering coverage in the state, citing heavy losses as Trump’s election cast uncertainty over the ACA’s future.

This year, about 175,000 Utahns were enrolled in Obamacare. Molina served about 70,000, SelectHealth roughly 100,000 and U. Health Plans about 5,000. But U. Health Plans, which had previously served only residents along the Wasatch Front, is now expanding to offer coverage plans in all of Utah’s 29 counties.

So how will those sign-up numbers look this year? It’s anyone’s guess. U. Health Plans is saying it expects around 40,000 to 50,000 to enroll on its plans, considering its expansion into addition counties and Molina’s departure. Its competitor, SelectHealth, declined to offer a prediction.

“Our biggest goal is to make sure people aren’t dropping coverage,” SelectHealth’s Castaneda said.

4. Some Utahns should brace for sticker shock.

The Utah Insurance Department last month said premium rates were expected to climb by an average of 39 percent; U. Health Plan officials said this week they were projecting about a 31 percent jump.

Considering the sharp rise, some people will be tempted to drop their coverage when they get their renewal letter in the mail. But they shouldn’t, experts say, because most people who buy insurance through Obamacare won’t actually feel the increase in their pocketbooks.

Here’s why: Trump earlier this month ended federal subsidies that helped insurers cover the costs of discounted health plans insurers are required to provide to lower-income Americans. And to make up the difference, insurance companies had to jack up their projected prices. In some states, including Utah, insurers have opted to attach most of these price hikes to their “silver,” or midlevel, insurance plans.

But a different subsidy remains intact, and it will shield roughly 90 percent of Utahns who enroll in the exchange from the price spike. This premium subsidy — which comes in the form of tax credits — goes to people in Utah earning up to 400 percent of the poverty line. They pay a set amount for their health insurance, based on their income.

So even as premiums climb, these people won’t pay more — their subsidy will simply be larger, said Stevenson.

Last year, for example, a single mother might’ve had a $300 monthly premium, with a $200 subsidy, making her bill $100, he said. This year, the same woman might have a $500 premium, but will now receive a $400 subsidy, so she’ll pay the same.

“She’s kept whole,” Stevenson said. “The subsidy keeps pace with the premium increases.”

5. Take the advice of experts: Shop around, because there are some new plans to help with rate spikes this year.

The premium subsidy, however, won’t help those people who make more than 400 percent of the poverty line, which is $47,520 for an individual or $97,200 for a family of four. Some of these people should be able to find cheaper plans off the Obamacare marketplace, Stevenson said. SelectHealth has added an off-marketplace plan that is comparable to a silver plan but less expensive, added Castaneda.

Another option is switching to a bronze or gold plan, which are less affected by the price hikes, Stevenson said. SelectHealth, for example, recently added a beefed-up bronze plan, which would cost dramatically less than a silver plan and still offer coverage that is nearly as good, according to Castaneda.

A third option, Stevenson said, may be to buy an inexpensive bronze plan, then stash away money for any big medical costs into a tax-free health savings account.

Added Castaneda: “You should definitely investigate your options.”

More information: You can preview insurance plans for sale Wednesday, and find agents and brokers in your area, at healthcare.gov. In addition, Take Care Utah is a statewide nonprofit network of insurance specialists who offer free help to Utahns searching for coverage. Go to takecareutah.org or call 2-1-1.