Expert advises not to panic over the Affordable Care Act
There’s been a lot of talk about how one enrolls in insurance provided by the Affordable Care Act, colloquially known as Obamacare.
The health care marketplace, which in Pennsylvania is provided by the federal government – Gov. Tom Corbett elected not to start a state marketplace – opened for enrollment on Oct. 1. Though the online system at healthcare.gov has not been very usable thus far, people can sign up for the new insurance plans.
Enrolling people in plans that fit their needs is the job of Jan Todd, who is the outreach coordinator for Susquehanna Community Health and Dental Center (not affiliated with Susquehanna Health) and is an officially recognized “navigator” of the new federal health care exchanges. Her work is funded through a federal grant.
Todd led a Q&A session on Tuesday at New Covenant United Church of Christ, sponsored by the United Churches of Lycoming County.
Her goal, she said, was to inform people about their options and dispel some falsehoods that have made the rounds.
“One of the big misconceptions is people will be sent to me, and they think they can get insurance right away that day. No matter if they signed up on Oct. 1 or whether they sign up on Dec. 14, you will get insurance on Jan. 1,” Todd said.
The open enrollment period goes until March 31, 2014; but if you sign up after Dec. 15, it will be about a month until coverage kicks in, Todd said.
The main advantages of Obamacare include that there are no longer lifetime caps to coverage; insurers can’t raise costs; insurers “are not allowed to discriminate against preexisting conditions any longer;” and other natural traits, like a woman being of child-bearing age, can’t factor into the insurers’ equations. Age as a whole, though, does factor into premium rates, Todd said. She said people also should know that if they “are on Medicare, they need to do nothing. If you have insurance, you don’t need to do anything. Those on medical assistance don’t have to do anything.”
If your employer coverage costs less than 9.5-percent of your income and it meets a list of 10 minimum essential benefits, you can shop in the federal marketplace for insurance, but won’t get tax credits or cost reductions offered in the law, according to Todd. However, if your coverage doesn’t meet those criteria, those credits and reductions will apply to a plan bought within the market.
Though the website hasn’t worked well for enrollment or shopping, there is a lot of information available there, Todd said.
The penalty for not having insurance will start in 2014, after the enrollment period closes. It will be $95 per person, $47.50 per child, or 1 percent of income.
“There is time,” Todd said. “You have up until March 31 to enroll if you have no insurance to avoid the penalty. I don’t think anyone should be panicking about the penalty.”