Organizations, individuals prepare for ACA
Most Americans have heard of the Affordable Care Act — also known as ObamaCare — and the controversy surrounding the law. But many people aren’t sure what the law means for them.
“The intention here is to get more people insured,” said Heather Logelin, River Falls Area Hospital Foundation and community engagement director.
To encourage people to get healthcare, the ACA requires every U.S. citizen to have health coverage or pay a fine of 95$ per adult or 1% of a person’s total annual income, whichever is higher. Fines will increase yearly to reach 2.5% of annual income or $695 per person in 2016.
Businesses will also be required to offer insurance for employees. Large companies that don’t offer coverage or don’t offer adequate coverage could face fines. Small companies may not be fined.
To avoid the fine, people simply need to have health coverage. Logelin said there are many options for this. Those who are already covered by their own health care plan or someone else’s do not need coverage. That includes people on Medicare, and children covered by a parent’s healthcare plan.
Two other major options are BadgerCare and the Health Care marketplace.
BadgerCare is Wisconsin’s Medicaid plan. The Federal Poverty Level (FPL) is used to determine BadgerCare eligibility.
The FPL is a number set by the federal government and used as an official measure to determine poverty. The FPL for a single person is a yearly income of $11,490. The FPL for a family of four is $23,550.
Starting in 2014, Logelin said children and pregnant women up to 300% of the FPL will be Eligible for BadgerCare. Right now, BadgerCare accepts children and pregnant women up to 100% of FPL. In 2014 childless adults who make up to 100% of the FPL will be eligible for BadgerCare. Logelin said childless adults were not eligible for BadgerCare before.
In Pierce County, Great Lakes Consortium operations manager Linda Struck said about 500 people will be new to BadgerCare in 2014. In St. Croix County, she said about 1,053 people will be new to BadgerCare.
But, the ACA also drops the threshold for parents and caretakers to be eligible for BadgerCare from 200% to 100% of the FPL.
That is about 545 people in Pierce County and about 1,358 in St. Croix, according to Struck.
Those no longer eligible for BadgerCare have the option to use the Health Insurance marketplace ccording to Logelin, the marketplace is one of the biggest changes made by the ACA. It offers a selection of insurance plans that meet federal standards for health care options and quality — and for affordability.
Each state has its own marketplace. But, Logelin said some state governors, including Wisconsin’s own Gov. Scott Walker, opted not to create a state exchange. Because of this, Wisconsin’s marketplace is run by the federal government.
Anyone can buy insurance through the market, though people below 400% of the FPL may be eligible for subsidies.
The marketplace started open enrollment Oct. 1 and remains open thorugh March 31.
Peole can sign up through hthe marketplace at www.HealthCare.gov or by calling 1-800-318-2596. Paper applications can also be printed from HealthCare.gov.
People can still buy private insurance if they want.
“I would recommend that folks check it out,” Logelin said of the marketplace. She said people could find similar plans to what they might find in the private market, but for less money, if they qualify for subsidies.
Logelin said the ACA will also affect other areas of the health care system, but health insurance is the focus right now.
“The bottom line is that this could result in more people having insurance…which should be better for all of us,” Logelin said. “We just need to work together and navigate what should be a really clunky system, for several months.”
There are a number of places people can turn for help, including:--Great Rivers—one of Wisconsin’s regional enrollment networks—which includes St. Croix Pierce, Dunn, Chiippewa, Eau Claire, Barron, Polk, Burnett, Washburn and Douglas counties. The Great Rivers Call Center can be reached at 1-888-283-0012.--Different local agencies including the RFAH and RFMC are trying to get staff members certified as Certified Application Counselors to help people who need assistance with enrollment.-- Pierce County has an Economic Support Unit, which can be reached at 715-273-6788. St. Croix County’s Department of Health and Human Services Economic Support Unit can be reached at 715-246-8257.--Many local insurance agencies are also working to help people use the marketplace.--The public library, where staff can help people who struggle to navigate the internet, although they aren’t able to answer insurance questions. The library also has computers with internet access people can use and printed information about the marketplace. The library’s website also has links marketplace information.--People can find more information, including where to find help, at www.HealthCare.gov, or through the marketplace help center at 1-800-318-2596.
For the full story, please see the Oct. 17 print edition of the River Falls Journal.