Deadline approaches for health insurance coverage
On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act, better known as "Obamacare." Four years later, the deadline is approaching for open enrollment on March 31.
According to Healthcare.gov, the key features of the Affordable Care Act (ACA) are improving quality and lowering healthcare costs, new consumer protections and being able to browse the health insurance marketplace, which allows individuals and small businesses to compare health plans on a level playing field.
Improving quality and lowering healthcare costs includes free preventative care, which Amy Roberts – director of public relations at the Park City Medical Center – said is a huge benefit for currently uninsured residents of Summit County.
"The ACA does require preventative care with coverage, so that’s really good as far as wellness services, mammograms and different types of services like those," she said. "This has not been the case in the past, because not all insurance companies cover different options for preventative care."
The ACA also provides discounts on prescriptions for seniors, protection against healthcare fraud and small business tax credits, while new consumer protections prevents insurers from discriminating against those with pre-existing conditions.
Nann Worel, executive director of the People’s Health Clinic, said it is especially helpful for the uninsured that walk into her clinic to meet with counselors to help them understand their health insurance options.
"The counselors look at each individual situation, their income, what programs they might be eligible for," she said. "They help them explore different options in the Marketplace that are available to them as well as the costs."
She added that the goal of the People’s Health Clinic is to get as many people health insurance coverage as possible, a goal the clinic has in common with the Obama administration. According to a report by the Associated Press, a target has been set by the Administration to insure 57,000 Utahns via the individual market exchange, which is better known as Healthcare.gov.
According to a Health Insurance Marketplace: March Enrollment report issued by the U.S. Department of Health and Human Services on March 11, 39,902 Utahns have signed up for private insurance through the ACA while those that signed up for insurance through Medicaid total 36,353.
Another goal of the ACA was to expand Medicaid coverage, an issue that divided the GOP at the state Capitol. Gov. Gary R. Herbert was in favor of using federal money to partially expand Medicaid coverage in the state while Speaker of the House Becky Lockhart said it would be wiser to use Utah state dollars to partially expand Medicaid coverage to Utahns. Legislators were ultimately unable to compromise before the end of the General Session.
According to Healthcare.gov, if Medicaid was fully expanded under the ACA in Utah, 332,970 (93 percent) of uninsured Utahns and its eligible population would qualify for either tax credits to purchase coverage in the marketplace or Medicaid.
Park City Medical Center Administrator Si Hutt said those in Summit County that are looking to sign up for insurance coverage under the ACA can meet with counselors at the Park City Medical Center.
"Enrollment counselors on-site can assist uninsured patients with understanding their options for Medicare, Medicaid and Federal Health Exchange plans," Hutt said. "Additionally, representatives from the hospital participate on the Promise Park City Healthcare Taskforce, focused on created a system of community partners to provide enrollment counseling and assistance to the uninsured in Summit County."
Worel said the People’s Health Clinic also provides counseling on health insurance options with an ACA navigator and and enrollment counselors from the Association of Utah Community Health (AUCH) every Friday morning. "AUCH sends those counselors up here every Friday to work one-on-one with community members that just want help with enrollment," she said.
She added that they have already helped many residents get started on their enrollment applications and are waiting to see how many of them get enrolled. For those that sign up for coverage under the ACA by the deadline on March 31, their enrollment fate may not be learned for several months "depending on how backed up the system gets," she said.
There are currently hardship exemptions for low-income families to avoid the "minimum essential coverage" penalty required if they do not have health coverage. Worel provided a list of those exemptions, which include ever being homeless, ever having received a shut-off notice from a utility company or having been evicted or facing eviction or foreclosure in the past six months.
"I think it’s important to know that these exemptions are available, because many people that are already low-income qualify for those," Worel said. "A lot of our patients fall into those categories where they are eligible for the hardship exemptions."
For more information on eligibility for health insurance coverage under the ACA or Medicaid, visit http://www.healthcare.gov or http://www.medicaid.gov . To speak with an insurance enrollment counselor, call the People’s Health Clinic at 435-333-1850 or the Park City Medical Center at 435-658-7000.
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