Ad-Express and Daily Iowegian, Centerville, IA

December 12, 2013

File for health care help

By Michael Schaffer Managing Editor
The Daily Iowegian

---- — A local health care provider is poised to help those who need to acquire health care insurance because of the federal Patient Protection and Affordable Care Act.

ACA is a 955-page piece of federal legislation passed and signed into law by President Barack Obama in March of 2010 that requires every American to have health care insurance or pay a tax penalty. Plus, the ACA, commonly called Obamcare, contains additional mandates.

No matter the reason you might need health care insurance, River Hills-Centerville has employees trained in accessing and obtaining insurance through the marketplace.

Starla Bulkeley, former Outreach and Enrollment coordinator now clinic receptionist at River Hills Appanoose County Clinic, 1015 N. 18th St., Suite C, Centerville, said the free service they provide helps consumers create an account on the marketplace, complete and submit their application, review their eligibility results and enroll in a qualified health plan.

“We can assist consumers getting enrolled online or with a paper application,” Bulkeley said. “When creating an account on the marketplace, a consumer must have an email address. We have also been helping consumers create email accounts if they do not have one. Additionally, we can help consumers file an appeal if they do not agree with their eligibility results, as well as file an exemption for which they may qualify for.”

Bulkeley recommended applicants bring the following information: Proof of income, like a W-2 or paystub, the names and social security numbers for anyone wanting to get health coverage and a username and password to an email account.

River Hills Appanoose County Clinic is open Monday-Friday from 8 a.m.-6 p.m. on Monday, 8 a.m.- 5 p.m. Tuesday through Thursday and 8 a.m.-4 p.m. on Friday.

River Hills Clinics in Richland, Centerville and Ottumwa have enrolled several consumers, Bulkeley said, but she couldn’t provide an exact number. Bulkeley said most of the consumers that have enrolled at their Centerville location did not have health insurance and no one has come to them to enroll in the marketplace who had their insurance dropped.

“There was one consumer that came in to see if they could get a better deal through the marketplace, and did just that,” Bulkeley said. “This consumer had a pre-existing condition and was paying more than $600 a month for insurance. After submitting an application through the marketplace, this consumer qualified for the premium tax credits and cost sharing reductions. They were able to choose a QHP at a little over $60 a month with a $400 deductible, and a $600 out of pocket maximum. This consumer was so ecstatic that I received a hug! It made my day!”

Bulkeley said since Iowa has extended their Medicaid program, many more individuals qualify for Medicaid. Others have been fortunate enough to qualify for premium tax credits and cost sharing reductions and have chosen a very cheap, if not free QHP.

Iowa has a partnership exchange, which basically means that it is set up with the federal marketplace, but run by the state. It can be accessed by going to www.insurancemarketplace.org.

According to www.insurancemarketplace.org, “The aim of the Affordable Care Act is to provide affordable health insurance for more Americans, which the ACA does through a series of regulations for the insurance industry, and expansion of federal health care programs and subsidies.”

Call it requirements or mandates, ACA requires insurance companies to cover all applicants despite pre-existing conditions, offer the same rates for individuals in a specific age range and region, regardless of sex, according to www.insurancemarketplace.org. The same site says the benefits are “minimum standards for health insurance policies subsidies for very small businesses who purchase insurance through an exchange, eliminates co-pays, co-insurance and deductibles for certain health care insurance benefits related to preventative care and expands Medicaid eligibility to include more low-income individuals, and offers federal subsidies to help low income families get affordable health insurance. The bulk of the changes instituted by the ACA go into effect in 2014, although some aspects of the ACA are being gradually introduced or phased in up through 2020.”

According to www.insurancemarketplace.org, ACA is a controversial but the most “substantial piece of health care reform since the passage of Medicare and Medicaid in 1965. The ACA is aimed at making health care more affordable for Americans, and reducing the overall cost of healthcare.”

The same website says the potential consequences of these changes to health care are individuals who aren’t covered by a health care plan are required to get insurance or pay a penalty, with a few exceptions and the ACA expands Medicaid coverage, and states can effectively opt out of this expansion, which means residents of some states may be caught in a gap in coverage.

The second article in this series exploring ACA will look at the cost of health care insurance through Iowa’s health insurance exchange and who and who doesn’t qualify for subsidies.