Health officials push to educate state
By KALEY CONNER
With big changes just around the corner in the federal health insurance industry, Kansas officials visited Hays on Monday to educate residents about what to expect during the next few months.
Several provisions of the federal health care overhaul will go into effect Jan. 1, and a new online exchange will go live Oct. 1. The exchange will allow citizens to compare and purchase insurance policies online.
"There were a number of people who were like, 'If you're somebody who's ever bought an airplane ticket on ... websites, it's kind of like that,' " said Linda J. Sheppard, director of health care policy with the Kansas Insurance Department. "While it's sort of like that, buying health insurance is way more complicated than buying an airplane ticket."
While some states have opted to create their own exchanges, Kansas did not. Residents will have access to the federal marketplace by visiting www.healthcare.gov.
By setting up an account and entering personal information, residents will be able to compare available policies. Specially trained navigators in northwest Kansas are being prepared to help residents access the marketplace and choose an appropriate policy.
The open enrollment period will continue through March.
One of the biggest, and perhaps most controversial, changes coming in January is the implementation of the individual mandate, which will require every American to have health insurance for at least nine months of the year or pay a fine.
When the health reform policy was being drafted, one of the main goals was to make insurance more obtainable, Sheppard said. Also beginning at the first of next year, customers will not be denied health insurance coverage based on pre-existing conditions.
The mandate was intended to help keep costs low by encouraging young and healthy people to enter the insurance pool in addition to those who need coverage due to medical problems, Sheppard said.
"If the only people that go into the market are people who are very unhealthy and require a lot of services, you can imagine what that would do to the cost for that pool that we're all operating in," she said. "For those who have insurance already or want to be in that market, potentially that cost would rise."
"What we really need is to have people who are younger and healthier also buying into the marketplace so we have all those premium dollars working together."
The fine for not having health coverage will start next year at $95 per adult, $47.50 per child or 1 percent of household income. There still is concern, however, that many will opt to pay the fee rather than assume the cost of monthly health insurance payments, Sheppard said, noting the fees will increase during the next few years.
Tax credits and subsidies will be available for Americans between 100 percent and 400 percent of the federal poverty level to help cover the cost of health insurance premiums and out-of-pocket expenses.
While that assistance could help many Kansans, there still are some who will fall between the cracks. The federal law was drafted with the vision that states would expand their Medicaid programs to cover more low-income people. Kansas lawmakers, however, have not voted to expand the public health insurance program. As a result, some people who are not able to afford health insurance still will not be able to get it.
"They will not qualify for Medicaid, and they also will not qualify for tax credits and subsidies to buy private (insurance)," she said. "So pretty much their situation remains the way it is now, which is they don't have the ability to buy health insurance coverage in any way."
Those individuals, Sheppard said, will be exempt from paying the fee.
That still is a concern for many Kansans, said Michelle Morgan, executive director of the Northwest Kansas Area Agency on Aging. Morgan was one of approximately 50 people who attended an afternoon education session Monday at Hays Medical Center.
"We get a lot of phone calls from people in their mid-50s up to Medicare age, and they have some horrible health problems that do keep them from working full-time, and they're just looking for some help with health care costs," she said. "And these people are unfortunately going to fall through the cracks, and there still won't be help for them."
The upcoming changes will not affect residents covered by Medicare.
For more information about the Affordable Care Act or health insurance marketplace, visit www.healthcare.gov or www.ksinsurance.org, which offers a calculator to estimate insurance policy costs.