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Valley woman hopes Affordable Care Act will help with insurance



Published: Sun, September 22, 2013 @ 12:05 a.m.

By William K. Alcorn

alcorn@vindy.com

YOUNGSTOWN

Terry Asberry of Campbell has no health care insurance. She said she can’t afford it.

Asberry, 54, and millions of other working poor in Ohio — who even if insurance is offered at their workplace may find it unaffordable — say they are looking forward to full implementation of the Patient Protection and Affordable Care Act, commonly known as Obamacare or the Affordable Care Act.

The statute was signed into law by President Barack Obama on March 23, 2010. Some of ACA’s requirements already have been implemented. For instance, the requirement that children can be covered by their parents’ insurance to age 26 is one of the early mandates of the ACA.

Implementation of the ACA mandate that businesses provide health insurance to their employees has been postponed until 2015. The mandate that individuals carry health insurance, however, has not been postponed and goes into effect Jan. 1.

Open enrollment for 2014, the period of time during which eligible individuals can enroll in a qualified health plan in the private insurance marketplace, begins Oct. 1 and runs through March 31, 2014.

For 2015 and later years, the open-enrollment period is Oct. 15 to Dec. 7 of the previous year. Under certain conditions, individuals may apply for hardships and enroll outside of the designated enrollment period.

Under the ACA, beginning in 2014, many individuals will be eligible to receive subsidized coverage in the private health-care marketplace, also called an exchange, if they are not eligible for Medicare, Medicaid or the Children’s Health Insurance Program (CHIP) and are not offered affordable coverage through their employer.

During the enrollment period, people can compare plans and costs and find out if they are eligible for lower costs for private insurance or public health programs such as Medicaid and CHIP.

There are 1.3 million uninsured Ohioans who can use the competitive marketplace to shop for health insurance coverage, according to Ohio Consumers for Health.

Of those, 959,123, like Terry and her husband, Eddie, 55, have a full-time worker in the family.

Eddie, an Army and Air Force Reserve veteran, is disabled and receives Social Security benefits.

Terry, a full-time employee at Dandridge Burgundi Manor, a skilled-nursing facility on Youngstown’s East Side, earns $7.95 per hour, up a dime from minimum wage of $7.85 she made a year ago when she was hired.

Terry said she knows health care insurance is not free under the Affordable Care Act, as it is under Medicaid.

But, she said, “I know President Obama will make the cost low enough so poor people like me can afford it.”

She said she has dental insurance through her job but no health insurance. When she needs care, Terry said she goes to the hospital under HCAP.

HCAP, or the Hospital Care Assurance Program, is the Ohio Department of Job and Family Services’ mechanism for meeting the federal requirement to provide additional payments to hospitals that provide a disproportionate share of uncompensated services to the indigent and uninsured.

Terry and others who don’t have health insurance, or who want to determine if they can get a better deal on health care than what they have, can start shopping next week.

But for many, the process will not be easy.

The information is voluminous, and in some cases incomplete and in conflict with other federal requirements, said Atty. George P. Millich Jr. of the law firm, Harrington, Hoppe & Mitchell, Ltd.

Millich has been studying the ACA for several months and has presented numerous seminars on it, primarily to businesses and to the Mahoning County Bar Association.

Many people are going to need help sifting though the information. Because most of the data is online, they are going to need access to a computer and the Internet, said Marilyn Montes, human resources director for the Mahoning-Youngstown Community Action Partnership.

The Asberrys have a computer, but say they can’t afford the Internet.

Free computer and Internet use is available at libraries, and an online calculator can greatly simplify the process, Montes said.

With just a few steps, entering information about household income, the number of adults and children, the calculator will provide an estimate of what a so-called Silver Plan would cost.

The plans are labeled bronze, silver, gold and platinum, with bronze offering the least coverage and platinum the most.

With a bronze plan, the individual pays the most for each visit to the doctor or medications, but pays the smallest monthly premium. Under a platinum plan, the monthly premium is higher, but the individual pays less for doctor visits and medications, according to the WebMD website.

“I’m hoping the state will offer some opportunities for training for our employees so we can we can provide i nformation and help for our clients,” Montes said.

Also, Access Health Mahoning Valley has received a one-year, $93,146 contract to provide navigator assistance to residents in Mahoning and Trumbull counties.


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