Local help on Affordable Health Care Act and federal view

inyo_courthouse.jpgUPDATE:  Affordable Health Care help in Los Angeles Times:  http://eedition2.latimes.com/Olive/ODE/LATimes/

INYO COUNTY IS ONE CRITICAL PIECE OF LARGE HEALTH CARE REFORM PUZZLE (Press Release – Inyo Health and Human Services Director Jean Turner)

Ready and Committed to Success

We are just days away from the Affordable Care Act taking a major step forward as millions of individuals and families begin to seize newly available opportunities to enroll in health care coverage.

For many in our communities, our County offices will be where the rubber meets the road in health care reform.  The Inyo County Health and Human Services (HHS) Department  is where many people will turn to understand their expanded health care coverage options available either through the expansion of Medicaid (known as Medi-Cal in California), or through the state insurance exchange, known as Covered California, which will offer income-based federal subsidies.

Between these two largest components of the Affordable Care Act, California will experience the biggest increase in health care coverage in two generations.  It is estimated more than 1.4 million Californians will newly enroll into Medi-Cal.  Covered California’s latest estimate for its core target group is 2.6 million who will be eligible for premium assistance.

Locally, it estimated that over 2200 Inyo County residents already on Medi-Cal will remain eligible, including the recent transition of over 280 children formerly on Healthy Families.  Further, it is estimated that another 350-400 residents will become Medi-Cal eligible on January 1, 2014.

Having worked to serve the needs of our county’s most vulnerable residents for over 25 years, I know how the Affordable Care Act represents a tremendous opportunity to improve the well-being of individuals and families across our county.  At the same time, readying our county for this unprecedented expansion – on tight timelines and often without all the answers from the many other entities involved in the governance of the Act – represents an enormous challenge.

Fortunately, our county has existing resources that gave us a terrific head start in this effort.  For example, Inyo County – like all 58 counties in the state – has an integrated eligibility system for enrolling people into Medi-Cal, and multiple other programs.  This system is how more than 8 million people statewide receive health and food assistance every day.  We offer an array of options for people to access our programs – by phone, by mail, online or in person in Bishop, Lone Pine and Tecopa.  We have a knowledgeable, trained workforce who knows their community well and understands the changing circumstances of people’s lives.

Our Health and Human Services Department has been tirelessly working on implementation activities to augment our existing resources.  We are doing everything we can and preparing all that is within our purview because we know we will be the place many residents turn to for help to enroll starting October 1 for coverage that begins January 1.  Our staff has undergone hours of training, adapting to new programs, new rules and policies, and learning how to serve new populations.  Additionally, we will be joining eight other counties to participate in a regional call center that will begin on October 1 taking health care enrollment calls.

Our HHS Department will play a critical role in determining eligibility and enrollment for health care and other assistance for residents.  That’s why we’ve done everything we can to prepare for the influx of clients while still serving our existing clients.  However, we’re just one piece of the puzzle.

Other entities at the state and federal levels are key pieces of the puzzle too.  We have been working with partners such as Covered California, the California Department of Health Care Services, the federal Centers for Medicare and Medicaid Services, and the IRS on procedures and technology that must work together to get people smoothly enrolled in coverage and receiving their federal tax subsidies.  Our county computer system has to be able to connect with new state and federal computer systems built just in the last year.

All the pieces of the puzzle have to fit together.  We won’t know how well all the technology and procedures will work together until after October 1.  Undoubtedly, there will be problems – some with easy fixes, some that are more difficult to overcome – we and our partners have to address.

For the next several months, it will be a very fluid environment.  Know that our county agency and county staff are doing everything in our control to bring health care coverage and the expansion into communities.

What we’re setting out to do with health care reform is a part of our HHS department’s core mission to promote the health and self-sufficiency of low-income children, families and individuals.  The Affordable Care Act provides an opportunity to forward that mission by leaps and bounds.

Jean Turner, Director, Inyo County Health & Human Services

(Federal News Release)

News Release
U.S. Department of Health & Human Services
News Division
Contact: HHS Press Office
Wednesday, September 25, 2013

Significant choice and lower than expected premiums available in the new Health Insurance Marketplace


A new report released today by the Department of Health and Human Services (HHS) finds that in state after state, consumers will see increased competition in the Health Insurance Marketplace, leading to new and affordable choices for consumers.  According to the report, consumers will be able to choose from an average of 53 health plans in the Marketplace, and the vast majority of consumers will have a choice of at least two different health insurance companies – usually more.  Premiums nationwide will also be around 16 percent lower than originally expected – with about 95 percent of eligible uninsured live in states with lower than expected premiums – before taking into account financial assistance.

“We are excited to see that rates in the Marketplace are even lower than originally projected,” said Secretary Sebelius.  “In the past, consumers were too often denied or priced-out of quality health insurance options, but thanks to the Affordable Care Act consumers will be able to choose from a number of new coverage options at a price that is affordable.”

In less than a week, the new Marketplace will be open for business where millions of Americans can shop for and purchase health insurance coverage in one place.  Consumers will be able to find out whether they qualify for premium assistance and compare plans side-by-side based on pricing, quality and benefits.  No one can be denied coverage because of a preexisting condition.  October 1 marks the beginning of a six-month long open enrollment period that runs through March 2014.  Coverage begins as early as January 1, or in as little as 100 days from today.

Today’s report finds that individuals in the 36 states where HHS will fully or partly run the Marketplace will have an average of 53 qualified health plan choices.  Plans in the Marketplace will be categorized as either “gold,” “silver,” or “bronze,” depending on the share of costs covered.  Young adults will also have the option of purchasing a “catastrophic” plan, increasing their number of choices to 57 on average. About 95 percent of consumers will have a choice of two or more health insurance issuers, often many more.  About 1 in 4 of these insurance companies is offering health plans in the individual market for the first time in 2014, a sign of healthy competition.

The report also gives an overview of pricing and the number of coverage options across the nation.  It finds that the average premium nationally for the second lowest cost silver plan will be $328 before tax credits, or 16 percent below projections based off of Congressional Budget Office estimates.  About 95 percent of uninsured people eligible for the Marketplace live in a state where their average premium is lower than projections.  And states with the lowest premiums have more than twice the number of insurance companies offering plans than states with the highest premiums.

Premium and plan options are broken down by state where information is available. For example, the report shows that a 27-year old living in Dallas who makes $25,000 per year will pay $74 per month for the lowest cost bronze plan and $139 per month for the lowest cost silver plan, taking into account tax credits.  And he or she will be able to choose from among 43 qualified health plans. For a family of four in Dallas with an income of $50,000 per year, the lowest bronze plan would cost only $26 per month, taking into account tax credits. The majority (around 6 out of 10) of the people uninsured today will be able to find coverage for $100 or less per month in the Marketplace, taking into account premium tax credits and Medicaid coverage.

Consumers can get help finding Marketplace coverage through a number of different resources.  They can get more information through HealthCare.gov, or cuidadodesalud.gov.   Consumers can participate in online web chats or call 1-800-318-2596 toll free (TTY: 1-855-889-4325) to speak with trained customer service representatives, with translation services available in 150 languages.  Community health centers, Navigators and other assisters are available in local communities to provide in-person help with coverage choices.  Local libraries will help consumers learn about their options and hundreds of Champions for Coverage, which are public and private organizations all across the country, are helping people learn about their options and enroll in affordable coverage.

To read the report on health insurance rates, visit: http://aspe.hhs.gov/health/reports/2013/MarketplacePremiums/ib_marketplace_premiums.cfm.

To view the data on rates released today, visit: http://aspe.hhs.gov/health/reports/2013/MarketplacePremiums/datasheet_home.cfm.

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