Obamacare deadline: What does it mean?

2014-03-16T00:00:00Z 2014-03-17T07:50:04Z Obamacare deadline: What does it mean?By MIKE DENNISON Gazette state bureau The Billings Gazette
March 16, 2014 12:00 am  • 

HELENA — With just two weeks until the “Obamacare” deadline for Americans to get health insurance or possibly face a tax penalty, enrollment specialist Kristi Scott has some advice for her fellow Montanans: Don’t wait until the last minute.

“This is a mad rush right now, but it will all work out if you just get in there, contact someone who can help you and know your options,” she said last week.

Scott, who works for the Mineral Regional Health Center in Superior, said she’s already helped about 110 people in rural Mineral County sign up for a policy and that many are pleasantly surprised with the price once subsidies are applied.

Still, tens of thousands of Montanans remain without health coverage — and, under the Affordable Care Act, also known as “Obamacare,” they’re supposed to have it by March 31 or face that potential income-tax penalty.

Private health insurers, their agents and counselors at health clinics and hospitals are gearing up for the last-minute push and urging buyers to start sorting through policies now and see what subsidies may be available.

“This is not car insurance; it’s not going to be just 15 minutes,” said Todd Lovshin, Montana director for PacificSource, one of three companies selling policies on the state’s online marketplace. “The advice is to really sit down, get your documents together, make sure you know your income and shop for those plans.”

The Obama administration also is adding capacity to www.healthcare.gov, the website where you can buy subsidized policies in Montana, and adding 2,000 staffers at call centers, to handle what it hopes is a pre-deadline rush to buy policies and make its signature health-reform law appear a success.

So far, the response in Montana and nationwide has been less than ACA supporters had hoped.

As of March 1, only 22,500 Montanans are covered by policies selected through the ACA’s online marketplace. Nationwide, it’s 4.2 million.

The Obama administration initially predicted that 7 million people would get coverage from policies bought on www.healthcare.gov this year, but later scaled back its goal to 6 million, after technical problems stalled the website through October and most of November.

However, the big question is whether the ACA and the website are achieving their goal of extending health coverage to those previously uninsured.

Private surveys have indicated that only one-fourth of those buying on the marketplace had no insurance before. If that fraction applies in Montana, 5,000 to 6,000 people without health insurance have obtained it through www.healthcare.gov — about 3 percent of the 175,000 to 190,000 Montanans estimated to be without health insurance last year.

Jennifer McKee, spokeswoman for Montana’s insurance commissioner, Monica Lindeen, said those numbers don’t tell the whole story and that it’s too early to judge whether the ACA has or will significantly reduce the number of uninsured.

For starters, some 50,000 Montanans earning below 100 percent of the federal poverty level — $11,670 for a single person — do not qualify for federal subsidies to help buy insurance and therefore probably aren’t able to afford it, she says. They’re also exempt from the mandate.

This group was supposed to be covered by an expansion of Medicaid by the state, but Republicans at the 2013 Legislature blocked it.

McKee also said some uninsured Montanans probably have bought health plans outside of the website, which isn’t reflected in the numbers and that the website numbers should increase in March.

“There are a lot of unknown pieces, and pieces that are still in flux, so it’s hard to say at this point how great of a dent Obamacare will make in the uninsured population in year one,” she said.

For some, the ACA and the website are working as planned.

Marilyn Bennett, who was diagnosed with breast cancer almost three years ago, said she had been paying $700 a month for a policy that had a $2,500 deductible and an out-of-pocket maximum of $5,000.

Under the ACA, she was able to get better coverage — a lower deductible and out-of-pocket maximum — and save almost $500 a month on the cost thanks to federal subsidies.

The 52-year-old Helena woman said the lesser financial burden is a huge help as she recovers her health and gets back on her feet and that she won’t mind paying more as her income increases and the subsidy decreases.

Most people earning 100 to 400 percent of the federal poverty level qualify for subsidies, which are on a sliding scale, higher for those in lower-income brackets.

Scott, the enrollment specialist in Superior, said she helped a local businessman in his early 60s save almost $10,000 a year on his individual health insurance policy.

He had been paying $900 a month for a policy with a $10,000 deductible. Once she helped him navigate the website, he got a policy for $71 a month with a $250 deductible, she said.

Scott said she and a co-worker have been “pounding the pavement” in Superior and neighboring communities, talking to workers at small businesses and anyone else who might need health coverage.

She said the vast majority of the people she’s signed up had no health insurance before. Some also are skeptical of the ACA, Scott said, but she tries to encourage them to at least take a look at it.

 “The reception I’ve had is better than I thought,” she said. “When I encounter a person who’s an opponent, I say, look, go through the enrollment process so you at least know the facts.”

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