Open enrollment puts varied impact of health care law back in focus Alex Nixon Saturday, Oct. 18, 2014, 9:00 p.m. Pat Dolan of Oakmont will lose his health insurance plan next year because it doesnt meet the Affordable Care Acts minimum standards for medical coverage. A comparable plan under President Obamas health reform law will cost the 56-year-old $1,800 a month — three times more than the $588 he spends on individual policies for himself and his wife. He is considering going without coverage. Barb Valaw, a 53-year-old developer from Carrick, is having a better experience and is thankful for the health law. She paid $30 less for coverage this year and added prescription drug coverage by shopping on the federal marketplace. The impact of the sweeping law, which has raised prices for some but opened access to coverage for millions, will get renewed focus with the start of open enrollment for the second year four weeks away. People such as Dolan, who face big price hikes, may choose to drop insurance and pay a tax penalty. In 2015, penalties will be 2 percent of household income or $325 per person, whichever is greater. “Its a mathematical question here,” said Dolan, who is weighing whether he should pay the higher premium for coverage when his current plan is canceled. “The extra $1,200 a month, thats real money.” But experts think there are more people who have benefited, such as Valaw, and will renew their coverage or sign up for the first time because they will qualify for tax credits that reduce monthly premium costs. “We see very few people who say they dont want their coverage anymore,” said Katherine Hempstead, director of coverage activities for the Robert Wood Johnson Foundation, a Princeton, N.J., nonprofit research organization. “But there will always be people who turned it down last year and will turn it down again this year.” Valaw doesnt qualify for tax credits, which are available to low-income workers, but saved money because of the law. And her Obamacare plan has prescription drug coverage, which her old plan didnt have, saving her thousands of dollars a year in medication costs. “The premium price and the coverage have been much better for me,” Valaw said. “The plans are certainly better than what we had in the individual market prior.” About 8 million Americans signed up during the last enrollment period, and more than 7 million remain enrolled. In Pennsylvania, 318,000 enrolled last year. The government expects 13 million to be signed up by the end of the next period, which runs from Nov. 15 to Feb. 15. To meet the goal, officials and supporters of the law are trying to learn some lessons from the last enrollment period. The Obama administration is hoping a smoother-running federal exchange helps boost numbers. Last year, an unwieldy, glitch-ridden website was initially overrun by large numbers of shoppers. This year, the website was streamlined, with fewer pages for the application, boosted performance to handle more people and a shopping function that doesnt require sign-ups first. Elizabeth Carpenter, a director in the health care practice at Avalere Health, a Washington consulting firm, said people who shopped for coverage last year may not want to go through the process again. Theyll be automatically enrolled in their existing plans if they do nothing, she said. But new insurers are joining the exchanges, and many are changing their prices, she said. “Patients would be well-served to shop and compare for 2015,” she said. The federal and state exchanges are adding 77 insurance plans for 2015, a 25 percent net increase, the administration said last month. In Western Pennsylvania, United Healthcare will sell plans on HealthCare.gov for the first time, joining last years carriers Highmark Inc., UPMC Health Plan and Aetna Inc.s HealthAmerica subsidiary. But its unknown how increased competition will affect prices in the Pittsburgh region. Neither the state nor the federal government has released 2015 premiums. But across the country, prices have been rising. Among 27 states and the District of Columbia that released data on premiums for next year, the average hike was 7.5 percent, according to an analysis by PricewaterhouseCoopers. Advocates say theyve learned that in-person assistance is key for gaining enrollments. Groups that support the law will be out in force across Pennsylvania and a handful of other states where Republican leadership has been resistant to it, and where federal funding for health care navigators has been low. Enroll America, a national nonprofit that supports Obamacare, said it wants to train 2,000 people in Pennsylvania and 10 other states as application counselors who can help people sign up. It is looking to recruit 25 people in Allegheny County for those volunteer positions, said Julia Cusick, a spokeswoman. And the group plans to push the message that many people will qualify for financial help. About three-quarters of all enrollees in 2014 received tax credits, federal data show. Under Gov. Tom Corbetts alternative Medicaid expansion plan, called Healthy PA, an estimated 600,000 poor Pennsylvanians may gain coverage next year. Working individuals and families with household incomes of as much as $16,100 for a single person or $32,900 for a family of four could be covered by Healthy PA. Meanwhile, tax credits may be available for individuals with incomes between $16,100 and $46,600, or for families of four between $32,900 and $95,400. “Many people dont know how affordable plans can be for middle class and lower income families,” Paul Cusick said. Alex Nixon is a staff writer for Trib Total Media. He can be reached at 412-320-7928 or anixon@tribweb.
Posted on: Mon, 20 Oct 2014 19:10:59 +0000