Healthcare forum answers difficult questions

Published 11:01 pm Monday, December 23, 2013

Pike County residents curious about their eligibility for the newly implemented Affordable Care Act had their questions answered Monday morning at a healthcare forum hosted by the Organized Community Action Program in Troy.

More than fifty people showed up to the meeting to find out if they are eligible for health insurance under the newly implemented law. Representatives of the Department of Health and Human Services fielded and answered questions related to the Affordable Care Act, and trained navigators from Enroll Alabama were on hand to help interested parties sign up for healthcare through the website.

Carlis Williams, regional administrator of the southeast for the Administration for Children and Families, said it was important for communities to host healthcare forums because they allow the public to become properly educated about the new law. “The number one thing we are trying to do is to educate the public,” Williams said. “A lot of misinformation has been spread around, and, and as a result, the public is confused about what exactly the new law does. It’s important for the government to go to small groups and talk about the law. One of the main things we do is go over the requirements to be eligible for coverage under the new law.”

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Williams hopes educating a small group of people will produce a larger ripple-effect throughout the entire community. “We hope the people we talk to take the information back to their friends, families and faith organizations,” Williams said. “Even if they may not be eligible, they may know somebody who is eligible. They may help somebody who doesn’t know about the new law with the information they learned today. We mainly want to make sure that word gets around about the new law and the requirements for eligibility.”

Demetricus Johnson, an outreach specialist for ACF, explained some of the cornerstones of the Affordable Care Act. “There are a lot of major misconceptions about the law,” Johnson said. “Most people don’t understand how the government subsidizes the cost of insurance for individuals and families. In order to qualify for government subsidies, you have to apply to the government marketplace. If you don’t apply to the government marketplace, then you aren’t eligible for subsidies.”

Johnson also said it is not true that everyone who does not have health insurance will have to pay a fine. “There are over 10 conditions that will exempt people from having to pay the fine,” Johnson said. “A major exemption in the state of Alabama has to do with the state not expanding Medicaid. If you would have qualified for Medicaid under the expansion, but live in a state that did not choose to expand Medicaid, then you are exempt from the penalty. In order to be exempt, though, you have to apply for Medicaid and be denied.”

People thinking of applying to the government marketplace need to make a decision quickly. In order to be eligible for insurance coverage on January 1, people need to enroll in a health insurance plan by Dec. 24. “People can enroll in a health insurance program on the healthcare website by March 31,” Johnson said.” In order to have coverage in January, you have to enroll by tomorrow (Dec. 24). If you don’t enroll by March 31, you can’t enroll on the healthcare site until the next open enrollment period, which is from Nov. 15 to Jan. 15 in 2014.”

Johnson said the law can help citizens who face prohibitively expensive medical costs. “If you are under 30, you may qualify to need only catastrophic coverage,” Johnson said. “That may save some people money who feel that they don’t need comprehensive health insurance. Another thing the law does is set a maximum out-of-pocket cost that consumers can be obligated to pay. In the event of a catastrophic accident, the maximum amount the consumer will pay is set at a threshold.”

Williams said she has also come across many misconceptions about the law during her time educating the public. “Some people think insurance will be too expensive for their family,” Williams said. “If you qualify, the government will help you pay your premiums. You won’t know if you qualify for these subsidies unless you go out and do the research.”

Williams said the law is meant to help people around the country. “I think the big thing about the law is the fact that it has allowed health insurance to become available to millions more people,” Williams said. “It is just incredible. It allows people with preexisting conditions to qualify for insurance, and it lets young people stay on their parent’s insurance until they are 26. It allows low- and middle-income families to get insurance that is affordable. There are so many good things about this law.”

Johnson shared Williams’ sentiments. “The Affordable Care Act helps to save the country money by cutting down on escalating costs,” Johnson said. “There are individuals in our country that have never had insurance and then suffer a catastrophic accident or illness. They receive medical care for that illness, but they have no way to pay for it. That cost gets passed on to the taxpayer. Under the new law, those individuals will qualify for preventative care. Preventative care has been shown to lower healthcare costs because it catches conditions before they become catastrophic.”

Wanda Moultry, executive director of the OCAP, said even she learned some new information about the healthcare law. “We have these events because we want to be inclusive of everything that concerns our community,” Moultry said. “We always want to give out information that might benefit families. I learned today that there are a lot of people who don’t have insurance here in Pike County. I was surprised at who does not have insurance even if they are working.”

Moultry added that she hopes Alabama will expand Medicaid in the future. “Our state has not yet decided to expand Medicaid,” Moultry said. “That creates a gap in coverage in people who qualify for health insurance. Hopefully our politicians will decide to expand Medicaid in the near future.”

People looking to enroll in the government’s healthcare program can contact Enroll Alabama at (205)-918-8192 (Main office) or (205)-382-2802 (Montgomery office) for help in navigating the government site.