by Dennis Dalman
Despite a crippled federal ObamaCare website, there are several other ways to check out and enroll in insurance programs under the Affordable Care Act, said attorney Ralonda Mason, who spoke at the St. Joseph Community Fire Hall Monday night.
Thirty people attended the two-hour meeting, which was an overview of the Affordable Care law. Mason is an attorney for “Project Care,” a St. Cloud-based program that helps people who are uninsured or underinsured enroll in health-care programs. She was also appointed by Gov. Mark Dayton to be a member of the Minnesota Health Reform Task Force. Project Care, which is a program of Mid-Minnesota Legal Aid, serves people in 14 counties, including the three counties in the greater St. Cloud area.
Mason emphasized she hosted the meeting only to explain what the Affordable Care Act is and what it is not, without giving opinions as to the law’s strengths or weaknesses. There were also no opinions expressed about the controversial law by those who attended the meeting. Instead, they asked lots of questions, mainly as to eligibility for tax credits and how to apply.
The federal website (www.healthcare.gov), which was a disaster at its Oct. 1 roll-out date, is in the process of being fixed, according to President Barack Obama, who said it should be at least 80-percent effective by the end of this month.
In the meantime, Mason gave options on how to check out insurance options and how to enroll. All of the following options are free.
1. People can go to www.mnsure.org, which is a website created by the State of Minnesota. Mason said the MNsure website has been working quite well, with not nearly as many glitches as the federal website.
2. Prospective applicants can call MNsure toll-free to apply via telephone or to ask questions and get answers about technical problems or general issues. Mail-in applications can also be requested. For the 24-hour, seven-days-a-week MNsure help-line, call 1-855-366-7873. However, the Newsleader is compelled to give this fair warning: There will likely be long wait times on that phone line. (A call to that line by the Newsleader Tuesday, Nov. 19, at 12:40 p.m. was placed on hold for more than 45 minutes during which time the same 10 or so bars of a Kenny G. saxophone solo kept playing over and over. The reporter, who had an aching head from the torturous Kenny G. repetitions, finally hung up.) It is probably best to call that line in the evening or very late at night.
3. People can schedule a sit-down visit with an insurance broker to do the application process, but the broker must be certified through special training. To find a list of qualified brokers, go to the MNsure website. Note: the brokers are listed by the counties where their offices are located, not their service areas.
4. People can go to their county Social Service departments to get an application to fill out and send in.
5. Project Care, who has a staff of trained helpers called “navigators,” will answer questions and give one-to-one free help with applications. To contact Project Care, call 320-253-0121, toll-free at 1-888-360-2889 or stop in to its office at 830 W. St. Germain St. in downtown St. Cloud. The business hours are from 8:30 a.m.-5 p.m., but it’s closed during the noon hour. Or email Project Care at email@example.com.
The first step in the application process, Mason noted, is for applicants to find out if they are eligible for advanced tax credits to help them pay for the insurance plans they choose.
The MNsure website or in-person helpers will determine the monthly amount of tax credits (subsidies) based on income information. Individuals can make up to $45,960 to be eligible. A family of five can make up to $110,280. The less income, the more the tax credit.
Individuals and families in a certain lower income level are already enrolled in or will be eligible for either MinnesotaCare or Medical Assistance (Medicaid), which has been expanded under the ACA.
The ACA states people should not have to pay more than 9.5 percent of their income on medical insurance.
Mason compared the insurance marketing exchange (MNsure) to the Travelocity computer search program in which people type in travel needs and then the best travel deals are instantly displayed on a computer.
People seeking affordable insurance plans on MNsure can do a similar thing by typing in what their current and anticipated health needs will be, as well as affordability factors, and then they can compare (apples to apples) the insurance plans that meet their needs.
There are four types of plans offered: bronze, silver, gold and platinum. Those “metal” ratings give seekers an idea of how much insurance companies will pay for health services (up to 60 percent for bronze plans and up to 90 percent for platinum plans). The customer will pay the rest of the costs through deductibles, co-payments and co-insurance.
So far, Minnesota is second only to California in the number of people who have enrolled in insurance programs through the state market exchanges (MNsure in Minnesota), Mason noted.
Between Oct. 1, the start-up date, and Nov. 2, nearly 11,000 Minnesotans enrolled, according to MNsure. That number is expected to increase dramatically as the system’s glitches are worked out and as the Dec. 15 deadline approaches for coverage that will begin Jan. 1, 2014. People actually have an extended period of up until the end of March to sign up, at which time their coverage would begin May 1.
Another plus for Minnesota, Mason added, is the premium prices on the MNsure exchange are the lowest in the nation.
Enrollment in MNsure is mandated, with some exceptions, for people currently without any form of health insurance. The penalty for not enrolling is $95 for an individual in 2014, a penalty that will increase to $695 by 2016. Penalties will be added to taxes due. Each year, those who enroll with receive toward the end of a tax year a certificate of insurance from the company with which they are insured. That certificate will be submitted, similar to a W2 form, when taxes are filed as proof the tax filer is enrolled in an insurance program.
Mason said the vast majority of Minnesotans won’t have to enroll through the ACA exchanges, however, because they already have insurance through Medicare, Medical Assistance, the Veterans Administration or through their employers.
Mason recommends two resource websites to learn the basics about the ACA/ObamaCare.
One is a video produced by the Kaiser Family Foundation, which can be accessed at:
The other site is a tool developed by the Minnesota Council of Health Plans: http://myhealthcarefuture.org.
The much-maligned federal ACA site, riddled with problems, is expected to be fixed by the end of November. It is: www.healthcare.gov.