Northwest Austin residents, businesses weigh in on Affordable Care Act

Since Oct. 1, organizations in Northwest Austin have been educating and enrolling residents in health insurance plans through the Affordable Care Act—also known as “Obamacare”—which requires all U.S. residents to have health insurance starting in 2014.

To help residents understand the new law and its requirements, organizations such as Lone Star Circle of Care, CommUnityCare, Central Health, United Way, Seton Healthcare and Enroll America are working together, said Ashlee Mooney, provider contracting manager at CommUnityCare.

“It’s going well in the fact that we are getting the message out,” Mooney said. “We are working in coalition with them to spread the word and make sure everyone knows where to go for enrollment assistance.”

Uninsured individuals must sign up for health insurance either through the Health Insurance Marketplace (HIM) or a private provider before March 31, or they will be charged a fee when they file their federal tax returns, said Maria Serafine, director of member services for LSCC.

The HIM allows people to purchase and compare health insurance options. Coverage includes essential benefits such as ambulatory services, hospitalization, surgery, maternity and newborn care, prescription drugs, and preventive and wellness services. Dental coverage is optional. Pricing for insurance plans is based on factors such as household income and family size.

LSCC Director of Communications Rebekah Haynes said that because of technical issues with the healthcare.gov website, some people continue to have trouble signing up online. Despite technical issues with the website, LSCC and CommUnityCare enrollment counselors have still been able to screen residents for eligibility. Enrollment counselors are certified in helping people with Medicare and Medicaid services.

Mooney said some people with lower income might qualify for tax credits that offer health insurance plans at a lower cost. People with higher incomes can still qualify for health insurance plans but may not qualify for tax credits, she said.

“Some people have the misconception that it is only for lower, poverty-level [applicants], but anyone can [qualify],” Mooney said.

Haynes said LSCC has screened about 1,900 people and enrolled four people since Oct. 1. As of Nov. 20, Comm-UnityCare successfully helped 14 people enroll for health insurance on the website and has screened about 3,719 people, Mooney said. Screenings include an assessment of whether an individual is eligible for health services including HIM, Medicaid and Children’s Health Insurance Program.

“We are expecting to see more as the word continues to spread,” she said.

Tennis instructor David Caramanidis was the first person to enroll successfully in a health insurance plan through the HIM at CommUnityCare. Before signing up, he said he had not had health insurance in about four years.

“I did the whole process in an hour. It could not have been easier,” he said. “Every time we went to another screen, more people would gather around the computer saying, ‘Wow, we’ve never seen anyone get this far before.'”

Northwest Austin resident Emily Schmitz said Blue Cross Blue Shield of Texas began notifying her in March that her health insurance premium fees would continue to rise because of the ACA. Schmitz has catastrophic health insurance, and her deductible is $5,000. For 2013, her health insurance rates rose 20 percent, or about $80 quarterly.

“Even with the catastrophic kind [of health insurance], I still have to pay premiums,” Schmitz said. “The premiums continue to go up. I feel like I don’t have any coverage because everything is out of pocket for the first $5,000.”

Dan Graham, founder and CEO of North Austin–based BuildASign.com, said he does not think his company will be greatly affected by the ACA because BuildASign pays for

90 percent to 100 percent of employee premiums. If the cost to provide health benefits substantially rises, Graham said the company might look into strategies for health care

budgeting.

“Providing solid benefits is one of those things that we are committed to do as an employer,” he said. “As premiums rise, we need to adjust our overall budget to make sure we are accounting for that, which ends up impacting other areas of business.”


 
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