With the federal deadline to sign up for health insurance coming at the end of March, many in Utah, and Grand County, are enrolling for coverage on the Affordable Care Act (ACA)’s online insurance marketplace, www.HealthCare.gov. Some local healthcare professionals believe that more residents would be signing up if they were aware of the subsidies available to them.
“Anybody making between $12,000 and $17,000, a single person in a household, they’re looking at low double-digit premium prices, and plans where there is zero deductible and $500 maximum out-of-pocket costs,” said Charlie Kulander, a certified application counselor at the Moab Area Free Health Clinic. “It’s as close as we get to free insurance in this country.”
So far, more than 29,000 Utah residents have signed up for coverage on the online exchange.
Problems with the HealthCare.gov Web site, which may have scared away some of those interested in purchasing insurance, are now a thing of the past, said Allyson O’Conner, the executive director of the Moab Area Free Health Clinic.
“HealthCare.gov not working is old news now,” she said. “It is fully functioning. It works and there is no reason for people to be afraid of it.”
The subsidies are available to help ensure the ACA’s goal that no one making over 400 percent of the federal poverty line would pay more than 9.5 percent of their income for health care, Kulander said.
But to receive immediate cost savings from these subsidies, individuals must sign up for health care no later than March 31. After March, the online exchanges will be closed until Nov. 15.
“You will still be able to purchase health insurance directly from the companies or with an insurance representative, but the marketplace, HealthCare.gov, will be closed,” O’Connor said.
Anyone who signs up after March 31 will still receive the subsidies, but not until they pay the year’s taxes. The ACA also requires all citizens to have health care for at least nine months of the year. Thus, anyone who signs up after March 31 will have to pay a fine.
In an effort to educate the public on the options available to them, the Moab Area Free Health Clinic and the Moab Regional Hospital have joined forces, creating the Get Insured Moab (GetInsuredMoab.org) campaign. Get Insured Moab provides free health insurance enrollment assistance every Wednesday at the Moab Regional Hospital from 9 a.m. to 3 p.m., and at the Moab Area Free Health Clinic from 9 a.m. to 1 p.m. every Thursday.
“We want people to just get on there and see what you’re eligible for, and they only have until March 31 to do it,” said Jen Sadoff, Moab Regional Hospital’s director of community relations. “Our slots have been full for people to come in and sign up with our certified application counselor.”
When signing up on HealthCare.gov, insurance is offered under three broad categories: gold, silver, and bronze.
In general terms, the bronze level has extremely low premiums, but requires the patient to pay 40 percent of medical expenses until the out-of-pocket maximum. Bronze also has deductibles of around $5,000. Silver plans are the middle-of-the-road option. Premiums are medium-level and the out-of-pocket maximum and deductible are lower than on bronze plans. Gold plans have the highest premiums, but the lowest out-of-pocket maximums and the lowest deductibles.
“If you make up to 150 percent of the federal poverty level there are silver plans that (with the available subsidies) your deductible drops from $3,000 or $1,750 down to zero and your out-of-pocket maximum, which is normally is running $5,000, drops down to $500,” Kulander said.
For Moab residents, Kulander and O’Connor say that the best options for health insurance are with the Arches Health Plan.
“Arches is a lot more attractive to people who live here,” O’Connor said. “It’s the cheapest and best coverage.”
Arches Health Plan is an insurance cooperative set up as part of the ACA. Like any cooperative, it’s run by its members for its members, said Judi Hilman, Arches Health Plan VP of strategic partnerships and consumer engagement.
“There’s a community development aspect to the co-op,” she said. “We have really bent over backwards to make sure providers in the area are part of our network.”
Arches Health Plan subscribers can use Grand Junction providers, including St. Mary’s Hospital and Regional Medical Center. By providing in-network, non-emergency access in the city closest to Moab, Arches Health Plan gives Moab residents access to more providers, for cheaper, than other insurance companies, Hilman said.
“It’s a labor of love,” said Doug Smith, Arches Health Plan’s Chief Medical Officer. “On the individual market we are the price leader in (Moab).”
“Arches sometimes seems too good to be true, but regardless, the way the insurance business works it is hard to put yourself in financial jeopardy,” Kulander said. “We are putting a lot of hope and faith that Arches will pull it off.”
But not everyone will necessarily save financially with the ACA. Those in the upper income brackets may not find a plan that saves them money, but most of Moab does not fall into that category, Sadoff said.
“There will be people who, based on their income, the exchange does not help out,” she said. “(But) those living at 100-to-400 percent of the poverty line, they will find insurance that will be helpful for them.”
Local health experts push for more residents to take advantage of insurance subsidies
“We want people to just get on there and see what you’re eligible for, and they only have until March 31 to do it,”