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285 here applied for health insurance under ACA : News : Oswego Ledger-Sentinel : Hometown Newspaper for Oswego and Montgomery, Illinois
285 here applied for health insurance under ACA
Counselor: Quite a few Kendall parents sought insurance for their children

by Matt Schury


Almost 300 people in Kendall County filed applications for health insurance coverage through the Affordable Care Act from October through April 23, most of whom applied for Medicaid when the state expanded that program.

Richard Larson, ACA counselor, says of the 285 applicants, 115 applied through the marketplace and 170 applied for Medicaid.

That figure for Medicaid enrollees comes to almost 60 percent, similar to what the State of Illinois was showing with 287,000 people signing up for Medicaid statewide during the six-month enrollment period. Meanwhile 217,500 signed up for the marketplace, he said.

While the emphasis was on getting people to sign up for insurance through the marketplace, the expansion of Medicaid was key to getting the needy coverage, Larson pointed out.

Working out of the county's Health and Human Services Building, Larson said he was glad to help people sign up for tax credits to purchase health insurance on the open market and considers the ACA success.

"You have people who desperately needed protection from medical costs now who theoretically have it," he said. "It's a good protection for a lot of people."

The changes in the ACA in Illinois extended Medicaid to those with incomes of up to 138 percent of the poverty level or $32,499 for a family of four.

"So if you are below the 138 percent, unless you get declined by Medicaid you cannot buy (insurance) on the marketplace and get a tax credit," Larson said. "Now if you go to some other states like Texas or others who did not expand it (Medicaid), then there is that whole gap of people that are in trouble because they can't afford the marketplace."

Larson said that there are still many people out there who would be eligible for the marketplace or Medicaid who never signed up.

"There are still a bunch of people out there who just don't want to do it," he said. "There will be a big push in the next two years to get those people in."

The government's goal was to get 7.1 million people to sign up for insurance through the marketplace under the ACA, and slightly over eight million people nationwide selected private plans through the marketplace.

Larson said that in Kendall County most people waited until the final month to sign up for insurance.

"More people signed up in March than signed up in all the previous months nationally," he said.

Larson's appointments jumped from about 50 to 60 from December though February to over 100 in March.

The government also focused on getting young people signed up for insurance with about 28 percent of the enrollees between the ages of 18 and 34 years old.

He added that young people are needed for the system to work but it can be tough to get them to sign up.

"I had quite a few parents bringing their kids in here," Larson said.

He emphasized that there is no deadline for enrollment in Medicaid and people can continue to enroll in it throughout the year. People can also enroll for a tax credit to buy insurance on the open marketplace if they have something deemed a "qualifying event."

He said a qualifying event is a change in the status of your family-getting married, divorced, having children, someone dying

"Anything that increases or decreases the size of your family," he said.

A qualifying event can also include moving outside of where your insurance carrier is located. It can be in or outside the state.

If you involuntarily lose your coverage, for instance, if your employer drops your coverage; or you lose your job or your Cobra runs out-you can apply in the marketplace or Medicaid.

Goals for 2015 and 2016
set as larger penalties loom

Looking ahead, the federal government has set goals to get people to sign up in the next two years with the next open enrollment scheduled to begin Nov. 15 and run through Feb. 15, 2015.

He said that more people should sign up as the penalty for not buying insurance increases progressively each year. This year the penalty is $95 per person or one percent of their income.

"There are a lot of people that could sustain the penalty this year, and next year the penalty is going to be ... $325 per person or two percent of your income capped at $975," he added.

In 2016 the penalty for not having insurance will increase to $695 per person or 2.5 percent of their income capped at $2,085.

"That would pay for your premium," he said.

Larson recalled that one obstacle to signing people up was just assuring them of the benefits of the program.

"There was a fair amount of misinformation that was flying around," he said. "I had people come in and tell me that they heard they were going to get a $200 a month penalty."

Larson added that people came in with things they heard rumors and hearsay that made them suspicious.

"I had people that came in or talked to me on the phone and you could hear it just in the tone of their voice-they had to spit out the word Obamacare," he said. "Getting (insurance) coverage wasn't the issue so much as they (felt) like they were being made to do it."

He added that it is still too hard to tell if insurance rates will go down because of the ACA.

"But the competition would cause the carriers to sharpen their pencils," he said.

While the ACA helped people get insurance who couldn't in the past, lower overall health care costs is another issue with high drug costs still very much a part of health care, Larson said.

"The insurance companies are still the insurance companies. They still do things the way that they did before," he said. "You still have prescription drug companies charging very large amounts of money for certain drugs."

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