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Health insurance marketplace opens for enrollment

Open enrollment for the Health Insurance Marketplace, part of the Affordable Care Act (ACA, also known as Obamacare), has started for coverage in 2015.

Open enrollment started nationwide last Saturday and will run through Feb. 15. Those who don’t enroll by the deadline will have to wait a year to get coverage, unless they have a major change of circumstances such as losing their job, having a child or getting married or divorced.

The ACA requires that citizens must – with some exceptions – have health insurance or pay a tax penalty for 2015 of $325 per adult and as much as $975 for a family, or 2 percent of taxable income above a filer’s filing limit, whichever is greater, according to the Kansas Insurance Department.

Numerous Kansas City metro-area organizations started helping people last Saturday with information about their options and guiding them through the enrollment process, and will continue to do so through Feb. 15. They include the Samuel U. Rodgers Health Center, Swope Health Services, the Rosedale Development Association and Enroll Wyandotte.

Marisol Escovedo, who is 24, came to the Rodgers Center looking for an affordable health insurance plan.

“It’s really important to me to have insurance,” Escovedo told Kansas City Hispanic News. “It is a little bit confusing. Since I don’t really go to the doctor that much, I think that I need to have (an insurance plan) that will cover me when I need it, but (that’s) not that expensive. … At my work, they do offer insurance, but I’m trying to get different ideas to see which one I’m really required to have.”

Another woman at the Rodgers Center last Saturday, who declined to identify herself, said that she’d come to learn about insurance options for her parents.

“They do a great job in there,” she said. “They’ve got some great staff who know what they’re doing and are sharing the objective point of view of what you qualify for. My parents didn’t qualify because they’ve got Medicare, but there are some great options for those who qualify.”

The center also has bilingual staff members who can help Spanish-speaking people with the process.

The woman said she’d been somewhat confused about her parent’s options.

“(Staff at the Rodgers center) shared with me that, as long as you don’t have Medicare, you can be considered for this,” she said. “If there’s no coverage and you’re working and you’ve never had insurance but you’re still making over, say, $1,500 a month, then this is for you. It still allows you to pay for the premiums. The supplemental helps you offset what it would’ve cost.”

People who earn less than 100 percent of poverty level don’t qualify for Obamacare “because our state (Missouri) didn’t support it,” she said.

“If our state would’ve supported it, everybody would have been part of it,” she said. “We are being punished. Every state that did not take Obamacare money (including Kansas), they affected and punished all the poor people in their states. That is not fair; that is discriminatory.

“So the poor people, all they can do is sign a waiver saying that they won’t get penalized for not signing up for insurance, but what does that do for their medical needs? Imagine the poor person who doesn’t have enough of an income to prove that they make enough money to pay for that insurance. They’re not even on the radar. Isn’t that ridiculous? We live in a country that should have affordable care for everyone, and we don’t.”

The woman’s parents have insufficient coverage through Medicare, she said. Her mother needs knee-replacement surgery, which will cost $20,000, and Medicare, “even if they cover 80 (percent of the cost), (her parents) still have quite a bit to pay, so that’s a lot of money that they don’t have the money saved up. I thought they were covering everything.”

Lucia Jones, a registered nurse and the project coordinator for Enroll Wyandotte, said that the organization’s work “changes most people’s lives” because people seeking insurance often feel insecure about the enrollment process. The organization’s goal is to educate people about their choices, guide them through the process and enable them to reap the system’s benefits.

“The key things for people to focus on are that now they have an opportunity to get health insurance and receive assistance to pay for it,” Jones told Hispanic News. “They need to be patient with the process, and now they have a system to help them. We want a healthier Wyandotte County that is able to make informed decisions about their health and their health insurance options.

“For me, it was always heartbreaking to see people in the emergency room and not have health insurance,” she said. “It’s also very important to stay healthy.”

Most preventive medical services under the ACA will be provided at no extra cost to consumers, she said.

Jim Torres, marketplace coordinator for the Rodgers Center, said that many people are still confused about their options and how the process works.

“They don’t know how to apply or whether they’re eligible, he said.

Americans are better off today than they were a year ago regarding health insurance, Torres said.

“About 13 million people now have health insurance who didn’t before Obamacare,” he said.

Torres agreed that some people have seen their health insurance premium rates and deductibles go up, but he said that “for the most part, what we have seen is that health insurance (cost) has been increasing at a slower rate than it had been in the past.”

“That is good,” he said. “Insurance plans are now having to meet the new standard under the law: They have to cover prescription drugs and preventative care at no cost, and these are improvements that most people are getting but they’re not even aware that they’re getting because of the law.”

For those who have insurance through the ACA, Torres recommends that they provide updated income information, which could lead to more financial assistance, and check to see whether their doctor is still part of their plan and whether they can find a less expensive plan that still meets their needs.

Torres said that information about the marketplace is available by calling 816-889-4634 or 816-889-1917 for those who primarily speak Spanish.

A list of organizations providing assistance in the Kansas City-area in Missouri and Kansas is available at www.coverkc.org/helpapplying.htm. Detailed information on the marketplace – including key dates to keep in mind for open enrollment and details regarding Medicaid, the Children’s Health Insurance Program (CHIP) and small businesses – is available at www.healthcare.gov/marketplace-deadlines/.

Help also is available 24 hours a day through the Missouri Health Insurance Marketplace by calling toll-free at 800-318-2596, and information on 2015 marketplace rates and plans is available on the Kansas Insurance Department’s website (https://www.ksinsurance.org/gpa/ccorner/2014-11.pdf).