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The Affordable Care Act and what it means for individuals and families can be a bit overwhelming for those not familiar with it. But a program offered by the University of Missouri Extension, part of the Health Insurance Education Initiative, is shedding light on the ACA for residents across the state.
The wintry weather kept many people home during a recent program at the Joplin Public Library. But two people came, and that was enough for the hour-long program to go on as planned.
It’s one of many that have been held so far, and several more are scheduled.
"We're just trying to provide some educational information so people can understand their rights under the new law and their responsibilities as well so when they start making decisions about health insurance they can make well informed decisions," she said.
Janet LaFon is a family financial education specialist with University Extension. She says many people they’ve talked to want to understand what the enrollment period is, what their eligibility is as far as cost sharing discounts and federal subsidies and how the MO Health Insurance Marketplace operates.
The presenters explain that individuals qualify for a premium tax credit if they can’t get affordable health insurance through their jobs or don’t have insurance, if they don’t have Medicare or if their household income is between 100% and 400% of the federal poverty level. To get the tax credit, they must use the Marketplace to buy coverage.
Individuals qualify for lower out-of-pocket costs if they receive a premium tax credit, they choose to buy a silver-level health plan through the MO Marketplace and they have a household income at or below 250% of the federal poverty level.
The program gives a broad overview of the Affordable Care Act, according to Kathy Macomber, community development specialist with University Extension, because, as she points out, it’s more than just the Marketplace.
"There are ten essential health benefits that every insurance plan must provide," she said.
Those include things like emergency services, maternity and newborn care for pregnant women, new moms and their babies, prescription medicine, rehabilitation and habilitative services and pediatric services for kids and babies including dentist visits and eye exams.
And the presenters talk about grandfathered plans that don’t have to be compliant with the law at this point and about employer plans.
LaFon says they also point out who the MO Health Insurance Marketplace might benefit.
"The Health Insurance Marketplace, you know, could benefit part-time employees, those people who are underemployed or unemployed, people who are self employed, like independent contractors, seasonal employees, people who are employees of small businesses or maybe businesses who are not offering health insurance, those who are thinking about retiring--the people who in like the 55 to 64 age that are maybe kind of wanting to but are concerned that they may not have health insurance coverage or may not be able to afford it until they reach Medicare, anyone with unaffordable or inadequate insurance or people who are on COBRA," she said.
One of the most important things stressed at the programs is enrollment dates. In order for coverage to start on January 1st, individuals must buy coverage before December 23rd. And the open enrollment period ends on March 31, 2014.
Macomber says the programs offer practical information.
"They get information about how to enroll in the marketplace. They get a handout with a checklist of what kind of information and documentation they need to have with them, and at most of our presentations we also have certified application counselors and navigators from local hospitals and other healthcare agencies," she said.
Attendees can’t enroll during the programs, but they can talk with representatives from area hospitals to receive help at a later date.
Camille Midcap, lead certified application counselor with Freeman Health System, was there to assist anyone who wanted to get help signing up for insurance through the online marketplace. She says while the Federal Health Exchange website was a challenge at first that has changed.
"Over the last few weeks we've noticed successful enrollments and having no issues going through the process with the application," she said.
She says anyone can receive help signing up through the marketplace for free.
One of those who attended the recent program in Joplin was Laurie Simmons who works for Carthage Head Start.
"I decided to come to the meeting because I work for a Head Start, and I wanted to get some information not only for the employees but for our people that attend Head Start classes," she said.
And she wanted information for herself since she’s planning to enroll through the MO Health Insurance Marketplace.
"Because I intend on doing it, but I just--I felt uncomfortable about not knowing the system," she said.
She says she feels more comfortable about the process now, especially knowing there’s free help available when she decides to enroll.
Anyone who would like to check out dates for future sessions on the Affordable Care Act or find information about the ACA can do so at extension.missouri.edu/insure