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Enrollment starts for Affordable Care Act : News : Oswego Ledger-Sentinel : Hometown Newspaper for Oswego and Montgomery, Illinois
Enrollment starts for Affordable Care Act
State, federal agencies offering information; area officials, hospitals await impact

by Tony Scott


The health insurance exchanges via the U.S. Affordable Care Act became available Tuesday, which means the uninsured and other citizens can check out and buy the available plans online.

Those interested in applying for coverage can visit the state's portal,, or the federal website for more information. Coverage will start Jan. 1, according to state officials.

According to Gov. Pat Quinn's office, the following insurance companies are participating in the exchanges: Aetna Life Insurance Company; Coventry Health and Life Insurance Company; Coventry Health Care of Illinois, Inc.; Health Alliance Medical Plans, Inc.; Health Care Service Corporation, a Mutual Legal Reserve Company (Blue Cross); Humana Health Plan, Inc.; Humana Insurance Company; Land of Lincoln Mutual Health Insurance Company.

According to Quinn's office, preventative care will be covered at no cost to the patient, and all marketplace plans will cover "important health benefits, including doctor visits, hospital stays, maternity care, emergency room visits, mental health services, chronic disease management, prescriptions and more. No one will be denied coverage because they are sick or have a pre-existing condition like asthma, diabetes or cancer."

Individuals and families with income of up to 400 percent of the federal poverty level - $45,000 for individuals and $95,000 for a family of four - will receive subsidies on a sliding scale if they obtain coverage through the marketplace, officials said.

State officials also said that the plan rates are lower than predicted.

"Illinois' health insurance plan rates are lower than many other states and 25 percent lower than earlier predictions," Illinois Department of Insurance Director Andrew Boron said. "Most people will also get help paying for their plan and many will be eligible for low-cost or free health coverage."

According to Quinn's office, officials hope to enroll at least 300,000 residents in the marketplace from Oct. 1 to March 31, the open enrollment period. Those interested in enrolling can do so online, via the Get Covered Illinois Help Desk at 866-311-1119, or in person at a state community partner with trained navigators. Those in-person sites can be found on the website, officials said.

According to the federal website, most people must have health coverage in 2014 or pay a fee of $95 per adult, $47.50 per child or one percent of your income, whichever is greater. The fee increases every year, and some people may qualify for an exemption from this fee, officials said.

"You're considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage," according to the federal website.

Non-profit organization
aims to get people enrolled

A private, non-profit organization based in Washington, D.C. called Enroll America has also launched a campaign called Get Covered America. The organization's goal is to get uninsured enrolled in a health care plan, its state director said Monday.

Enroll America's board of directors includes representatives of the Catholic Health Association of the United States, the National Association of Community Health Centers, Blue Shield of California, Kaiser Permanente, and the American Hospital Association. The organization also has an advisory board of partner organizations including Planned Parenthood, United Way Worldwide, AARP, the American Heart Association, Catholic Charities USA, the March of Dimes and several others.

David Elin, the Illinois state director of the organization, said those interested in the campaign can visit or text the word "COVERED" to 877877 to get more information.

"Our mission as an organization is to maximize the number of people that enroll in healthcare plans made available by the Affordable Care Act," Elin said. "We are highly interested in making sure people take advantage of this new opportunity. We recognize that there's a lot of options, and we want to make sure folks know what those options are and that they can go get the help they need to make an informed decision for themselves and their families."

Elin said the main goal is to give information to those curious about the exchanges.

"It's a huge undertaking, and we know that," he said. "We also know there's a lot of confusion out there, so we're trying to make sure that everybody knows that they can go find accurate and reliable information."

Elin stressed that the health care exchanges are "moving forward."

"Until recently most of the conversation has been about politics," he said. "But what's most important here is that, this is happening, it is moving forward, and folks need to go to those reliable sources to find out what they can do to get their health insurance needs met."

He continued, "We want to make sure that folks know there's all kinds of different options. Not only are there different options for plans, but there are different options to get that one-on-one advice and help from someone who is completely neutral in the process. That's what those assistors are for - they don't work for any insurance plan, and they don't represent one over the other. They're just there to help people make decisions for themselves."

Insurance, hospitals await
impact of new exchanges

Yorkville insurance agent Joel Ottosen said it would be a rough first week for those in his field.

"We're operating in the dark," he said. "Reality is that the next few days will probably be a little disruptive. I think it will probably settle out."

For example, he said the training he and his colleagues were supposed to receive regarding the Blue Cross Blue Shield product hasn't occurred yet because the BCBS product hasn't yet been approved by the government. There are still bronze, silver and other levels, but within those levels are a variety of plans, he explained.

"Those are all kind of similar in terms of the percentages, but then there's different plan designs and different setups that are still available on the marketplace," he said. "Those sorts of things I think are a little bit of a quandry."

While Ottosen cautioned that he is "not an expert at all at this point," he predicted that the law will help people.

"I do more individual health than group, and I can tell you that, for some people that have had some health issues, this is a good thing," he said. "The cost thing kind of depends on where they fit and whether or not there's a subsidy or something like that that might come into play."

Rush-Copley Medical Center spokesman Courtney Satlak said Tuesday that the hospital is still waiting to see what impact the law will have on their facility.

"Rush-Copley is working closely with several state and local agencies on the ACA and is monitoring what, if any impact it will have for hospitals," she said. "As this is more of a public health issue than a hospital issue, we are directing people to contact their local health departments for information and assistance."

Thousands now uninsured
in Kendall County, area

According to data from the Centers for Medicaid and Medicare Services (CMS), the Public Use Microdata Area (PUMA) comprised of all of Kendall County and portions of western Kane and western McHenry counties, includes 9,681 uninsured people, or 4.5 percent of that area's population, that are eligible for Affordable Care Act coverage.

A PUMA is a designated area within a state that includes at least 100,000 people, according to Enroll America.

Of those who are uninsured, 21.8 percent are on food stamps, according to CMS. The greatest number of uninsured, 3,608 (37.3 percent), are between the ages of 35 and 54, according to the data.

The majority of uninsured in this area, 5,452, are white, non-Latino residents, while 2,910 are Latino, 1,051 are Asian-American, and 238 are African-American, according to CMS demographic data. Most, 7,738, are English-speaking, while 1,147 speak Spanish.

Of the 9,681 people who are uninsured in the area, 770 are college graduates, 7,369 are high school graduates and 1,542 have less than a high school education.

Most of the uninsured, 8,057, have at least one adult full-time worker in the family, according to the CMS.

Dr. Amaal Tokars, director of the Kendall County Health Department, estimated Tuesday that there are approximately 10,000 people in Kendall County alone that do not have health insurance coverage. One of the largest groups of those without health care coverage is the unemployed without children, she said.

"In the new marketplace, they won't be eligible for the same subsidy as the adults with children, but one thing that will change, hopefully in a meaningful way for these persons, is that Medicaid in 2014 will be expanded to cover some of these individuals," she said.

Tokars said the Illinois marketplace website will direct people to Medicaid if they are eligible for it.

Tokars said it isn't clear yet what impact the Affordable Care Act will have on the services the Health Department provides, but added it "depends on whether or not people participate."

"We will have to see how this goes, but we're just watching it very closely and it's evolving constantly," she said. "Participation levels will matter for how successful this is, it will matter for the public confidence, it will matter in how our Congress works together. More to come."

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