What to know about the Affordable Care Act

Rex Robinson | 9/4/2013, 5:12 p.m.
If you are one of the estimated 75,000 people in Will County without health insurance, your options to get that ...

If you are one of the estimated 75,000 people in Will County without health insurance, your options to get that insurance are about to open up in a big way through the Affordable Care Act, also known as ObamaCare.

People will have the opportunity to start signing up for the coverage on Oct. 1 when the Insurance Marketplace (previously known as the Exchanges) opens up. Also, information about how to do that will start becoming available within the next couple of weeks. People will have until Dec. 15 to sign up for the coverage, which begins Jan. 1, 2014.

A public information forum on the Affordable Care Act will be presented by the Campaign for Better Health Care from 2 to 3:30 p.m. Sept. 22 at the main branch of the Joliet Public Library, 150 N. Ottawa St.

Jillian Phillips, an organizer for the group and one of the trained counselors of the Affordable Care Act, will be the presenter at the public forum. The Campaign for Better Health Care and the Will County Health Department are among 44 community-based organizations in Illinois selected to receive grant funding to participate in the outreach and enrollment of the Affordable Care Act.

As one of the counselors, Phillips will conduct outreach, provide education and facilitate enrollment through the Illinois Health Insurance Marketplace. She hopes many people attend the forum at the library to learn more about the Affordable Care Act. Phillips said she is excited to see the program get started so the estimated 1.7 million uninsured people in Illinois can get insurance coverage.

“What’s important to know is that it’s very unlikely there’s going to be anything that’s going to stop this law from being implemented at this point in the game,” Phillips said.

But, what exactly does it mean to the people who are without insurance or who are underinsured?

According to Phillips, one thing it means is that insurance companies will not only have to insure people with pre-existing conditions, but also will not be able to rate (or charge) people based on their health status. They will, however, be able to rate individuals based on age, whether or not they use tobacco and their geographic location, Phillips said.

“It’s not going to be based on health status anymore,” she said. “There won’t be any fine print. It will be very clear and transparent in terms of what’s covered and how the deductibles and co-payments work.”

While the Affordable Care Act is not perfect, it does go a long way in putting everyone on the same level in terms of coverage availability, Phillips said.

“Before the Affordable Care Act, insurance companies got away with a lot of abusive practices,” she said. “Some of those practices have already been put to an end, but many of the big improvements are happening in 2014.”

While there is much misinformation about what the Affordable Care Act is and how it works, within the next couple of weeks there will be plenty of information available about the new Insurance Marketplace and people will have clear direction on how to get that information, Phillips said.

In Will County, for example, anyone wanting to sign up for the coverage on Oct. 1 can call (815) 727-5990 and leave their name and phone number. One of four counselors or navigators being hired by the county’s health department will then contact them as soon as more information becomes available on how to sign up for coverage, according to Vic Reato, media services manager for the Will County Health Department. People also can e-mail questions to info@willcountyhealth.org.

One very important thing for everyone to keep in mind is there will be a penalty for those who are uninsured and do not sign up for insurance coverage through the Affordable Care Act.

For 2014, the penalty for those who forego coverage will be either $95 or 1 percent of their income (whichever is greater), according to Phillips. That percentage increases in subsequent years.

The navigators and counselors, like Phillips and the four being hired by the Will County Health Department through a $400,000 federal grant the department received, will be able to assist or “navigate” people through the new Insurance Marketplace and find the coverage that’s right for them, according to Reato.

Phillips said once the program gets underway, individuals should start at the new Insurance Marketplace to shop for a plan because it is there where they will find out if they’re eligible for the new adult Medicare plan.

“It’s where you’ll want to go to learn about all your different coverage options and you can compare plans from a variety of different insurers from throughout Illinois,” Phillips said.

Premium subsidies will be calculated based on the individual’s current income. Also, most will be eligible for some type of premium subsidy, where the federal government will help pay a portion of people’s monthly premium based on their income, according to Phillips.

The Affordable Care Act also means some good things for small business owners, Phillips said.

“It’s important to know that small businesses will not be penalized for not offering insurance, but because of the Affordable Care Act small businesses will in some ways have the same purchasing power as large businesses,” she said. “Small businesses can shop for a small group plan through the SHOP (Small business Health Options Program) Marketplace. There’ll be a list of registered brokers available through the state at no additional cost.”

A couple of websites to check out and stay up to date on what’s going on with Affordable Care Act, include illinoishealthmatters.org and healthcare.gov.