communitycommon.com

Dialing In on Obamacare

January 29, 2014

Andrew Pierron BSPharm R.Ph., Director of Pharmacy Services, Compass Community Health


As everyone begins to settle in with the Affordable Care Act (aka “Obamacare”), those of us working in the healthcare industry cannot help but wish the enrollment process had been easier, smoother, and more effective from day one. But, several months in there is progress to report. Navigators are now trained, credentialed, and licensed. Certified application counselors are able to better assist enrollees, and agents and brokers are able to access the online information they were trying to access last fall.


Americans with pre-existing conditions are breathing a sigh of relief, as they no longer have to be concerned about being denied health insurance coverage. Plan limits and exclusions no longer apply, so hard working individuals no longer have to worry about a diagnosis of financial ruin to go along with their sickness or chronic condition.


Unfortunately, some are still finding premiums to be too expensive. Some of those same individuals and others were not given the option to continue the insurance they had in the past. For these individuals frustration, confusion, and anger are familiar feelings. The President did make a promise he was unable to keep, so there are parts of the Affordable Care Act that may need to be examined and treated as it moves forward into the marketplace.


As of today, 2.1 million new applicants are enrolled. The White House was hoping for more. Their original goal had been about 7 million. To reach this goal, penalty fees for not enrolling would need to be much higher and tax credits would need to be much greater. Politically, it would have been impossible to set the fees as high as they would need to be, but it would have allowed the offsetting tax credits to be greater. Even if this had happened, enrollment would have still been impacted by the issues which plagued distribution of funds to hire and train navigators, development of the website, and the continuation of bureaucratic inefficiencies.


Locally, many of those who were previously without health care coverage are finding they are now eligible for Medicaid under Medicaid expansion. Medicaid expansion is vital for our area. Our community needs to become healthier and stay employable for economic growth and opportunities which lay ahead. The responsible approach to a lifestyle of wellness starts with a trip to a doctor or family healthcare center. (The total cost of a wellness visit is fully covered under the Affordable Care Act.)


Do you need help figuring out all these changes to our health care system? Pike County CAO has trained navigators to assist you. Pam Ross and Sandy Perdue are very knowledgeable and will take as much time as needed to enroll individuals and families. Agents and brokers can also assist, so give them a call. SOMC has several certified application counselors to help as well. SOMC’s phone number is 740-356-5000 and Pike County CAO’s number is 740-835-8747. The Scioto County Health Coalition will hold a final Affordable Care Act informational session on Wednesday, February 12th, 6:30 pm at SOMC’s Friends Center. All navigators and certified application counselors are welcome to attend. So, if you need more information keep this date in mind.