Straight talk about enrolling in the Health Insurance Marketplace

Beginning in 2014, millions of Americans will have access to affordable, quality health insurance through the Affordable Care Act. They will be able to compare health plans through the Health Insurance Marketplace created by the health reform law. Consumers will find various plan options available in their state in simple, easy-to-understand language.  Individuals will be able to enroll beginning on October 1st of this year. (If you obtain insurance through an employer or a government program such as Medicare or Medicaid, you do not need to enroll through the health exchange.) 

I know that many of my constituents have questions about the enrollment process, the types and cost of coverage that will be available and many other aspects of this phase-in of the health reform law, more commonly known as Obamacare. It’s unfortunate however, that critics of Obamacare have gone out of their way to spread misleading information, use fuzzy math or omit important details to create fear and confusion. That’s a disservice to the people I represent. My goal is to help ensure that our hardworking families and individuals have accurate information and know where to find it.

An example of misleading information can be found in the recent news release issued by the Ohio Department of Insurance. It announced that average premiums in Ohio will increase 41% next year as a result of the Affordable Care Act. That’s technically true but in practical terms, meaningless. Consumers will not pay an average based on all levels of plans available. It’s like averaging the price of a budget compact car with a high end luxury SUV. If you’re in the market for a low cost car, you’re not paying anywhere near the “average.” 

In the Health Marketplace, consumers will have an option to purchase insurance in four different levels to best meet their needs and budget. They may opt for lower monthly premiums (with higher deductibles) or pay more per month but face smaller out-of-pocket costs if a major medical expense does occur.  A number of states that have worked hard to implement the law smoothly are reporting premiums will cost less in 2014 than what is currently available. In New York, not only will new insurers be entering the market to offer plans to consumers, the cost for even the most comprehensive plans will be down by over 50% according to the state. In Nevada, a young person can buy a catastrophic plan for less than $100.

It’s also important to note that Ohio permitted insurers to sell bare bones policies that had glaring loopholes in coverage.   They may have lacked maternity coverage, were available only to men (until Obamacare, health insurers were free to charge women more) or were not available to someone with a pre-existing condition. In 2013, all plans must offer a more comprehensive suite of benefits, preventive care services and include prescription drug coverage.

The Ohio Department of Insurance also glossed over the fact that more than 80% to 90% of Americans eligible to purchase insurance on the Health Marketplace will qualify for tax credits which will make the cost of coverage even more affordable. These tax credits, or subsidies, will lower the cost for an estimated 915,000 Ohioans in 2014. They will be available on a sliding scale based on income and family size, up to 400% of the federal poverty line (which is approximately $45,000 per year for an individual and $94,000 for a family of four). Now doesn’t that seem worth mentioning?

In many cases, consumers will be able to choose their doctor or keep one they like. That ability may depend on the level of plan they purchase. In some existing health plans, freedom of choice is already limited depending on which physicians are in a plan’s provider network. It simply isn’t true that Obamacare automatically removes that ability to choose a physician in every case.

If you would like more information on the Health Insurance Marketplace, I encourage you to contact the official U.S. Department of Health and Human Services website, Healthcare.gov.  Consumers will be able to enroll directly through that website or by phone. The toll-free hotline number is 1-800-318-2596. Please keep in mind that they are set up to provide information at this time but the ability to enroll will not begin until October 1st.

Constituents in the 11th Congressional District are also welcome to call my district offices with any questions about the Marketplace or any other aspect of the health care law’s implementation; Cuyahoga County District Office: 216-522-4900, Summit County District Office: 330 -835-4758.

Congresswoman Marcia L. Fudge represents the Eleventh Congressional District of Ohio, a diverse district that encompasses 32 communities in Northeast Ohio from Cleveland to Akron. Elected to a third full term in 2012, she currently serves on the Agriculture and the Education and the Workforce Committees in the U.S. House of Representatives.


 

Congresswoman Marcia L. Fudge

Congresswoman Marcia L. Fudge represents the Eleventh Congressional District of Ohio, a diverse district that encompasses 32 communities in Northeast Ohio from Cleveland to Akron. Elected to a third full term in 2012, she currently serves on the Agriculture and the Education and the Workforce Committees in the U.S. House of Representatives.

*NOTE TO THE EDITOR: Some copy was inadvertently missing from the version of the article sent approximately 45 minutes ago.  Please use this version of the article instead.  My sincerest apologies for any inconvenience.
Belinda Prinz, Communications Director
(216) 522-4900

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Volume 5, Issue 8, Posted 1:27 PM, 09.12.2013