NorthShore Medical Group will be one of two locations in Klickitat County where those eligible can enroll for low-cost health insurance through the Affordable Care Act beginning Oct. 1.
The Patient Protection and Affordable Care Act, otherwise known as “Obama Care,” was signed into law in 2010 and overhauls the health insurance industry by requiring all Americans to obtain health insurance through a variety of measures that make it accessible and inexpensive.
Starting Oct. 1, those who meet the income and circumstantial requirements under the Affordable Care Act in Klickitat County can either go to NorthShore Medical Group at 212 Skyline Drive in White Salmon or Klickitat Valley Health at 310 S. Roosevelt Ave. in Goldendale to enroll for low-cost health insurance.
Insurance benefits will not take effect until Jan. 1, 2014 and the enrollment period ends in March, according to Cindy Robertson, administrator of NorthShore Medical Group.
“It will increase opportunities for people locally and we’re happy to help those who need insurance,” Robertson said.
There are two big changes to ways individuals can qualify for insurance, according to Robertson, the first of which involves Medicaid expansion to those who are under 138 percent of the federal poverty level. That translates to the equivalent of a single person making $15,415 or a family of three making $26,344 yearly.
Washington is one of 25 states that chose to move forward with Medicaid expansion, according to the Henry J. Kaiser Family Foundation. Washington is also one of 17 states that have declared a state-based exchange system, which is the other new way health insurance can be purchased under the Affordable Care Act.
“The Exchange is a website you will go to and will walk you through the different options available for insurance in your county and for your specific circumstances, income level, and household composition” Robertson said.
The Exchanges will take the information gathered from each individual or family, including age and smoking status, and calculate if they qualify for a federal tax credit that can then be applied to one of the multiple plans purchased through the Exchange.
If an employer does not offer insurance or the cost of a plan offered through an individual’s employer is greater than 9.5 percent of a household income or said insurance covers less than 60 percent of health care costs that individual is eligible for subsidies, according to Robertson.
According to the Kaiser Family Foundation, tax credits will be made available to those individuals whose income is up to 400 percent of the federal poverty line, or those who make $44,480 for an individual or $76,360 yearly for a family of three.
According the Office of the Insurance Commissioner, 75 percent of the 4,400 currently uninsured residents in Klickitat County will either qualify for the Medicaid expansion, or subsidies for plans sold through the Exchange. That comes to about 1,400 who will qualify for Medicaid expansion and 1,900 who will qualify for subsidies through the Exchange.
Insurance plans purchased under the Exchange range in price, but all plans will cover hospital and doctor visits, maternity care, mental health care, and prescription drugs. Health insurers cannot deny or charge more for coverage to those with pre-existing conditions and men and will women will pay the same for coverage, according to the Kaiser Family Foundation.
Under the new law, young people will eventually pay more for insurance, but can stay on their parents’ insurance until they are 26. Those who do not purchase insurance from the exchange or do not become covered under Medicaid will be fined.
On the flip side, companies with more than 50 employees will be required to offer medical insurance to full-time employees and smaller companies will be offered temporary tax breaks for extending health insurance benefits to employees.
After the cut-off date for enrollment, individuals will not be able to obtain low-cost medical insurance until the next enrollment period begins. Robertson encourages anyone with questions about enrollment or eligibility to call NorthShore at (509) 493-2133.