When the virtual marketplace created by the Affordable Care Act opens for enrollment on Oct. 1, almost everyone will have questions about how it impacts them.Getting the right answer is going to take time.
How much time? According to Access Health CT CEO Kevin Counihan, it will take about 55 minutes to get through the application by phone and all but three percent of the population expected to enroll will need help getting through the process.
Experian, one of the three credit rating agencies, came up with the application under the direction of the federal government. Counihan said Experian’s application included a few curveballs. He said he was able to convince the federal government to nix a question about your Zodiac sign and one about the amount of your monthly car loan.
“The original application up until about two weeks ago, asked for your Zodiac sign as part of the eligibility determination,” Counihan said.
“They agreed to take that out,” he told a group of insurance industry executives on July 23. “The second thing they agreed to take out was: ‘what is your monthly car loan?’” Experian uses the questions as part of their standard credit rating evaluation and verification process.
Enrollment in the exchanges will occur over the phone, online, or in person at one of the six Access Health CT storefronts. There will be about 157 people answering the phones and 100,000 Connecticut residents are expected to sign-up in its first year of operation. The biggest influx of individuals enrolling is expected to happen in December and March 2014.
All the research that’s been done on the enrollment process shows that individuals feel like buying insurance is “complicated, overly expensive, and they all think they’re getting screwed somewhere, but they don’t know where,” Counihan said.
In an effort to reach out to the public with information about the health insurance changes on the horizon, Counihan and his team launched a $15 million marketing campaign in June.
Connecticut is only the second state, after Colorado, to advertise its exchange on television, radio, and in newspapers, according to Counihan.
“You’re probably aware already that 7 percent of the population think the Supreme Court found the ACA to be unconstitutional. Twelve percent believe Congress has already overturned the ACA,” Counihan said. “And 40 percent believe it’s been deferred until 2014. So already there’s a knowledge gap.”
He said the advertising campaign seems to be working because 30 percent of residents have heard of the exchange or Access Health CT.
In order to reach out further into the community, Access Health CT has also given 300 part-time workers training and equipped them with laptop computers with wifi access to help enroll individuals from the field. The workers were hired with a $1.9 million federal grant. Click here to read about their first meeting.
There also are organizations like the AARP, which didn’t accept any grant money, but which will help get the word out partly because it supported the 2010 legislation.
Nora Duncan, executive director of AARP in Connecticut, said last week that her organization is training 15 volunteers who will be available to got out into the community and host discussions and answer questions about Obamacare. There’s also free, printable brochures and fact sheets for organizations available online. Some of the one-page brochures are titled: “What It Means for People Ages 50-64” and “The Health Care Law and Medicare.”
Last week, AARP launched a new website, HealthLawAnswers.AARP.org, to help their members get answers to questions about the ACA and to link them to the appropriate resources in their states. The website walks individuals through a series of seven simple questions about their age, gender, state, and current insurance situation. At the end, they receive a report telling them what they will need to do, if anything, to prepare for the changes in the law.
For those who have Medicare Part D prescription plans, these aren’t going to change or be offered through the exchange, Duncan said. Seniors will still have to go through the regular enrollment process for these plans and everyone will still have out-of-pocket costs for monthly premiums, but the coverage gap will gradually get smaller until it disappears in 2020.
In 2012, seniors received a 50-percent discount on brand-name prescriptions and a 14-percent discount on generic prescription drugs when they were in the “doughnut hole.” In 2013, seniors get a 52.5-percent discount on brand name drugs and a 21-percent discount on generics.
Still confused? AARP launched an online “doughnut hole” calculator for seniors to plug in their specific prescriptions to see where they fall when it comes to coverage. The only seniors who will be paying more for Medicare Part D under the ACA are couples who make more than $170,000 a year and individuals who make more than $85,000 a year.
Duncan said she’s already spoken to at least a couple of groups and said she was unable to find any seniors who fall into those income brackets.
Aside from more preventative benefits like annual physicals and screenings for diabetes and certain cancers, no changes were made to Medicare Part A or B. However, under the ACA the federal government will be giving fewer subsidies to private insurance companies who offer Medicare Advantage plans, so benefits and services may be dropped by some of those companies. Some plans may raise their premiums and co-payments, and others may decide to get out of the market completely.
Starting in 2014, Medicare Advantage plans must limit how much they spend each year on administrative costs. For each dollar in a premium, they can’t spend more than 15 cents on administrative services.
