By Lisa Bertagnoli
Mary Patton, an AARP volunteer since 1998, knows how difficult it is to understand the 1,000-plus pages of the Affordable Care Act (ACA).
As one of 50 AARP Illinois legislative volunteers, the Peoria resident talks to people at AARP chapters, church groups and senior fairs about the 2010 federal health law and what it will entail. The question she encounters most is about cost.
“They are worried their premiums are going up. I tell them the new law limits the cost of premiums,” Patton said, referring to a provision that caps health insurance premiums for older people to no more than three times the cost for young policyholders.
“I talk about the subsidies [and] the free annual checkups” for preventive care such as mammograms and blood pressure screenings, said Patton, 77, a retired circuit clerk of the Peoria County Circuit Court.
Beginning Oct. 1, uninsured state residents will be able to compare plans and enroll for coverage through the Illinois Health Insurance Marketplace. Coverage will take effect Jan. 1 for those enrolled by Dec. 15.
Affordable health care “is important for the financial security of everyone,” said Patton. “We need to let people know what’s out there for them and how to get these new policies.”
Six Illinois-based insurance companies will offer plans available statewide. Plans will fall into four price groups: Bronze—for people who aren’t big users of health care—will cover 60 percent of costs and will have the lowest monthly premiums; Silver will cover 70 percent; Gold, 80 percent. Platinum, for heavy users of health care, will pay 90 percent of costs but carry the highest cost to the consumer.
Low- and middle-income people—ranging from single people with no dependents who earn up to about $46,000 to a family of four with an income of about $94,000—may qualify for a subsidy that can be used to lower the monthly premium or can be taken as a tax credit on their federal income tax returns.
In 2014, “the rules of health insurance change dramatically,” said Laura Minzer, associate vice president, government affairs, and executive director of the Healthcare Council at the Illinois Chamber of Commerce.
Among the changes, insurers won’t be able to deny coverage or increase rates because of an applicant’s preexisting condition, gender or occupation.
Almost all must obtain health care coverage or pay a fine of at least $95 on their federal income tax return.
AARP plans to educate people about the ACA via email, newsletters, direct mail, meetings, presentations and media placements, said Jennifer Creasey, AARP Illinois associate state director for advocacy and outreach. AARP will not be directly assisting in enrollment.
Pushing for state exchange
Next year, Illinois will operate the exchange in partnership with the federal government. AARP Illinois plans to resume its push next legislative session for a state-run exchange in 2015. That proposal passed the state Senate but wasn’t called up in the House A state-based exchange would be more consumer-friendly, Creasey said, because proposed insurance rates would be reviewed by a board of directors devoid of insurance-industry representatives, who are on the current board.
Enrollment in the 2014 exchange is open to individuals and small businesses with fewer than 50 full-time employees.
State officials estimate that 486,000 people will sign up for the exchange. Nearly 340,000 Illinois residents ages 50 to 64 are uninsured, according to an AARP Public Policy Institute report.
In addition, Illinois is expanding its Medicaid program to include residents whose annual income is up to about $15,900 for an individual and up to about $32,500 for a family of four. The Medicaid expansion could cover nearly 200,000 people.
To enroll in the marketplace, residents can go online to illinois.gov or visit an assistance center and enroll in person.
Two programs will provide assistance: The federal Navigator program and Illinois’ In-Person Counselor program. The state’s Department of Insurance selected and trained assisters over the summer.
To arrange for a trained AARP volunteer to visit your group to talk about the ACA, call Gerardo Cardenas at 312-458-3609, or email email@example.com.
For more information about how the Affordable Care Act can affect you, go to healthlawanswers.org.
Lisa Bertagnoli is a freelance writer based in Chicago