How Whatcom County residents can sign up for health care as reforms kick in

THE BELLINGHAM HERALDSeptember 14, 2013 

A key piece of federal health care reform kicks in Oct. 1, when most uninsured people can start applying for Medicaid or buy private health insurance for 2014.

That means thousands of Whatcom County residents up to age 65 who couldn't previously access coverage now can.

There are an estimated 725,000 Washingtonians who don't have health insurance, according to the Urban Institute.

That total includes 25,100 Whatcom County residents - 19,400 of whom could receive financial help paying for insurance premiums or out-of-pocket costs, or could get free coverage because of the state's decision to expand Medicaid, a state and federal health insurance for the poor and disabled.

Both are provisions of the federal measure frequently called Obamacare.

Here's what Whatcom County consumers need to know during the run-up.

When can I sign up?

Open enrollment runs Oct. 1 through March 31. Coverage begins Jan. 1 if you enroll before Dec. 23.

People buying private plans have until the end of March to enroll, or else they will have to wait until Oct. 1, 2014.

Medicaid enrollment continues year-round. Medicaid expansion will allow adults earning up to 138 percent of the federal poverty level - representing an annual income of about $15,856 for a single person - access to coverage.

Health care coverage begins the first of the month after signup, provided it's done before the 23rd of the previous month.

What happens if I refuse to sign up for health coverage?

Because most people are required to have health insurance beginning in 2014, you will be fined in increasing amounts each year, unless you are part of a group that's exempt.

Starting in 2014, individuals without insurance will have to pay a fine of $95, which will increase to $325 in 2015, and to $695, or 2.5 percent of household income, in 2016.

For families, the penalty will start at 1 percent of household income, or $285, in 2014, whichever is greater, and up to $2,085, or 2.5 percent of household, income in 2016.

I already have Medicare, Medicaid or insurance through my employer. What should I do?

Nothing. Keep the plan that you have. You will not be fined.

What if I have health insurance through my employer but I don't like it and want to buy insurance through the new exchange?

You can buy insurance through the health exchange, but you won't qualify for tax credits because you have access to a plan through your employer, said Dorothy Bradshaw of the nonprofit Whatcom Alliance for Health Advancement.

Who's exempt from the requirement to carry insurance?

• If you are very low-income, in that you would pay more than 8 percent of your income on insurance or you don't make enough money to have to file taxes. While you may not be fined, officials said you should apply because you likely will qualify for free coverage.

• You are a member of a recognized American Indian tribe.

• You have a religious exemption.

• You are incarcerated.

Also, undocumented immigrants cannot buy health insurance through Washington Healthplanfinder, which is the new online marketplace the state created to let consumers know how much insurance might cost and whether you will get a subsidy to help pay for it.

How do I know if I qualify for health care coverage for myself or my family?

Go online to wahealthplanfinder.org.

"This isn't a whole new kind of health insurance, it's just a new way to buy it," Bradshaw said.

Look for the calculator on that website. Type in the number of people in your household, income, age, and the number of people who need coverage. The calculator will show how much money you will spend on premiums, or indicate whether you qualify for Medicaid under the state's expanded eligibility.

Officials are encouraging people to go to the website - and not just those who might benefit.

"What we need is everyone to, hopefully, take a look. If not for themselves, it could be for a loved one, a family member or someone in their church or religious community," said Michael Marchand, director of communications for the Washington Health Benefit Exchange. "Someone knows someone who could benefit from this."

Still, others might be surprised that they can receive help paying for coverage, including those who see themselves as middle class, officials said.

Examples of people who could qualify:

• A family of four making less than $32,500 a year can get free health coverage.

• A family of four making up to $40,000 can get about $985 in tax credits per month to help pay for coverage.

• A family of four making up to $90,000 could get about $436 in tax credits per month.

A family of two making $45,000 a year could qualify for tax credits, too.

"A lot of people don't realize that," said Bradshaw, manager of the In-Person Assister Program with Whatcom Alliance for Health Advancement. "In many ways, I think there are a lot of people that don't think this applies to them."

The Whatcom Alliance for Health Advancement was one of 10 lead organizations chosen statewide to help consumers enroll in a health plan. WAHA is serving residents in Whatcom, Skagit, San Juan, Island and Snohomish counties.

The Bellingham-based organization is building and overseeing a network to provide impartial information to consumers in-person, online and on the phone - including training more than 200 people in the region.

How do I sign up come Oct. 1?

• Go online to wahealthplanfinder.org to compare private health insurance plans, costs, coverage levels and to enroll. Plans being offered for 2014 will be at the bronze, silver and gold level. (There will be no platinum level for Washington in the coming year.)

• Dial the call center toll-free at 1-855-923-4633 to enroll and get customer support. Help will be available in up to 175 languages, with trained representatives available 7:30 a.m. to 8 p.m. weekdays. You can call now with questions about getting coverage through the state insurance marketplace because the center opened Sept. 3.

• Enroll with one-on-one help from an in-person assister through Whatcom Alliance for Health Advancement; Interfaith Community Health Center; Mt. Baker Planned Parenthood; Opportunity Council; and Sea Mar Community Health Clinic.

Such assisters can help you through the process, but they can't recommend a health plan to you.

Go online to whatcomalliance.org/get-enrolled for the list of in-person assister organizations, and their contact information to make an appointment beginning Oct. 1.

• Enroll with the help of more than 1,000 registered insurance brokers. Unlike assisters, they can recommend a specific plan based on your needs and budget. Just make sure it's one of the more than 40 health plans offered through Washington Healthplanfinder if you want to be eligible for financial help. Go to wahealthplanfinder.org or contact the call center to make sure you're dealing with a broker registered by the state exchange.

HEALTH SERIES

This is one in a series of stories The Bellingham Herald will publish about how the Affordable Care Act will affect Whatcom County residents. Look for more articles as the Oct. 1 deadline nears.

Reach KIE RELYEA at kie.relyea@bellinghamherald.com or call 715-2234.

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