Editorial: What’s the Obamacare (ACA) Buzz?

It’s time to surf, call, talk — start the process

By Margie Doyle

Anyone remember when Medicare was signed into law (1965)? Social Security (1937)?

The arc of U.S. history is finally, slowly, making huge changes in providing health care to all its citizens. It DID take a national act of Congress — and now, after the passage of the Affordable Care Act (ACA or “Obamacare”) in 2010, it’s coming quickly to a location near you, specifically Orcas Island:

• Oct. 1, 2013 State Health Care Exchange opens enrollment
• Jan. 1, 2014 coverage begins
• March 31, 2014 enrollment closes

Affordable — this could mean you. There are several websites to help you learn if you qualify, and how to go about applying, without identifying yourself or committing to registration.  Only you can start the process to determine how best to obtain health insurance  coverage; by reading, talking, asking, listening, and deciding.

Orcas schools, medical centers and family resource center are all working to help obtain answers and direction so that we can all help each other obtain affordable healthcare for ourselves and our families.

One of the factors in the new law is that almost everyone will be required to have health insurance by January 1, 2014. If you get your health insurance through your employer, your coverage probably will not change.

All are required to have health insurance coverage, either through private insurance companies or through the Washington State Health Exchange. There is a penalty for failure to obtain health care insurance. You may never get “caught,”  you may have great health coverage now, you may feel you don’t want “government” telling you want to do or that you’re going to trust your luck and good health. But as a young Orcas resident, a 34-year old teacher with a 2-year old and monster college loan debt, says, “We need affordable care, we’ve been asking for it for years; now we need to help make it work.”

To find out what’s involved in enrolling in “Obamacare” go to:

https://www.Health Care Authority.wa.gov

WaHealthCareFinder.org

https://www.wahbexchange.org/

All private health insurance plans offered in the Marketplace will offer the same set of essential health benefits. These are services all plans must cover:

• Ambulatory patient services (outpatient care you get without being admitted to a hospital)
• Emergency services
• Hospitalization
• Maternity and newborn care (care before and after your baby is born)
• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
• Prescription drugs
• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services

Essential health benefits are minimum requirements for all plans. Plans may offer additional coverage. There are four categories of coverage, with respective costs.

To learn more about the kinds of plans available, and the four categories of coverage, call  1-800-318-2596, 24 hours a day, 7 days a week. (TTY: 1-855-889-4325) (from healthcare.gov)

Those who are on the following programs are exempt for signing up for the Washington State Health Care Benefits Exchange:

• Medicare
• Medicaid (Apple Health)
• Children’s Health Insurance Program (CHIP)
• TriCare
• Veterans Health program
• “grandfathered” plans with at least the “bronze” level of coverage, providing 60 percent of the costs of the required services

Take the time to learn from these sites information that may be incredibly helpful to your health, your rights and your pocketbook (and remember that while registration on the Washington Health Care Exchange opens on Oct. 1, 2013, you have until Dec. 31 to enroll in coverage that begins on Jan. 1, 2014, and the enrollment period lasts until March 31, 2014.)