AFFORDABLE CARE ACT

Consumers get many new choices, some higher prices

Andrea Vasquez, left, a health-care navigator for Toledo-Lucas County CareNet, helps a customer at the Dental Center of Northwest Ohio.

THE BLADE/JETTA FRASER
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Andrea Vasquez, left, a health-care navigator for Toledo-Lucas County CareNet, helps a customer at the Dental Center of Northwest Ohio.

One in a series

Toledo-area residents will face an explosion of insurance plan choices and higher costs for some insurance premiums as the second enrollment period for the Affordable Care Act’s health-care marketplace begins this Saturday.

The number of insurance companies offering plans in the Toledo area on the health-care exchange has risen from seven to 11, and the number of health-plan options to choose from has mushroomed from 66 last year to nearly 450 this year.

Also new on the exchange will be a separate section of the Web site where small business owners, those with 50 or fewer employees, can purchase health insurance.

Those already covered with insurance can renew or change their policies over the next three months.

As for those Web site issues that plagued the launch of healthcare.gov last year, officials expect Toledo-area consumers will have an easier time logging in this year.

The first enrollment period that started in October 1, 2013, was marred by computer glitches that slowed the Web site and added to the confusion of consumers, who were already adjusting to a new way of acquiring health insurance.

“We have our fingers crossed that the Web site functionality will be better this time,” said Jan Ruma, executive director of Toledo-Lucas County CareNet, the agency that will provide navigators to help people enroll in health insurance in northwest Ohio.

“I think it is going to be substantially easier,” said Trey Daly, Ohio director for Get Covered America, an advocacy group that supports implementation of the Affordable Care Act.

Working out the kinks

Mr. Daly said the sign-up process has been streamlined, and the federal government has eliminated many of the screens that people had to navigate last year.

The U.S. Department of Health and Human Services has had down time over the summer to work on any remaining issues on the site. Despite the rough start last year, 7.3 million people purchased health insurance nationally, Ms. Ruma said.

In Lucas County, the number of uninsured was nearly cut in half after the first enrollment period. The number of those without health care shrank from about 45,000 to approximately 24,000, but a large portion of that group, about 72 percent, were enrolled in Ohio’s Medicaid program through the federal expansion.

Ms. Ruma said that because of the success of the first enrollment period in decreasing the number of uninsured, the federal funding for navigators to help people enroll in health plans was cut back across the state.

The Ohio Association of Foodbanks received $2.2 million in federal grants to finance navigator programs across Ohio.

That group partnered with agencies such as CareNet, which received $250,000 to hire and train navigators in Toledo, Ms. Ruma said.

The number of navigators in the Toledo area has been reduced from about 20 last year to nine, she said.

Those nine people will provide free help to residents in Lucas County and 19 other surrounding counties in northwest Ohio.

“Population-wise, we are getting our fair share of the money coming to Ohio,” Ms. Ruma said.

In Michigan

Michigan Consumers for Healthcare received the largest share of the federal grant money to provide navigator service across the state — $1.4 million — said agency Director Don Hazaert.

He said that, overall, Michigan received the same amount of resources from the federal government for navigators this year, so there will roughly be the same amount of help available to assist consumers.

The agency is behind the enrollmichigan.com Web site that directs consumers to local health-care agencies and health departments.

“The Web site lists all the navigators in the state, not just ours,” Mr. Hazaert said.

He said the site makes it easy for people to search by region and find all the navigators and certified application counselors available in their county.

“The difference between navigators and certified application counselors is the navigators have more training and they can also assist small businesses,” he said.

In Michigan, 272,539 people enrolled in health plans through the marketplace last year, and nearly 440,000 have signed up for Medicaid, said Kalena Murphy, navigator services coordinator with Michigan Consumers for Health Care.

She said the uninsured rate in Hillsdale County dropped from 19 percent to 11 percent, from 14 percent to 8 percent in Monroe County, and from 17 percent to 10 percent in Lenawee County after the first enrollment period.

More choices

People who signed up for health insurance last year and who elect not to review and change plans will be rolled over and keep the same selections in 2015.

Officials are recommending, however, that they log into healthcare.gov because there are major changes this year. That includes more insurance companies and new plan options that were not available last year.

Time, UnitedHealthcare, and Coordinated Health Mutual (InHealth) are some of the new insurance providers on the Ohio health exchange this year, said Robert Denhard, spokesman for the Ohio Department of Insurance.

The number of insurance providers and plans offered on the exchange varies by state and by region within a state.

In the Toledo region, consumers will choose from nearly 450 health plans from 11 insurance companies.

The Toledo region includes Lucas, Defiance, Fulton, Henry, Williams, and Wood counties.

Plan levels of bronze, silver, and gold will be offered again, but new this year is consumers can choose a platinum-level plan.

The platinum plans cover 90 percent of health-care costs, but the monthly premiums can be very expensive.

According to the Ohio Department of Insurance, the average premiums will increase by 12 percent for individuals and 12 percent for small businesses in 2015, according to approved rates submitted by Ohio health insurance companies.

In Michigan, there are four new insurance companies offering health plans on the exchange: Physicians Health Plan, Harbor Health, Time Insurance Co., and UnitedHealthcare Community Plan. In all, there will be 17 insurance companies providing health options for Michigan residents.

Some premiums are increasing by 7 percent, depending on where a person lives and which health plans are selected. Others are staying flat.

“It all depends on what you choose,” said Andrea Miller, spokesman for the Michigan Department of Insurance and Financial Services.

The average premium being paid in Ohio by those who enrolled through the marketplace last year is $332.58 per month, based on information supplied by the Ohio Department of Insurance.

According to the federal Department of Health and Human Services, however, 60 percent of those who enrolled received tax credits or subsidies. After tax credits are applied, the average monthly premium being paid by Ohio residents is $121.

Updating data

Ms. Ruma said those who enrolled last year also need to update their financial information to make sure they are receiving the correct amount of subsidies and tax credits from the federal government.

She said people who don’t report a job change or increased income will find that they are penalized when that information comes to light in tax returns.

After the first open enrollment period, Enroll America conducted a survey to find out why some uninsured people did not sign up for coverage, Mr. Daly said.

“The reason people gave for not enrolling was they did not think they could afford it and they were not aware of the tax credits or the Medicaid coverage,” he said.

He said the survey also provided insight into how to motivate those who remained uninsured to get health insurance coverage. What they found is if people more fully understand that they will have to pay a penalty if they do not have health coverage, it could move them to sign up for insurance.

The federal tax penalties are increasing this year for those who have not obtained health insurance by Jan. 1. The penalties will increase from $95 for adults or 1 percent of taxable income, to $325 per adult or 2 percent of taxable income, whichever is greater.

Those who already have private health insurance or are on Medicaid or Medicare are considered covered and will not face a penalty.

Those who sign up by Dec. 15 can have coverage beginning Jan. 1.

Contact Marlene Harris-Taylor at mtaylor@theblade.com or 419-724-6091.