2013-12-27 / Community

Cape, South Portland prepare for ACA changes

By Sean P. Milligan
Contributing Writer


A panel that included Emily Brostek of Consumers for Affordable Healthcare, Bethany Beausang, a representative from Rep. Chellie Pingree's office, and Kevin Lewis, CEO of Maine Community Health Options, presented information to South Portland and Cape Elizabeth residents about the Affordable Care Act recently. (Sean P. Milligan photo) A panel that included Emily Brostek of Consumers for Affordable Healthcare, Bethany Beausang, a representative from Rep. Chellie Pingree's office, and Kevin Lewis, CEO of Maine Community Health Options, presented information to South Portland and Cape Elizabeth residents about the Affordable Care Act recently. (Sean P. Milligan photo) SOUTH PORTLAND/CAPE ELIZABETH – Representatives from South Portland and Cape Elizabeth hosted an open information session for the Affordable Care Act recently to help better inform the community of the changes, if any, that will affect their health coverage.

Hosted by Representatives Kim Monaghan-Derrig, Terry Morrison, and state Sen. Rebecca Millett, the six-person board also included Emily Brostek from Consumers for Affordable Health Care, a Maine-based nonprofit that advocates health care reform, Bethany Beausang, a representative from Sen. Chellie Pingree’s office, and Kevin Lewis, CEO of Maine Community Health Options.

The board of experts outlined many of the burning concerns from the audience such as cost of premiums, different levels of coverage and frustration regarding the forced change perceived by many self-employed citizens.

The focus of the bill is to provide more comprehensive coverage at rates that fit different income levels, said the board. According to Consumers for Affordable Health Care, no individual within 400 percent of the federal poverty line will be responsible for paying more than $6,530 a year. People who have incomes within 200 percent of the federal poverty rate will see a yearly payment cap around $2,500.

Currently, 29 states will cover health insurance benefits through the marketplace for citizens with incomes less than the federal poverty line. Maine is not one of those states and will continue to utilize Maine Care for low-income subscribers.

Failing to enroll in an appropriate insurance plan by March 31 will result in a $445 fine for the first year. Exceptions include individuals whose only options will cost them more than 8 percent of their yearly income and anyone whose religious affiliation prohibits them from buying health insurance.

Seniors receiving Medicare benefits are also exempt from choosing another health insurance provider.

In Maine’s insurance marketplace there are two providers available: Anthem and Maine Community Health Options. Two main differences between the competing insurance agencies are tobacco use and coverage at Mercy Hospital. Anthem’s policies only cover care at Maine Medical Center in the Portland area.

MCHO also covers unlimited attempts to quit smoking at no inflated cost with any FDA-approved nicotine replacement therapy. Anthem bases its premium costs partially on the participant’s tobacco use status.

“Well, our hope is by making care more accessible we are able to provide and able to support the right care at the right time in the right place,” said Lewis “We hope this leads to better outcomes for our members. If it works better for the members, it works better for the providers, as well as the insurance companies.”

President Obama signed the ACA, more commonly known as “Obamacare,” into law on March 23, 2010. Enrollment in the program began Oct. 1, 2013, and was met by many technical issues on the signup website, healthcare.gov.

“We are still hearing from folks really down to the details of ‘this is how far I got’ and ‘I hit this page, how I do I fix it,’” said Beausang. “We help them navigate to the next step. We’ve seen a transition from people just being so distraught and frustrated and just needing to yell at somebody … to ‘this is where I am. How do I fix it because I really want healthcare for myself and my family.’”

Beausang said logging on after peak hours solves many of the issues faced by visitors to the online healthcare marketplace.

The change in national health care policy will also see the termination of Maine’s Dirigo Health Agency. The state agency provided coverage to about 10,000 people employed by small businesses in Maine.

“They are transitioning out,” said Rep. Morrison. “They are phasing out right now, but an important role that the board of directors is playing is transitioning all the folks that are currently on the program into the Healthcare marketplace so the transition will be seamless and smooth.”

Open enrollment began Oct. 1 and will run through March 31. For coverage to begin through Healthcare.gov on Jan. 1 people must be enrolled by Dec. 23.

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