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home : news : news Wednesday, May 25, 2016

3/22/2014 Email this articlePrint this article 
Nearly 1,500 Clinton County residents newly insured through ACA

By Jeremy Huss
Staff writer

About 3.1 percent of Clinton County residents have signed up for health insurance plans through the website since the implementation of the Affordable Care Act (ACA) in October, according to data released by the Iowa Department of Human Services.

As of Feb. 28, 1,466 Clinton County residents were enrolled in the Iowa Health and Wellness Plan. Statewide enrollment as of Feb. 28 was 72,997, about 2.4 percent of the state population.

Depending on their income, Iowans signing up for health insurance have a couple of choices.

The majority of the enrollees are signing up for the Iowa Wellness Plan available to residents whose income is at or below 100 percent of the federal poverty line.

Federal guidelines put the income limit at $11,670 annually for a single individual, $15,730 for a two-person household and $23,850 for a four-person household. Additional information on poverty guidelines can be found at the Iowa Department of Human Services website.

Low-income options

In Clinton County, 1,169 of the enrollees fall under the income limit for the Medicaid insurance, and statewide 58,715 enrollees are under the limit.

Individuals enrolled in the Iowa Wellness Plan will be able to access the Medicaid network of health care providers, according to Kimberly Kim, health insurance navigator for Genesis Health System.

The Iowa Marketplace Choice Plan is available to residents whose income is 100-133 percent of the federal poverty line and offers enrollees their choice of two insurance plans from Coventry or Co-Opportunity Health, Kim explained.

As of Feb. 28, 297 Clinton County residents have enrolled in a marketplace plan.

Individuals who sign up will receive information from the state on the competing insurance plans, usually within two weeks, Kim said. The plan will give enrollees access to the Medicaid provider system as well as supplemental insurance allowing them to access doctors in a private network.

"From what we understand, the plans are very similar, but the difference is the providers in the network," Kim said.

The Co-Opportunity Health plan has providers found in the Genesis and University of Iowa network, Kim said, while the Coventry plan has providers in the Trinity/Unity Point network.

Navigators are encouraging enrollees to look carefully at the providers available in each network when selecting a plan, Kim said.

Residents whose income is greater than 133 percent of the poverty guideline may be eligible for a cost-reduced plan that has lower deductibles and out-of-pocket costs or a tax credit depending on their income.

"So if someone makes too much for Medicaid, they have two options," Kim said.

Cost-reduced plans, in which the government subsidizes the cost of the insurance, are available to residents with income of 250 percent or less of the poverty line, while tax credits are available to individuals who earn 400 percent or less of the poverty line.

Enrollment trends

Kim said the majority of residents visiting navigators for enrollment assistance are individuals who now qualify for Medicaid due to expanded eligibility requirements, but navigators also are working with many retired residents who are under 65 and not yet eligible for insurance through Medicare.

Also signing up are employed individuals who can't access insurance through their employer or whose employer-based insurance is not deemed affordable under the law, Kim said.

The health care law bases insurance affordability on the annual cost of an individual premium divided by household income. To qualify as affordable, the individual premium cost cannot be greater than 9.5 percent of household income.

Residents who can access insurance deemed affordable under the law still can shop for plans on the exchange but are not eligible for a tax credit or cost-reduced plan, Kim explained.

"Unfortunately, sometimes people feel it's not affordable, but under the law it is," she said.

Navigators are encouraging residents seeking insurance to act promptly because the deadline for open enrollment is fast approaching.

"The most important thing for people to know is the deadline for open enrollment is March 31, and we really don't want people to delay," Kim said.

Navigators expect to get busier as the deadline nears, and Kim said there are likely to be technical issues as the website gets bombarded with visitors in late March.

"Call now, come in now, don't wait till the end of the month," Kim said.

Navigators are available to help residents sign up for health insurance at the Clinton County administration building, 1900 N. 3rd St., Clinton, on Wednesdays, 9 a.m.-noon, through the end of the month.

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