The new federal health care law that went into effect on Tuesday will have a major, and positive impact on Grays Harbor County, according to Director of Grays Harbor County Public Health and Social Services Joan Brewster.
“People should know, now it has begun and we are ready,” she said of helping individuals maneuver the Affordable Care Act, also known as “Obamacare.”
Much of the county’s low income, long-term unemployed or those who lost health insurance in the recession — an estimated 11,300 individuals who are currently uninsured — will benefit either from the recently implemented government health care plan finder that helps people navigate through insurance options, or from expansions to Medicaid (now designated by the state as “Apple Health”— a name that stems from the previously formed Apple Health for Kids), she said. About 5,600 Grays Harbor residents are qualified to sign up through the health care plan finder and about the same number are qualified to sign up for the Medicaid/Apple Health, said Brewster.
The addition of those individuals to the health care system will benefit the county — which currently ranks last for overall health in a state-wide health survey of counties by the Robert Wood Johnson Foundation — by helping individuals maintain preventative health measures, said Audra Lutz, the clinic manager of Sea Mar Community Health Centers in Aberdeen and Ocean Shores.
“Often what happens (with the uninsured in Grays Harbor), is they aren’t sure where to go and they end up in the ER,” she said adding it is often after allowing issues that may once have been easily treatable to fester. And most often there is no complete reimbursement for the care they receive in those visits, she said. “… It’s probably one of the biggest economic costs(of having those uninsured) in the county.”
Kim Carson, Nursing Supervisor for Grays Harbor County Health, said Wednesday that she was surprised they had not yet received a single phone call regarding the new law or help with intentions to sign up, though Brewster said they had been hoping for a “soft opening,” and planned the majority of their outreach for when after the law went into effect. However, zero phone calls was still surprising considering the state’s website was malfunctioning after its debut Tuesday morning; the site — www. wahealthplanfinder.org — was shut down on Tuesday due to the issues. It did, however, receive 170,487 page views, and saw 6,385 accounts created on the first day, according to a press release from Washington Health Benefit Exchange.
The federal insurance buying marketplace website, www.healthcare.gov also had logjam problems, which President Barack Obama spoke to Tuesday saying that the influx of people logging on exceeded expectations and caused issues within the new site. The website was used by at least 2.8 million people by Tuesday afternoon.
Washington’s website seemed to be working better Wednesday, but was still experiencing issues, according to the Washington Health Benefit Exchange.Wednesday, their website noted they are working on the issue and reminded applicants to save their information and return to the site later if a situation is to arise.
Grays Harbor County Public Health currently has seven people at their Sumner Avenue office in Aberdeen who are trained to help individuals figure out the new law and will have a person on site who is fluent in Spanish; both the state and federal sites also offers instructions in English and Spanish. Those in need of in-person assistance in signing up for their health plan can go there or to the Sea Mar Community Health Center, or they can make an appointment at the Olympic Area Agency on Aging.
Residents have until Dec. 23, to sign up for coverage that begins on Jan. 1. The initial open enrollment period for the 2014 year is six months, extending through March 31, 2014. Those who have insurance already, through their employers or otherwise, do not need to make any changes. They may want to compare and contrast through the state’s exchange, though most often employer-offered insurance will be the better deal, said Brewster.
“If you have insurance right now you’re good to go,” she said.
Carson said those previously denied Medicaid should try again with the new expanded version as they have changed their criteria dramatically. Washington was one of only 26 states who decided to move forward with expanding Medicaid after the Supreme Court ruled in June that the decision should be up to the states.
“If you were denied in the past, look at this as a new opportunity,” said Brewster, adding the new version looks at income differently. Eligibility for Medicaid/Apple Health and for subsidized health insurance through the Exchanges will be calculated using a household’s Modified Adjusted Gross Income— a new income definition introduced by the Affordable Care Act — from the most recent federal income tax filings and the number of people in a household. The Washington State Health Care Authority’s website promises eligibility can be determined within 45 minutes, saying in the past it took about 45 days to do so.
Individuals under 65 years of age who earn up to 138 percent of the federal poverty level ( or $15,856 per year for an individual or $32,500 for a family of four in 2014) will be eligible, as well as first time, low-income adults who do not have children. If an application is accepted, the coverage will start on Jan 1, 2014, unless you are a new applicant who is a child, pregnant woman or a family medical Medicaid/Apple Health program, in which case your coverage will begin on the first day of the month in which your application was submitted.
Lutz, the Sea Mar clinic manager, said there is a common misconception that coverage will be available to “everyone,” but undocumented immigrants will not qualify, although undocumented immigrants can still apply to cover their children under the age of 19 through children’s Medicaid, Apple Health for Kids.
Families should keep in mind that each member may end up on a different insurance plan, said Carson, adding each member must be treated as an individual because coverage will differ depending on certain things, such as age or whether one smokes.
The next challenge for Grays Harbor will be dealing with an influx of newly insured patients while there is already a primary care physician/patient ratio that shows a need for many more doctors. Grays Harbor’s doctor to patient ratio is 1,429 to one, compared to the state average of 736 to one, and the target rate of 631 to one, according to Brewster. While she said there currently is not a plan laid out to attract more physicians to the area, she said the hospital “works very hard” to do so.
“It will be an extra challenge,” she said. “… As a community, we need to look at how to recruit more people.”
To apply online, or in person for health care coverage under the new law, individuals will need the following items according to county health services: their social security numbers, birth date information, passport (in some cases), alien or other immigration numbers for any legal immigrants who need coverage, income information for all adults and minors age 14 or older who are required to file a tax return, and information about health insurance available to your family.
Those who do not have health insurance by the imposed deadline will need to pay a penalty of $95 or 1 percent of your income, whichever is higher. The penalty will rise exponentially in 2015 and 2016.Those who do not pay will have the money withdrawn from their tax refund and could accrue interest in they do not pay.