Countdown: Obamacare exchanges affect health care plans
5:12 PM, Sep 30, 2013
7:15 PM, Sep 30, 2013
KANSAS CITY, Mo. - Starting Tuesday, life for millions of Americans as they have always known it will change.
At the stroke of midnight, thousands upon thousands will have to begin to change their health care plans-- whether they are uninsured or underinsured-- because of President Obama's Affordable Care Act.
The ACA, or Obamacare, is one of the most comprehensive laws that will eventually affect every single American. But still, more than half of us say we know little about what is about to happen on Tuesday.
When asked, Patrick Thomas, who is insured, said, "I didn't know anything about it at all. I probably should but I don't."
In fact, according to a recent Kaiser Family Foundation poll, 64 percent of Americans polled say they do not know the biggest phase of Obamacare goes into effect Tuesday.
Millions of primarily uninsured Americans and people who buy their own coverage will have a new option: the federal government's Health Insurance Marketplace, or exchange. That means for people like 28-year-old DeMarcus Micks, he will be able to see his own doctor for the very first time.
Micks goes to the free health care clinic now. If he's really sick he said he goes to the ER. "It takes forever, it's expensive and you pretty much don't get any good results as if you had insurance and a doctor," Micks said.
The online exchange is a group of private insurance companies like Blue Cross Blue Shield that have agreed to offer new plans and comply with a new, broader set of insurance requirements. This includes expanded preventative care like well woman visits, weight control and smoking cessation programs.
The online exchange is managed by the federal government.
"(It's similar to) websites like Amazon or Southwest Airlines or any website where you can purchase, compare and shop," Wayne Powell, Vice President of Executive Services at Blue Cross Blue Shield, explained.
The 85 percent of the American people who get health benefits from large employers or who are enrolled in government programs like Medicare do not need to use the exchanges now.
Micks is one of millions of individuals who will be required by law to get health insurance at the beginning of the year.
He will also be one of about 300,000 in the Kansas City area who will be able to afford coverage for the first time; a dream some believe is too good to be true.
"I kind of hope and then it's like it ain't going to happen," Gilbert Millan, a Vietnam vet who has been uninsured for years because he cannot afford it, said.
How will he and others be able to afford the sticker price when they cannot afford it now? "That sticker price is not necessarily what the individual pays," Ed Fensholt, Senior Vice President at Lockton Insurance, said.
Many of the uninsured and those in certain income brackets will qualify for government assistance, a federal subsidy, to help pay for their health insurance.
"So who pays the rest of that price?" Fensholt asked. "The American taxpayer pays the rest of that price."
The less a person or family makes, the more government assistance they can get through the exchange. A lot of people will qualify, not just the poor or the uninsured.
Under the new rules, a single person can qualify for help to pay for insurance if they make between $11,500 to $45,960.
A family of four can qualify for assistance if they make between $23,500 to $94,200.
Heatlh and Human Services Director Kathleen Sebelius applauded the new plans as new opportunities for millions of people. "This is a huge health security opportunity for millions of people," she said.
However, insurance companies say it is already costing a lot more to pay for new insurance taxes and the new broad benefits for the many brand new people to the system.
They warned those extra costs will translate to higher prices for all.
The government has trained people to help those getting on the exchanges for the very first time at places like Samuel U. Rodgers Health Center, CVS, Walgreens and some libraries.
The exchanges go live Tuesday and coverage begins in January.
For more information about the ACA, go to the government's website at http://healthcare.gov.