While questions still remain about health care plans in Kentucky, open enrollment as part of the Affordable Care Act is set to begin Oct. 1.
The Affordable Care Act requires that every American have health insurance or pay a tax penalty beginning Jan. 1.
Like other states, Kentucky is establishing a state insurance marketplace, an infrastructure where people can learn what subsidies will be available to them and select among a number of approved health care plans. The health care exchange will be available online through kynect.ky.gov.
The goal of the law is to provide all Americans with affordable care. The law requires that approved health care plans cover 10 basic areas, including maternity, mental health and substance abuse services, and pediatric services including oral and vision. Nobody can be denied health care under the new law and medical history cannot be used to determine health plan rates.
Insurance providers are still in negotiations with Kentucky to come up with plans that meet minimum standards of services and affordability. Those plans are expected to be approved and available online by Oct. 1, when enrollment begins.
To have health coverage by Jan. 1, consumers should enroll between Oct. 1 and Dec. 15. Open enrollment ends March 31, 2014, according to Cara Stewart, an attorney with AppalRed Legal Aid.
Stewart spoke during a seminar in Columbia Monday afternoon at the Adair County Extension Office about the health care exchange.
Following the enactment of ACA, often referred to as Obamacare, Kentucky Gov. Steve Beshear made the decision to expand Medicaid. Beshear said the expansion, which is originally funded with federal dollars, would provide Medicaid to 308,000 additional Kentuckians beginning in January. Those subsidies will be reflected when consumers search through the online portal.
Individuals or families will pay for coverage based on income, and subsidies are available for people who earn up to 400 percent of the federal poverty level. Individuals can expect to pay no more than 9.4 percent of their monthly net income for health coverage. Stewart said plans expected to be purchased most often, the silver plan, should cost individuals around 4 to 5 percent of their net income.
Only around 200 people in Adair County will not be eligible for subsidized health care, Stewart said. Currently, more than 5,700 residents are enrolled in Medicaid. Medicaid expansion is expected to help an additional 1,762 people qualify.
Consumers who do not obtain health care coverage in 2014 will pay a $95 tax penalty. That penalty increases to $395 in 2015 and $695 in 2016.
Consumers can go online to kynect.ky.gov where they will be able to compare different health care plans once they are available. Locally, AppalRed Legal Aid has signed up to be a “kynector” (pronounced connector) to provide assistance as well. Their representatives can be reached at 270-384-4707.