Eligible for Affordable Health Insurance? Go to www.communityhealthadvocates.org

David R. Jones, The Urban Agenda

New Yorkers will be able to sign up for affordable health insurance under Obamacare, the Affordable Care Act (ACA), starting on October 1, 2013, for coverage beginning on January 1, 2014.  If you don’t know where to go to sign up, go to www.communityhealthadvocates.org/, the website of Community Health Advocates, the state’s designated consumer assistance program.

The ACA was passed in response to the 47 million people in the United States (2.6 million in New York State) who are uninsured.  Half of uninsured adults in New York State work full time, yet they either cannot afford health insurance or their employers do not offer it.  One in three New Yorkers say that they or someone in their family has postponed medical care or filling a prescription in the past year because of a lack of money or insurance.

Parts of the law are already in force.  Parents can now keep their children on their insurance until age 26. About 160,000 young adults in the state have gotten coverage under this provision.  Lifetime dollar limits on health benefits have been banned, so 6.4 million New Yorkers no longer have to worry about running out of insurance benefits if they get sick.  After all, we take out health insurance for it to be there when we are ill.

Obamacare will eliminate health-based discrimination by insurance carriers, make health insurance more affordable, and reduce the growth of health care spending.  For those with low- and moderate incomes (earning less than $94,200 for a family of four), there will be financial assistance from the government to help pay for insurance.  People will not be denied health insurance on the basis of a pre-existing condition.

Yet four in 10 Americans are unaware that the Affordable Care Act is law, according to an April study by the Kaiser Family Foundation.  The percentage is even higher among populations that stand to benefit most: 60 percent of households earning less than $30,000 annually are aware of the law.

CSS Named as Navigator

The Community Service Society (CSS) was recently selected by the New York State Department of Health to set up a “navigator” network to help New Yorkers and small businesses shop for and enroll in health coverage through the New York Health Benefit Exchange (NYHBE).  The “exchange” is an online marketplace where consumers can shop for insurance, compare prices and benefits, and select health plans that meet their needs.

Building on its trade-mark “hub-and-spoke” model, CSS will partner with 38 community-based organizations and small business-serving groups in 61 of New York’s 62 counties.  The goal is to enroll 55,000 individuals, families, and small businesses and their employees into the exchange each year.

When the ACA goes into full effect, 1.1 million New Yorkers are expected to newly gain affordable insurance.  Black and Latino New Yorkers, who historically have had low rates of health insurance and disproportionately high rates of health-related illnesses, especially stand to benefit from the new law.  

Under the ACA, New York State will receive $2.4 billion a year in federal subsidies to make insurance affordable.  In addition, the state will save $2.3 billion a year in Medicaid costs while expanding the program to cover 80,000 new enrollees.

Federally subsidized health insurance exchanges, or insurance marketplaces, have been set up in 17 states to administer the ACA.  New York is one of them, leading the way in establishing a model Exchange that will make getting health coverage consumer-friendly for the first time.

Reduced Costs

When NYHBE opens on October 1, consumers will be able to compare health insurance plans, enroll in Medicaid, or apply for subsidies to buy commercial coverage.  And the state’s small businesses will be able to apply for $220 million in tax credits to provide insurance to their employees.

Individuals and families that purchase coverage directly through NYHBE will see their health costs drop by as much as 66 percent.  For small businesses, the cost to their employees for health insurance may drop by as much as five percent.  Already, the impact of ACA exchanges has caused several insurers in California to lower their rates in order to be competitive. 

Governor Cuomo provided the leadership for health coverage in the state as well as a model for the rest of the nation.  When the State Senate refused to set up a state health insurance exchange legislatively, the governor issued an executive order doing so.  Since Governor Cuomo’s executive order, the state has received almost $370 million in federal implementation grants.  New York has also expanded its Medicaid program to ensure that low-income residents can get coverage.

Across the country, conservative governors have refused to establish state-run exchanges.  They will be set up by the federal government.  Conservatives in Congress have also blocked a budget request of $1.5 billion to help implement the exchanges and conduct a public education campaign about enrollment. 

But when asked what their plan is, opponents of the law have no answer.  That is unacceptable.  The ACA is law.  Like Social Security and Medicare, it is here to stay.       

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