The ins and outs of the Affordable Care Act are enough to confuse the average insurance shopper. When you add New York state’s list of exceptions and accommodations, it can become overwhelming.
According to the New York State Department of Health, in New Rochelle, Mount Vernon and White Plains alone, there are 97,928 uninsured individuals.
Despite the confusion of the new law, there are resources within Westchester County that can help you navigate the ACA and register for health coverage.
All New York state residents must be enrolled in a qualified plan by March 31, 2014. President Obama’s announcement on unqualified policies being allowed for another year does not apply to New York.
The Children’s Defense Fund and its partners in the Children, Youth & Families Taskforce of Healthcare for All New York held a briefing in White Plains on Thursday, Dec. 12 to present critical resources that will help the uninsured in Westchester learn about the ACA.
NY State of Health (NYSH) is the state’s healthcare marketplace, which provides individuals and small businesses one-stop shopping for subsidized and unsubsidized coverage.
According to Flor Ramirez, program director of the Retail Action Project, shoppers can use the web portal to easily compare health plan options. It is also the only place to check your eligibility and apply for financial assistance to enroll in qualified health plans.
Individuals and Families
Individuals can enroll through March 31, 2014. To receive coverage by Jan. 1, they must enroll by Dec. 23. Medicaid and Child Health Plus are on consistently open enrollment.
Ramirez said for the first time, Medicaid and Child Health Plus (CHP) applications can be filed online.
NYSH has a call center where shoppers can ask questions, complete applications via phone and receive assistance in over 170 languages.
NYSH additionally provides three types of in-person assistors: navigators, certified application counselors and insurance brokers.
Navigators complete all applications and are compensated by Department of Health grant programs. Certified Application Counselors complete applications for individuals only with no compensation. Insurance brokers complete small business and/or individual applications on commission.
The web portal includes a tax credit and premium rate estimator based on county. Additionally, it provides fact sheets, county-specific lists of navigators and health plans, and application demonstration videos.
Shoppers can also access information via social media such as Twitter, Facebook, YouTube and Google Plus.
The online market place differs slightly for small businesses. Open enrollment began on Oct. 1, and employers can window shop for plans, as opposed to individuals who need to complete a registration process.
Employers can select health plans at a variety of price points and set fixed contribution to employees’ healthcare coverage.
Kyle Brittingham, director of the Small Business Assistance Program of the Community Service Society of NY, said small businesses with fewer than 25 fulltime equivalent employees with average annual wages below $50,000, including non-profits, are now eligible for tax credits.
“If you’re a small business and haven’t been taking advantage of your tax credit, you should refile your taxes immediately,” he said.
Additionally, small businesses do not have an employer mandate. If they have 50 full-time equivalent staff members or less, they are not federally obligated to offer healthcare.
According to Rebecca Telzak, health advocate supervisor at Make the Road NY, NYSH has made special effort to increase outreach to immigrants.
These efforts exist in order to overcome language and cultural barriers, handle families with mixed immigration status, and fears and misconceptions immigrants may have about affordable healthcare.
Make the Road is in the process of bringing community-based education and outreach to uninsured immigrant communities in Westchester.
Under the ACA, Naturalized citizens and “lawful present” immigrants will have the same access to affordable health insurance as United States-born citizens.
Undocumented immigrants have access to advanced enrollment in emergency Medicaid, CHP for children under 19 and Medicaid for pregnant women (PCAP).
Women and LGBT Persons
Maryanne Tomazic, health policy associate at Raising Women’s Voices, shared information on outreach being performed by New York to help women and LGBT individuals enroll.
Get Covered NY is doing educational outreach and providng resources to women who, according to Tomazic, are generally the ones enrolling in healthcare for their families.
Additionally, Get Covered NY has reached out to the LGBT community – including tabling at events in the White Plains LOFT center.
According to Tomazic, an estimated 130,000 LGBT people in the New York City area are uninsured.
“NYSH cannot discriminate based on certain demographic factors, including sexual orientation and gender identity. LGBT married couples and families will be able to enroll into joint health care plans,” she said.
Among the list of navigators that can help shoppers find health plans in NYSH, there are several organizations that traditionally serve LGBT people.
The NYSH customer service call center can be reached at 1-855-355-5777 for anyone in New York State looking for more information or assistance.
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