Nancy Vaughan column: Health care is available despite enrollment challenges | Columns


Nancy Vaughan column: Health care is available despite enrollment challenges | Columns

For the third year, there is a very short window – Nov. 1 to Dec. 15 – to sign up for health insurance through the federal marketplace; however, 2020 is challenged unlike any other with in-person assistance funding cut by more than 80 percent and advertising extremely limited.

Additional efforts to undermine the marketplace – ending the mandate penalty, creating alternatives meant to draw younger and healthier people out of the marketplace, and general political battling – have left people feeling confused and uninformed about options. That’s why the work of Covering Kids & Families of Indiana (CKF) is so important.

United Way of Madison County has led the local CKF Coalition since 2009, navigating through the implementation and ongoing challenges to the Affordable Care Act (ACA) to make sure that health care is available to everyone. By organizing collaborative efforts among health care providers, health insurers and nonprofit organizations, the focus has always been on providing free information and direct assistance to uninsured individuals and families who qualify for a health plan options such as Hoosier Healthwise, the Healthy Indiana Plan or Children’s Health Insurance Plan (CHIP), or a marketplace plan.

Open enrollment is the only time that people who make too much to qualify for a state option and have not had a qualifying event (such as loss of health insurance through an employer) can apply through the federal marketplace that was established by the ACA and is accessible at HealthCare.gov.

It’s also the time for people who currently have a marketplace plan to review their coverage and pricing to make sure their current plan is still their best option.

It’s important for people that visit HealthCare.gov to understand some important components of the ACA, however, such as the fact that most people can find an affordable plan after ACA extra savings and/or advanced premium tax credits are applied. In fact, for the past two years, more than four million people were able to find plans with $0 monthly premiums. The pricing and plan details can be confusing, too, and that’s why navigators are so important.

Navigators are licensed assistants employed by organizations to help people find the best options available. They do not promote any insurer or provider, but they can explain in-network and out-of-network costs, deductibles versus co-pays, and the actual out-of-pocket costs.

Locally, navigators are employed by both hospitals and Jane Pauley, Meridian and Open Door health centers, and by United Way. Julie Barton, United Way’s navigator, is also a Thrive income support coach and maintains regular office hours in Anderson, Alexandria and Elwood. She can be reached by calling 765-608-3062.

Of course, COVID-19 has impacted health access in 2020 as it has every other aspect of life. Even prior to the pandemic, 11,000 individuals – nearly 9% of the population in Madison County – remained uninsured. Recent studies have documented significant increases of uninsured children in Indiana, as well as decreased use of health care services such as primary care, preventative services, screenings, dental and mental health services for all children enrolled in CHIP.

Health care is essential. The cost of caring for the uninsured impacts all of us. The six-week enrollment will go by quickly, so it’s important to act sooner rather than later to avoid system delays and crashes.




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