Senior managers at Pocahontas Memorial Hospital have stated consistently that the Affordable Care Act (ACA) will be good for the hospital, because more patients will be able to afford health insurance and pay their bills. During every monthly board meeting, PMH managers perform the unwanted tasks of assigning unpaid bills to collection agencies and writing off bad debt. Although government programs pay a fraction of that bad debt, unpaid bills remain a significant financial burden to the hospital.
In order to increase ACA health care plan enrollment, hospital representatives are going into communities to provide ACA enrollment information. On Friday evening, hospital employees Tiffany Ryder and Kate Alden provided an information briefing at the Snowshoe Career Center in Marlinton.
Alden explained why Congress passed the ACA.
“There were so many Americans who didn’t have insurance,” she said. “When people don’t have insurance, they still get sick and then they end up going to the emergency room, which is the most expensive way to see a doctor. If they can’t afford to pay for their insurance, they usually can’t afford to pay for their emergency room visit. So the costs get passed on to the hospital, which eventually gets passed on to the insurance companies, which gets passed on to consumers. It’s a very expensive way to do it. So, by having everybody, presumably, buy insurance, it makes it more affordable for everyone.”
A vital feature of the ACA is expanded Medicaid health coverage for low income families. The U.S. Supreme Court upheld the constitutionality of the ACA last June, but the practical effect of its decision was to make the Medicaid expansion optional for states. West Virginia Governor Earl Ray Tomblin and 25 other governors quickly decided to allow this benefit for their citizens.
Alden distributed a chart with new Medicaid eligibility information.
West Virginia is one of the states that expanded Medicaid,” she said. “People in this room who might qualify for Medicaid, you’re in luck, because that’s a really good thing. If you’re a household of one and you make $15,876 a year or less, you probably qualify for Medicaid. For a household of four, it goes up to about $32,000.”
Governors who blocked Medicaid expansion are facing increased resistance, as four million people have obtained coverage in the 26 states allowing the benefit. More states, including Virginia, where a new governor was elected, are expected to allow expanded Medicaid this year.
Many people who make too much to qualify for expanded Medicaid can get a tax credit.
“You won’t get free health insurance like you would with Medicaid, but you’ll get substantially cheaper health insurance than you might if you were buying it privately and not through the marketplace,” Alden said. “If you make up to close to $46,000 for an individual, you will qualify for some type of a tax credit. For a family of four, it’s up to $92,000.”
Ryder explained that three different levels of health plans are available in West Virginia – gold, silver and bronze.
“Bronze is not as good as the silver, of course,” she said. “Silver is basically like what your job would offer you – kind of like what we get through the hospital, that type of insurance.”
Although the government’s health care website at www.healthcare.gov had technical problems at the outset, those problems have been fixed and the website is one of the ways people can get information and sign up for a plan.
“You can go online and look at the health care marketplace,” Alden said. “You can go all the way to the end and find out what you’re eligible for. There’s no pressure to actually buy a plan. Once you get to the end, you find out what plans you could qualify for and buy. You don’t have to buy one. If you have a computer, it’s worthwhile. It only takes about 20 minutes to go through the whole thing, if you have all your information in front of you.”
Other ways to sign up are by telephone and a paper application. ACA sign-up information and assistance is available at PMH.
“Right now, PMH has three certified application counselors and an in-person assistant,” Alden said. “Between the four of us, there is someone there pretty much every day of the week. We like meeting new people. Feel free to call us anytime at 304-799-7400.”
The open enrollment period for ACA health coverage is from now until March 31. A penalty of $95 will be assessed on many who do not obtain some type of health insurance during the 2014 open enrollment. The penalty will become higher every year thereafter.
Ryder said ACA enrollment in Pocahontas County started off slowly, but that more and more people were visiting the hospital to get information and sign up for plans.
Alden described a free bonus of obtaining health insurance.
“We hope that everyone here is interested in getting some type of insurance,” she said. “If you’re not sure of the benefit of insurance – it’s peace of mind. You don’t know what could happen and it’s just really better to be covered.”