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Health Care Reform
2015 Open Enrollment ended February 15, 2015, now only those with "Special Enrollment" reasons can enroll. Reasons or "life events" like:
1) Did you or anyone in your household lose health coverage in the past 60 days OR do you expect anyone in your household to lose coverage in the next 60 days?
2) Changes in household size because someone got married, had a baby, adopted a child or had a child placed with you for foster care, got divorced and lost health insurance or there was a death in the household.
3) Changes in circumstance like you moved outside your health plan’s coverage area, had a change in income, a changes in status (gained citizenship or lawful presence in the U.S.) or released from incarceration (jail or prison).
If you qualify for a Special Enrollment Period to change plans or enroll for the first time, you’ll have 60 days from the life event to enroll.
The 2016 Open Enrollment will be from October 15, 2015 through December 7, 2015 and coverage will start January 1, 2016.
1) Community Connections Free Clinic, 101 East Fountain Street, Dodgeville
Is taking appointments most Tuesdays from 2-5 pm. Call 608.930.2232 to make an appointment.
2) FREE consultations and assistance. Local insurance agents listed below have volunteered to help you with your healthcare marketplace application.
Call to make an appointment Monday through Friday.
• Jeff Walker and Pat Weier, Walker & Weier Insurance, Mineral Point - 608-987-3255
• Brian Lundell, Lundell Insurance, Dodgeville - 608-319-2033
Come prepared! Bring a pay stub, birth dates and social security number from all wage earners in your household. (Past tax returns work great! Bring them if you have them.)
RESOURCES FOR APPLYING TO THE HEALTH INSURANCE MARKETPLACE
There are 4 ways to apply for insurance in the Health Insurance Marketplace:
- Apply in person. Visit a trained counselor at the help sessions described above.
- Apply online. The federal website for enrollment is https://www.healthcare.gov/.
- Apply by phone. Call 1-800-318-2596 to apply for a health insurance plan and enroll over the phone. (TTY: 1-855-889-4325)
- Apply by mail. Complete a paper application and mail it in. Mail-in application forms can be found by clicking here or by picking one up locally at the help sessions mentioned above.
If you are wondering if you even qualify for the Health Care Marketplace and what to quickly browse some of the plans, click here and find out more.
These one-page flyers from the Wisconsin Council on Children and Families may also assist. The Top 10 Things you need to know about Wisconsin Health Care Insurance and a great chart that shows, based on where your income falls in relation to the Federal Poverty Level (FPL) what insurance you may qualify for (BaderCare, Health Care Marketplace or getting it on your own).
An excellent series of frequently asked questions about the health insurance Marketplace has been published in the New York Times:
- Answers to some Questions about Health Care Exchanges
- A Guide to the New Exchanges for Health Insurance
- Questions Often Asked About Health Law
The Dodgeville Public Library has put together an excellent list of resources about the online Marketplace, click here to go that site.
What is in the News
MICHAEL HILTZIK, Los Angeles Times
Deborah Cavallaro is a hard-working real estate agent in the Westchester suburb of Los Angeles who has been featured prominently on a round of news shows lately, talking about how badly Obamacare is going to cost her when her existing plan gets canceled and she has to find a replacement.
She says she's angry at President Obama for having promised that people who like their health plans could keep them, when hers is getting canceled for not meeting Obamacare's standards. "Please explain to me," she told Maria Bartiromo on CNBC Wednesday, "how my plan is a 'substandard' plan when ... I'd be paying more for the exchange plans than I am currently paying by a wide margin." Bartiromo didn't take her up on her request. So I will.
The bottom line is that Cavallaro's assertion that "there's nothing affordable about the Affordable Care Act," as she put it Tuesday on NBC Channel 4, is the product of her own misunderstandings, abetted by a passel of uninformed and incurious news reporters. I talked with Cavallaro, 60, after her CNBC appearance. Let's walk through what she told me.
Her current plan, from Anthem Blue Cross, is a catastrophic coverage plan for which she pays $293 a month as an individual policyholder. It requires her to pay a deductible of $5,000 a year and limits her out-of-pocket costs to $8,500 a year. Her plan also limits her to two doctor visits a year, for which she shoulders a copay of $40 each. After that, she pays the whole cost of subsequent visits.
This fits the very definition of a nonconforming plan under Obamacare. The deductible and out-of-pocket maximums are too high, the provisions for doctor visits too skimpy.
As for a replacement plan, she says she was quoted $478 a month by her insurance broker, but that's a lot more than she'll really be paying. Cavallaro told me she hasn't checked the website of Covered California, the state's health plan exchange, herself. I did so while we talked.
Here's what I found. I won't divulge her current income, which is personal, but this year it qualifies her for a hefty federal premium subsidy. At her age, she's eligible for a good "silver" plan for $333 a month after the subsidy -- $40 a month more than she's paying now. But the plan is much better than her current plan -- the deductible is $2,000, not $5,000. The maximum out-of-pocket expense is $6,350, not $8,500. Her co-pays would be $45 for a primary care visit and $65 for a specialty visit -- but all visits would be covered, not just two.
Is that better than her current plan? Yes, by a mile. Read more by clicking here.
OUR HEALTH CARE TASK FORCE
With the Affordable Care Act (ACA) Health Care Exchanges opening in Wisconsin on Oct. 1, 2013, the Grassroots task force is working hard to help local people who are eligible to sign up for these Exchanges. We are working in partnership with the Dodgeville Public Library, the Community Connections Free Clinic, Upland Hills Health, Iowa County Social Services Department, ADRC and other local organizations.
In addition, the Task Force is actively engaged in promoting Health Care Wellness in our local communities, in partnership with other community organizations. (More details to come.) We sponsor showings of the riveting films Escape Fire and Hungry for Change. We are working to bring together an all-community Health Care Coalition that addresses the issues of obesity and fitness.
The task force has also been considering the difficult decisions that patients and the medical establishment must make about end-of-life-care by promoting the showing of the film Consider the Conversation.
What is Next
Our Heath Care Task Force continually seeks reliable sources of information about new and proposed federal and state health care legislation. We communicate this information to our local communities through forums, press releases, etc. The task force is also deeply interested in researching and recommending modifications that would improve state and national legislation.
OUR CURRENT HEALTH CARE PROJECTS:
- Monitoring Walker administration proposals - With cost-cutting as its paramount goal, the Walker administration will soon be unveiling its vision for health care in our state. We can expect significant changes to the BadgerCare system and tense interplay with the Federal government over implementation of the Affordable Care Act (ACA). It is essential that we monitor these developments closely and initiate public discussion when appropriate.
- Considering end-of-life care - Often neglected as a healthcare issue, palliative care and end-of-life planning are on the agenda for Grassroots Citizens of Wisconsin this year. Working in cooperation with the Bioethics Committee of Uplands Health in Dodgeville together with regional and statewide coalitions, we are developing plans to raise awareness of the medical, legal, ethical and spiritual dimensions of decision-making as life moves toward its close.
Who We Are
In 2006, Grassroots members concerned about the lack of universal health insurance coverage and escalating medical costs started a Health Care Reform Task Force to monitor the rapid-fire developments and to educate local people about what is going on in Washington D.C. and Madison. We work closely with the statewide Health Care Reform Coalition, headed by Citizens Action Wisconsin, and host local forums and discussions. Today over 100 people from throughout southwest Wisconsin are part of our Health Care Reform Initiative.
Core group members include Dr. Aaron Dunn and Dr. Cathy Kaiser of Mineral Point, Doug Huebner of Hollandale, Lola Gregg of Avoca, Linda Pittz and Earl Barnes of Dodgeville.
What We Have Done
Topics for our local forums, held in Spring Green, Dodgeville, Platteville and Darlington, have included:
- "Exploring health care models around the world"
- "A close-up look at the top national health care reform plans"
- "Defining the key issues in health care reform"
- "So why is health care reform so hard to achieve?"
- "Health care reform: A question and answer session"
- "Paying for health care"
- "National health care reform: What should it look like?"
We've run a Dodgeville Chronicle advertisement addressing the need for health care reform, which was signed and paid for by local citizens.
In partnership with the Dodgeville Chamber of Commerce, we co-sponsored a dialogue between Dr. Aaron Dunn and a representative of the Wisconsin Manufacturers and Commerce organization.
We continue to encourage our members to volunteer and financially support the Community Connections Free Clinic in Dodgeville.
To Join Our Health Care Reform Initiative contact:
2473 Mount Hope Road
Dodgeville, WI 53533
Telephone: (608) 623-2109