September 16, 2013

Mainers can get help navigating Obamacare

Federally funded workers will fan out to explain options in the insurance marketplace being created by the Affordable Care Act.

By Jessica Hall jhall@pressherald.com
Staff Writer

From lobster wharves and supermarkets to town libraries and public health centers, the topic of health insurance will be inescapable starting Oct. 1.

 
Health Care Reform
On Oct. 1, Mainers can begin enrolling for health insurance coverage under Obamacare. How will you be affected? Send your questions to the Portland Press Herald/Maine Sunday Telegram. We'll provide the answers as we publish a series of stories throughout the month of September on the Affordable Care Act.

A team of more than 125 so-called navigators -- essentially, insurance translators -- will blanket the state to help Mainers understand the insurance marketplace being created by the Affordable Care Act.

"We'll go down to the docks. We'll call community meetings. We'll go to the libraries and shopping centers. We'll make ourselves known," said Brian Delaney, spokesman for the Fishing Partnership Health Plan, based in Massachusetts, which is working with the Maine Lobstermen's Association to help explain the new insurance laws to fishermen. "The insurance changes are going to happen. It is imperative to get everyone signed up. It's our job to find everyone, reach out and explain what's changing and how it will affect everyone."

The health insurance exchange, now known as the insurance marketplace, was mandated under the Affordable Care Act, or Obamacare. The marketplaces will be the place for individuals to buy health insurance. Subscribers can sign up from Oct. 1 to March 31 by mail, online or in person with the help of a navigator.

Beginning Jan. 1, Obamacare will require almost all Americans to have health insurance or face tax penalties.

In Maine, the marketplace will feature insurance products from Anthem Blue Cross and Blue Shield and Maine Community Health Options.

Choices will include plans ranging from bronze -- the cheapest, providing coverage for about 60 percent of health care costs -- to platinum, the most expensive plan, covering roughly 90 percent of eligible expenses. Gold and silver plans, which offer different levels of coverage, will also be available.

The Maine Bureau of Insurance expects 5 percent to 8 percent of state residents, or 65,000 to 104,000 people, to purchase insurance on the exchange. The federal government aims to sign up 7 million people in the U.S. in the first year.

That number is expected to grow to 24 million in 2016, according to the Congressional Budget Office.

The likely buyers of insurance through the marketplace will include those who don't get insurance through an employer or a government program, as well as self-employed workers and the unemployed.

Although the insurance marketplaces will begin enrolling subscribers in just a few weeks, a Kaiser Family Foundation poll released in August found that nationally only one-third of Americans say they've heard about the new exchanges in their state.

The navigators will be the on-the-ground networkers who will help people learn about and enroll in the marketplace

Two groups won federal funds totaling $542,000 to help Mainers navigate the insurance options. The grants were part of $67 million awarded 105 agencies throughout the country from the U.S. Department of Health and Human Services.

One agency, Western Maine Community Action, received $475,000 to set up eight informational offices throughout the state. The group has 59 staffers statewide who are being trained and it hopes to have a network of 48 trained volunteers, as well. The group will have eight centers -- in Sanford, Portland, Bath, Belfast, Waterville, Wilton, Ellsworth and Presque Isle. The other group, the fishing partnership, received $66,846 to reach out to lobstermen.

The federal government also awarded $1.4 million to 19 Maine health centers to help them sign up residents for insurance under Obamacare. The funds will allow the centers to hire 25 workers to help people jump through the hoops of finding insurance care.

The grants were awarded in August, giving groups in Maine and nationally little time to train teams of navigators and map out strategies to reach people. The groups must make arrangements to reach people with disabilities -- such as going to people's homes, if needed -- and to work with translation services for non-English speakers.

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