By Mitch Talley:
For the past 21 years, the Northwest Georgia Healthcare Partnership, headquartered in Dalton, has been an incubator for innovative programs that aim to make local residents healthier.
Past successes include MedBank, the Boys & Girls Club, and the Partnership HealthCenter.
Now the local not-for-profit organization is turning its attention to helping area residents get the most out of the Affordable Care Act (ACA), also known as “Obamacare” that went live nationwide on Oct. 1.
“The Affordable Care Act is supposed to be helpful to communities, and so if it’s going to be helping communities, we certainly want ours to benefit too,” said Ali Whittier, health promotion/marketing director for the Healthcare Partnership.
While “Obamacare” has been a hot political topic, the 29-member board of directors of the Partnership just wants to make sure the public knows as much as possible about the new law.
“We’re not at all a political organization,” Whittier says. “So our board decided that when it came to the ACA, we should educate the public on what’s out there, not agree or disagree with the law. Nonetheless, it’s the law right now so we at least want the community to be ‘in-the-know’ so they can make the choice that’s right for their family.”
To help out, Whittier has been collecting as much information as she can on the new law.
“There are some good things, but there are also some confusing things about the ACA,” she says, “but basically what the Partnership wants the community to know is to at least go take a look at the Marketplace, especially if you’re uninsured.”
Whittier stresses that the ACA will affect each person and family differently.
“From me to you, our plans might be completely different on the Marketplace because we have different households, different incomes, my spouse might have affordable insurance for me while yours might or might not,” she said. “The plans on the Marketplace are very individual so we want everyone to know where to go to apply and see what’s available before making a decision.”
Two ways to get reliable information on the new law are by visiting healthcare.gov or calling 1-800-318-2596.
Georgia Mountains Health Services, which received funding for four navigators to help area educate area residents in ACA, will also be reaching out to the community very soon. Georgia Mountains Health Services operates the Partnership HealthCenter located in the Mack Gaston Community Center in Dalton.
“There will be a person that they can see and sit as close as we are right now and say, ‘OK, here’s my income, here’s all my information, what do I do now?’ These navigators can walk people through that process.”
Residents can also call the Healthcare Partnership at 706-272-6662; Whittier says the Healthcare Partnership will soon have the resources to direct people to the right place.
At least two insurance companies in the community – Advance Strategies and Adcock Financial Group – also offer help with the ACA.
“People can also go to the Dalton-Whitfield Library, where they have computers set up with icons that will take them directly to the Marketplace (also known as the Exchange) where the insurance is sold,” Whittier said. “Dalton State College’s library too will have some of their computers ready for people to explore the ACA at healthcare.gov.”
Deadline to enroll in the program is March 31, 2014, and coverage could start as soon as Jan. 1, 2014 for people who sign up early enough.
“If you’re uninsured, go to healthcare.gov or call the 800 number because you might qualify for a subsidy that will help pay for an insurance plan,” Whittier says.
“If you have pre-existing conditions or any sort of health issues that you fear might not help you get affordable insurance, go look on the Marketplace at healthcare.gov. There’s potential for people in this community to have their health insurance covered through their subsidy. They might not have to pay much or anything at all. It just depends on your income, where you live, your household size, and your access to affordable health care coverage.”
“Every case is going to be different,” she says, “so try not to believe everything you read, go see for yourself in the Marketplace. You really won’t know until you look for yourself.”
Whittier says there are a lot of unknowns about the ACA.
“People are not sure what to expect,” she says. “It’s a big step. This is a big change. But, I know it’s not good for people not to have access to primary health care. That is one of the worst things that can go on in any community.”
At a glance…
Requirements: The new health care law generally requires individual plans to provide certain protections and benefits starting in 2014. These include coverage of services for pre-existing health conditions, limits on how much your premiums can vary based on your age, and coverage of 10 essential health benefits, including ambulatory patient services (outpatient care you get without being admitted to a hospital), emergency services, hospitalization (such as surgery), maternity and newborn care (care before and after your baby is born), mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy), prescription drugs, rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills), laboratory services, pediatric services, preventive and wellness services and chronic disease management.
Preventive services required: All Marketplace (also known as Exchange) insurance plans and many other plans must cover a list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. This applies only when these services are delivered by a network provider.
How to get more information about the Affordable Care Act (or Obamacare): Visit healthcare.gov or call 1-800-318-2596.
Open enrollment deadline: March 31, 2014
Earliest coverage can begin: Jan. 1, 2014