What You Need to Know to Keep Your Health Coverage

Posted on October 23, 2017 by Vanessa Briggs, President and CEO, Brandywine Health Foundation and Antoinette Kraus, Director, Pennsylvania Health Access Network

If you are wondering what will happen to your health insurance as a result of the policy debates going on in Washington, you are not alone.  The Affordable Care Act (ACA) – which many in our region rely on for their health coverage – is still at risk of being dismantled through executive orders or repealed and replaced, and Congress continues to consider cuts to essential programs like Medicaid and the Children’s Health Insurance Program (CHIP).

The bad news is that some of the policy proposals that have been debated in Congress would negatively impact the health coverage of millions of Americans, especially people with disabilities, children, pregnant women, and seniors.  It could reverse the great work of the Brandywine Health Foundation and its many grantees in securing coverage for vulnerable populations in the greater Coatesville area.  The good news, however, is that ACA remains the law of the land, and you can still obtain health insurance coverage through the ACA marketplace for 2018.

First, let’s look at the facts:  How many Pennsylvanians have benefitted by the ACA, Medicaid, and CHIP?

FACT #1:  Over 1.1 million Pennsylvanians have gained health coverage through the Affordable Care Act, reducing the uninsured rate in the state from 10.2% to 6.4% in four years.

FACT #2:  More than 439,000 individuals and families buy coverage through the healthcare marketplace.  76% of them get financial assistance through the ACA that enable them to pay lower out-of-pocket costs.

FACT #3:  Medicaid & CHIP combined provide coverage to over 2.8 million, or 1 in 5 Pennsylvanians, almost half of them children.

FACT #4:  In Chester County, 20,144 people are enrolled in a Marketplace plan, and 12,554 have gained coverage through the ACA’s Medicaid Expansion.  Chester County’s uninsured rate has gone from 8% to 3% since 2013.

FACT #5:  Approximately 1 in 4 Marketplace enrollees reside in the greater Coatesville area.

What’s the concern about this year’s Open Enrollment Period?

  • The Open Enrollment period has changed from 3 months to 6 weeks.  Open enrollment goes from Nov. 1st through Dec. 15th.
  • The current Administration has slashed marketing & outreach budgets for this year by 90% and in-person outreach & enrollment assistance by 43%.

With a shortened enrollment period and reduced resources, this means people will more likely miss deadlines and ultimately lose their health coverage if they don’t take action before this year’s Open Enrollment deadline of Dec. 15th.

Who needs to sign up for insurance during the Open Enrollment Period?

  • If you don’t have health insurance from another source, you must sign up during Open Enrollment.  Other sources include:  your employer or your spouse’s employer, government coverage such as Medicaid, Medicare, or Veterans’ benefits, or your parents’ insurance if you’re under 26.
  • If you don’t have insurance and miss Open Enrollment, you may not be able to sign up for coverage and may have to wait for a year to sign up.  This will leave you with no coverage unless you qualify for a special enrollment period or for government programs like Medicaid or CHIP.

Special enrollment includes:  divorce, marriage, birth or adoption of a child, death of a spouse or partner that leaves you without health insurance, your spouse or partner who has you covered loses his/her job and health insurance, you lose your job and with it your health insurance, your hours are cut making you ineligible for your employer’s health insurance plan, or you are in an HMO and move outside its coverage area.

If you’re purchasing health insurance through the ACA marketplace, what can you do to make sure you and your family have the health coverage you need in 2018?

  1. Sign up before Dec. 15, 2017.  Make sure you enroll before the deadline and take the time to prepare.  It’s important not to delay.  Remember, the Open Enrollment period is shortened!
  2. Check out new plans, compare costs, and learn about what’s covered.  Whether you’re considering renewing your current plan or finding a new one, make sure it will cover your preferred doctors, hospitals, and the prescription drugs you take.  Take the time to compare costs between plans – certain plans may better meet your needs.
  3. Find out whether you qualify for financial help.  4 out of 5 people qualify for assistance that will lower out-of-pocket costs.  Find out here if your income qualifies you for financial help this year.
  4. Under the Affordable Care Act, you must have health insurance or pay a penalty at tax time.  You can avoid these penalties if you act before the deadline.

Confused?  Free In-Person Help is Available!  Trained navigators can help you understand, apply for, and enroll in health coverage free of charge.

Here are two ways in which you can get help:

  1. Contact PA Health Access Network’s helpline by calling or texting “HELP” to 877-570-3642
  2. If you are looking for assistant in the greater Coatesville area, here is a list of organizations with trained navigators that could assist:
    1. ChesPenn (located in the Brandywine Center) – 744 East Lincoln Highway, Suite 110, Coatesville.  Phone:  610-380-4660
    2. Maternal and Child Health Consortium – 30 W. Barnard Street, Suite 1, West Chester.  Phone:  484-378-4030
    3. Planned Parenthood – 1001 E. Lincoln Highway, Suite 101, Coatesville.  Phone:  610-383-5911

Although the ACA remains intact, there is still work to be done to defeat future efforts to repeal it.  You can sign up for campaign updates here.  Get involved and contact your legislator.  Let them know health care is a right and not a privilege.