Athens resident Jami Mays landed in the emergency room the day after Christmas and nearly a week before her health insurance coverage under the Affordable Care Act started in January 2014. But when it began, she immediately saw surgical consults on Jan. 2 for pancreatitis and underwent surgery on Jan. 7—all covered after a $500 deductible. Now, a year later, though she’s still paying down $50,000 in bills for gall bladder issues that stacked up between October and December 2013 and led to the pancreas problem, she no longer worries about her health care and insurance coverage.
That’s great news as she rings in 2015 with news of her own: She’s expecting and due this summer. “This wouldn’t have happened if we didn’t have insurance,” Mays says. “Pregnancy is often considered a pre-existing condition.”
For 2015, Mays and husband Colin (a cancer survivor) renewed their Gold plans under the federal Healthcare Insurance Marketplace. Their premiums went up $15 each this year. “Though it’s our biggest bill outside of rent, it’s more affordable than it would have been,” she says. “We won’t complain. We’re grateful we have something.”
Open enrollment for 2015 in the Health Insurance Exchange extends through Feb. 15, and those who sign up by Jan. 15 can receive coverage that starts Feb. 1. More than 4 million people signed up in December, according to a Department of Health and Human Services report. This year’s target number is 9 million customers nationwide.
This year, more consumers are finding it easier to access the marketplace website and understand tax credits. In fact, about 87 percent of people who already chose health insurance plans for 2015 were eligible for financial assistance to lower monthly payments, compared to 80 percent last year.
In Georgia, about 187,000 residents have picked coverage for 2015 so far, with about 89 percent receiving financial assistance. In December, the state attracted the fourth-highest number of signups among the 37 states with a federal exchange, following Florida, Texas and North Carolina.
Several Georgia groups are holding information sessions around the state to help residents learn more and sign up. InsureGA, a statewide nonprofit cooperative, is partnering with regional groups to give free, non-biased information about the coverage options. About 250,000 Georgians are eligible to enroll, according to Health and Human Services estimates, which leaves about 60,000 more who could sign up and possibly find financial assistance before the deadline.
In Athens, local health navigators are helping residents sign up by holding information sessions at the Athens-Clarke County library and enrollment sessions in the library’s second-floor computer lab. “We’re thinking this month and February are going to be busy like last year, with people trying to take care of business after the new year,” says Harold Weber, a navigator based at the Athens Neighborhood Health Center. “We’re here to serve whatever needs they have.”
This year’s higher tax penalty will play a role in sign-up numbers, Weber adds. For 2014, individuals without coverage must pay $95 for adults and $47.50 for each child on their taxes. This penalty was worth the savings for some, Weber believes. But when the tax deadline rolls around next April, that may not be the case. For 2015 taxes, adults will pay a $325 penalty and $162.50 for each child. “That’s quite a big difference from last year,” he says. “We’re seeing a higher income level coming out to sign up as they take a hard look at what they want to pay.”
This year, the updated federal website works better, which should help, and residents seem more knowledgeable about health plans and their options, Weber says. “I can see the difference in people using terminology, such as ‘deductible’ and ‘out-of-pocket max’,” he says. “New enrollees are savvy. They know more than what I would have thought.”
What You Need In Order to Sign Up:
• Names and Social Security numbers for every member of the household.
• Employment income information, such as pay stubs or tax forms.
• Information about any other health policies your family has.
Athens Area Information Sessions
Ellison, Walton & Bryne Urology Clinic, Wednesday, Jan. 14, 10 a.m.–2 p.m.
Bogart Public Library, Wednesday, Jan. 21, 12–4 p.m.
Health navigators at the Athens-Clarke County library:
Enrollment lab session, Wednesday, Jan. 14, 9 a.m.–2 p.m.
Enrollment lab session, Friday, Jan. 16, 9 a.m.–2 p.m.
Information session, Monday, Feb. 2, 12–2 p.m.
Enrollment lab session, Monday, Feb. 2, 9 a.m.–2 p.m.
Enrollment lab session, Wednesday, Feb. 4, 9 a.m.–2 p.m.
Enrollment lab session, Friday, Feb. 6, 9 a.m.–2 p.m.