Over the past several months, community leaders, nonprofits, the media and health care administrators have embraced the challenge of educating people about the Affordable Care Act and how to navigate enrolling in the new Health Insurance Marketplace. Open enrollment ended on March 31, and 8 million Americans — including 734,000 Texans — signed up for a private health insurance plan.
But the effort to get more Texans covered is just getting underway.
Here in McLennan County, 23 percent of residents are reported to be uninsured. That’s been a burden for our community on many levels. At the individual level, it has meant very personal battles with financial and emotional crises that too often come with injury and illness. At the city, state and national levels, it has contributed to the rising cost of health care. I’ve seen firsthand what a difference it can make as neighbors and friends get access to affordable health care for the first time.
For most of us, access to quality, affordable health care is a highly personal issue. Many in our community still don’t know what coverage options are available to them and what health care reform means for them.
Previously uninsured residents of Waco and surrounding communities who got covered are now establishing contact with providers and learning how to use their new insurance. The millions who still need coverage may not know that another enrollment period opens in November. And some may not have to wait: They may qualify to sign up for coverage, or change plans, between now and when the second open enrollment begins — a lifeline for many, when they need it the most.
To enroll now, someone needs to either qualify for Medicaid or CHIP — which most uninsured children in Waco already do — or have recently had a qualifying life event. These include events such as a change in family size like getting married or divorced or welcoming a new child into the family, certain changes in income, losing job-based insurance, moving away from the area or turning 26 years old. Applicants can enroll within 60 days of any of these events. And there are in-person enrollment experts who can help answer questions for those who believe they may be able to get insured now.
Getting covered sooner means getting greater financial security and better access to health services sooner. It also can reduce the fine you might have to pay if you remain uninsured. Staying uninsured when you could have gotten covered will lead to a fine when you go file next year’s taxes — but that fine will be smaller for those who take advantage of special enrollment, CHIP or Medicaid to get members of their family covered as soon as they can.
Regardless of when you enroll, the process is simple. Applicants can find out more about what resources are available to help you at GetCoveredAmerica.org. In person, at a local hospital or community health clinic, application counselors are on hand to help connect people with coverage.
Enrollees can’t be denied coverage or charged more for pre-existing conditions. Optical and dental insurance is also available to all children and in some adult plans. Most applicants qualify for financial assistance to help keep monthly premiums and out-of-pocket costs for health care services affordable. In fact, 84 percent of the Texans who got covered in the first enrollment period received financial help.
There’s no limit to what we can build together when we do what’s right both for individuals and our community: getting as many people as possible the coverage they need.
Kelly McDonald is a national health care advocate for people with rare medical disorders, serves on the Texas Department of Health’s Newborn Screening Advisory Committee and is local field organizer for Enroll America and the Get Covered America campaign. For more information visit www.getcoveredamerica.org/waco.