Local seminar offers scoop on new health care law

bmilazzo@centredaily.comNovember 20, 2013 

— Margo Sue Danley attended the Affordable Care Act seminar Tuesday night at the State College Municipal Building to see how it might impact Medicare.

She found out it wouldn’t have much of an impact on her situation.

“It’s just good to know the facts,” Danley, 74, said.

The lecture gave the scoop on what ACA means for individuals, families, small businesses and the options for those who will still be uninsured after the first of the year.

Moderator Jon Eich said 47 million people in the United States are uninsured, while health care costs are the leading cause of bankruptcy in the country.

The ACA was signed March 23, 2010, as a way to get people into affordable group insurance plans. On Oct. 1, eligible residents were able to enroll in a number of plans under the act.

For individuals, the ACA includes numerous industry reforms, according to Brandn Green, professor of environmental studies and director of the Place Studies Initiative at Bucknell University:

• There will be no denial of coverage based on pre-existing conditions;

• No more lifetime coverage limits;

• Pulling coverage when you get sick is now illegal;

• Children can stay on parents’ insurance plans until they are 26;

• Gender discrimination is illegal;

• There will be out-of-network emergency room access coverage;

• There is direct access to OB/GYN with no referral needed; and

• There is free preventative care.

For small businesses that make up a large part of downtown State College, on the other hand, it has new choices, according to Walt Whitmer, extension associate at Penn State University Extension.

Small businesses employ 3.2 million workers in Pennsylvania, and only 48 percent of small business owners report that they can afford to offer health insurance, Whitmer said.

Small businesses with less than 25 employees and average wages of less than $50,000 qualify for tax credits to help with the cost of coverage for workers.

Tax credits currently cover up to 35 percent of the cost of coverage. Next year that will increase to 50 percent, Whitmer said.

In October, small businesses were also able to buy coverage through the SHOP Marketplace that will allow it the same purchasing power that large companies have. SHOP-eligible businesses must have 50 or fewer full-time equivalent employees and at least one employee on payroll in addition to a proprietor and spouse.

Whitmer said sole proprietors are considered individual citizens thus not eligible for small business ACA coverage.

By 2016, SHOP eligibility will increase to 100 employees.

SHOP, Small Business Health Options, will start as soon as the first of the year if employers and their employees register by Dec 15.

Whitmer said while the Affordable Care Act coverage is offered to small businesses, those employers are not mandated to offer health insurance.

For those who cannot afford health care or opt out of health coverage, there will be a financial penalty.

For anyone eligible, Centre Volunteers in Medicine would also continue its services, said Cheryl White, CVIM executive director.

“It was not meant to be universal, but you can’t legislate away poverty,” White said.

CVIM was established in 2003 to provide medical, dental and vision coverage free of charge to Centre County residents in need.

White said 11 percent of Centre County residents are uninsured. There are 200 people on the medical waiting list with 1,800 on the dental waiting list.

While CVIM will continue to meet the needs of its clients, case management officers are currently training to be certified to help people in the ACA insurance application process.

And the biggest tip the experts said was to find the best option that fits resident needs.

“Do your due diligence. Explore your options,” Whitmer said.

For more information, visit healthcare.gov.

Britney Milazzo can be reached at 231-4648. Follow her on Twitter @M11azzo.

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