Affordable Care Act insurance enrollment starts Oct. 1

An estimated 30,000 county residents will be eligible for programs; local health officials encourage those who qualify to participate

jlavelle@thetribunenews.comSeptember 28, 2013 

For most people who get health insurance from their employer or Medicare, Tuesday will be just another day.

But for the 8 million Californians with no health insurance — including at least 30,000 San Luis Obispo County residents — Tuesday could be life changing.

Covered California, the new health insurance exchange created by the federal Affordable Care Act, will start open enrollment Tuesday for coverage starting Jan. 1. The exchange is the cornerstone of the health law and is designed as an online marketplace where uninsured people can buy affordable health insurance. Federal subsidies will be offered to help with the cost, depending on income.

Low-income residents may qualify for Medi-Cal in a vastly expanded program funded by the federal government.

“There are two things people without health insurance need to know,” County Medical Officer Dr. Penny Borenstein said. “That’s CoveredCA.com and 800-300-1506.”

That’s the website and phone number for Covered California.

Anticipating the launch of Covered California, local officials have been holding community meetings in recent weeks to get the word out about what the exchange does and how to apply. Last week, they held a news conference at the San Luis Obispo Veterans Memorial Building with panelists including state Sen. Bill Monning, county Supervisor Bruce Gibson, a representative for Rep. Lois Capps and several others.

Monning said the Affordable Care Act not only offers a path to health insurance for many people starting in 2014, but also that much of the law already has gone into effect.

The law now requires insurers to provide free preventive care in health plans, allows parents to keep young adult children on family policies until age 26, and prevents insurers from denying coverage to children with pre-existing medical conditions, among other things.

Starting next year, adults with pre-existing conditions can no longer be denied coverage, under the federal law.

“This (law) will be transformative for many families that have been without health insurance,” Monning said. “For some, it already has been lifesaving.”

The exchange opens for business Tuesday, but information is on the website now.

People who sign up for health insurance through Covered California before Dec. 15 will have coverage that starts Jan. 1, 2014. Federal subsidies are only available through the exchange, and open enrollment ends March 31 to be eligible for a 2014 subsidy.

In August, Covered California named 12 insurers who will offer health plans on the exchange. But in San Luis Obispo County, the choices are much slimmer. Only two insurers — Anthem Blue Cross and Blue Shield — actually have a network of health care providers in the county.

Borenstein said an estimated 15,000 uninsured county residents will be eligible to buy insurance through Covered California.

Another 15,000 uninsured people may qualify for Medi-Cal under the expanded program, she said, a huge jump from the 28,000 county residents who now get it.

“These are not folks who want to be uninsured,” Borenstein said. “Many of them have been kept out of the marketplace because they had health problems and pre-existing conditions that prevented them from getting insurance or they couldn’t afford insurance. This provides a great opportunity for them.”

About 3,200 people in the county now get medical help through the County Medical Services Program, the local safety net for low-income residents who don’t qualify for Medi-Cal.

Most probably will qualify for Medi-Cal under the expansion, Gibson said.

“The promise here is that with the expansion of Medi-Cal, we’ll get a whole bunch more people connected to medical services and preventative care,” he said. “Our community is going to be much better as the Affordable Care Act is rolled out.”

To gear up for an influx of Medi-Cal applicants, the county Department of Social Services has set up a call center to handle referrals from Covered California. The department also is hiring 11 more specialists to help applicants at its six offices, said department assistant director Tracy Schiro.

“People who aren’t sure if they’re eligible for insurance or for Medi-Cal should call Covered California,” Schiro said. “But if they know they qualify for Medi-Cal, then they can just walk in our door.”

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