Affordable Care Act Enrollment

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Enrollment for health care insurance is underway again under the Affordable Care Act. This year, the government’s web page for enrolling for insurance is not facing the problems it had last year. Allen Gjersvig, the director of healthcare innovation for the Arizona Alliance for Community Health Centers, will give an update on sign up for health insurance in Arizona under the ACA.

Ted Simons: Good evening and welcome to "Arizona Horizon." I'm Ted Simons. The latest three month enrollment period for health insurance under the Affordable Care Act began last weekend. Here with an update is Allen Gjersvig, director of healthcare innovation for the Arizona alliance for community health centers. Good to see you. Thanks for joining us.

Allen Gjersvig: Glad to be here. Thank you.

Ted Simons: What exactly began on Saturday?

Allen Gjersvig: On Saturday, people could start enrolling again in the marketplace. These are the insurance products that are available. Some people would say through Obamacare, but HealthCare.gov, the web site is now open for business again.

Ted Simons: And this is going to go on for three months?

Allen Gjersvig: Three months until February 15th.

Ted Simons: Who is eligible?

Allen Gjersvig: Who is eligible? Actually anyone that doesn't currently have coverage can shop on the marketplace. But only certain people are going to be eligible to receive financial assistance.

Ted Simons: Who are those folks? What is necessary?

Allen Gjersvig: To be eligible for financial assistance, first you don't have employer coverage. Based on family size and income. The less you make the more you might be eligible for in the way of assistance to be able to purchase insurance on the marketplace.

Ted Simons: The equations are there for you?

Allen Gjersvig: There are multiple ways you can find out. One way is to go to HealthCare.gov, and you can shop before you buy. A window shopping experience where you put in your age, your income, your family size, and it will show you the plans for Arizona. And you can start getting an idea and it will calculate based on just a few pieces of information the financial assistance that you might be eligible for.

Ted Simons: As far as the plans are concerned, are there more insurance options this go-round than last go-round?

Allen Gjersvig: Yes, last year, in Maricopa County, 111 plans, this year more than 130. And three new companies. Arizona has a very robust insurance market compared to some states.

Ted Simons: With that in mind, let's say I'm interested. I go online. I tap in health care, do the whole nine yards. What hits me in the face on the screen?

Allen Gjersvig: What hits you on the face is multiple choices, but what's really important is this. Eight out of 10 people last year received financial assistance in Arizona. About 120,000 people purchased marketplace plans. So, most people are going to go online to see if they qualify for any kind of financial assistance. And what hits you is the information is displayed that says your premium might be $300 a month. But you are getting $100 in tax credits, so you only pay --

Ted Simons: Insurance in general can be confusing to some folks.

Allen Gjersvig: That is -- that is so true. What is important that we all remember is people that found, a community-based assister that is trained, they were four, five times more likely to complete the process than people that did it on their own. The organization that I represent, we have approximately 300 trained and licensed assisters throughout the state of Arizona. So, help is available.

Ted Simons: Is this -- are you a navigator, is that what you are?

Allen Gjersvig: I am technically a navigator. Certified and licensed. The Arizona alliance for community health centers has received the largest navigator grant in Arizona for the last two years. But we also work with all community health centers of the state. But it is important to note that more than 600 organizations have come together to collaborate under the cover Arizona moniker and coverAZ.org is a great web site where you can find the help that you need right now.

Ted Simons: CoverAZ.org.

Allen Gjersvig: Correct.

Ted Simons: Let's get back to the enrollment process. If you are already enrolled, do you need to reenroll?

Allen Gjersvig: Yes, you do. Each policy in the marketplace is good for 12 months. If you are already enrolled, you are in the 120,000 that enrolled last year, both the Federal Government and your insurance plan have sent you notices saying that it's time -- time is coming. You need to reenroll. What is so important about reenrolling is this. You can allow to go on automatic, but if you allow it to go on automatic, you may be short-changing yourself. So, if you want no gap in your coverage, you need to take action by December 15th, so you have coverage as of January 1st.

Ted Simons: If you are happy with your insurance plan, just press what a little button and say I'm happy and move on.

Allen Gjersvig: Actually automatically enroll you, but we counsel differently. We counsel people with a marketplace policy to go in and update their account. Because their income may have changed. They may be eligible for more financial assistance because the parameters have changed. So, if you go on automatic, you may short-change yourself. So, go into that account and update it.

Ted Simons: When you reenroll, look at what else is out there because there might be something better for you.

Allen Gjersvig: There may be something better. Even if you want to stay with the same plan, you may be eligible for more assistance than last year.

Ted Simons: This is all based on the fact that the computers are working and the web sites okay. It wasn't all that okay the first time through. Has it improved?

Allen Gjersvig: Yes, last year Arizona had a very solid start in the marketplace in spite of all of the difficulties. Secretary of health and Human Services on Sunday in her notice said there were a few hiccups on Saturday. We can survive hiccups. A full head-on crash is a little harder to survive. Our staff and our partners have been enrolling people consistently since Saturday. Sometimes there is a little problem. They may have to go into the waiting room because there is too many people trying to get on. But now it tells you are in the queue. So, all in all, the experience has been very good. One of the big improvements, last year a person had to go through 74 screens to get enrolled. This year it's 16. I would say that's an improvement. So, while the time to act is now, before December 15th, if you want to keep coverage or have coverage for January 1st, or February 15th. And much has changed. We should also mention that in addition to the 120,000 people that got coverage last year, more than 230,000, 240,000 got coverage through expanded and restored Medicaid access.

Ted Simons: Through the state program.

Allen Gjersvig: So, more than 350,000 people have coverage now that didn't have coverage last year. That's five times the population of Flagstaff.

Ted Simons: Last question. This is obviously to get people to enroll. What are the penalties if you don't enroll?

Allen Gjersvig: Yes, it is a law that you have to get coverage. The penalty for 2015 is $325 or 2% of your income, whatever is greater. Now, that's per adult. And it does get a little complex. Think of it this way. $325, excuse me, per adult, or 2% of your income. Whichever is greater.

Ted Simons: These penalties increase every year you do not sign up?

Allen Gjersvig: Every year they go up. It's is more than $600 in 2016.

Ted Simons: Out of curiosity, how do they collect on that? Is someone knocking on your door?

Allen Gjersvig: No, no, you file your taxes. I hope you file your taxes. And they will. But what's important is people can get help simply by going to coverAZ.org. We have a connecter tool where you can schedule an appointment with a helper all over the state.

Ted Simons: All right. Good information. Good to have you here.

Allen Gjersvig: Thank you very much.

Allen Gjersvig:Director of Healthcare Innovation, Arizona Alliance for Community Health Centers;

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