Affordable Care Act Update

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We are in the middle of the enrollment period for health care coverage under the Affordable Care Act.
David Sayen, regional administrator of the Centers for Medicare and Medicaid Services in San Francisco and who oversees Arizona’s ACA system, will give us an update.

Ted Simons: Another enrollment period for health care coverage, under the Affordable Care Act is underway, and here to give us an update on the aca in Arizona is David Sayen, regional administrator of the centers for Medicare and Medicaid. Good to see you again and thanks for being here.

David Sayen: Delightful to be here.

Ted Simons: Enrollment period, where are we and when did it start and when does it end?

David Sayen: Well, it began last month, and we're going through January 31st. But, in order to have coverage on January 1st, you need to act by the 15th of December.

Ted Simons: Oh, my goodness, ok. If you don't act, if you miss this deadline, we talked about this before, there is a penalty. Is that any different than if you missed previous deadlines?

David Sayen: Well, yes, so folks who have insurance in the market place, if they don't act, they will stay with the same carrier, but the coverage may be different. That's why we want people to go and check, but for those people who remain without insurance, the penalty is more significant. It's either 695 dollars or 2.5% of the income. With the 2,500 ceiling for the family. So, it's more important than ever that people act.

Ted Simons: How many are -- do you expect will be signing up this go around?

David Sayen: Well, we don't like to have a target or, or at least I don't. I like to see everyone who has a chance to do so, sign up. We're at 90% of people with insurance nationally, which is a real milestone, so we're trying to get to the rest now.

Ted Simons: In Arizona, though, the uninsured rate, while it's dropping, it's down to 13 some odd percent from 17%. It's encouraging but much more than the national average. What's going on?

David Sayen: That's why we're here. This is one of the areas that we're really focusing on. We know that there are a lot of Hispanic speaking voters, or folks that we're not reaching, and we want to make a special effort there, and it's a competitive insurance market here, the premiums are good, so we think that it's a matter of getting the information out, and we're doing that every chance that we can.

Ted Simons: How do you?

David Sayen: We were at a native health event for American Indians, and have navigators and assistors doing in-person events, we're doing Urban Day of Coverage and we have weekend events, so, if you look at that website, you will see there is a number of places to go and get in-person help. And that's something that helps people get over the hump.

Ted Simons: There are concerns regarding premiums increasing in Arizona. I know I heard the Silver Plan, the premiums are like an 18% increase next year. First, what's going on with that, and second, is it a bump or something that we're leaving out later? What's happening here?

David Sayen: Arizona is a very competitive insurance market, and last year, actually, had the lowest price for the silver, which is the benchmark plan, and in the first year, they were -- the second lowest in the country. So carriers are evening it up but it's a competitive rate, and it's important to remember that eight out of ten people could save money by switching. On average, about 160 dollars. So, there is, you know, eight issuers, there's 69 plans to choose from, and we want people to make a phone call and take a look.

Ted Simons: So perhaps Arizona's rates were unsustainabley low in the first place and now getting back to more realistic levels? Is that what you are saying?

David Sayen: I think here's a new opportunity for people who haven't had insurance before, and carriers may have been more aggressive in their pricing. They have people onboard and they can be more conservative. And the underlying cost of health care is expensive. One needs to keep in mind you are buying insurance to protect you from things that are expensive.

Ted Simons: You mentioned how many companies are offering plans. I am here like the Emeritus and others are closing up shop. They're not around anymore. Are the options more limited than in years past?

David Sayen: I don't think that they are, that they are more limited, as I said, 69 plans to choose from is quite a few, but businesses come and go, and insurers come into the market and out of a market, and it changes, and we have to live with that. What we're trying to do is have a sustainable system where people can get affordable coverage that's comprehensive and meets their needs, and I believe that we have a good panel of choices there for people to look at, and remember, that while premiums may go up, more than 80% of the people are enjoying some subsidy that's lowering the cost of the premium.

Ted Simons: So for those who may have been with Emeritus or some other firms that had decided that they are done at the end of the year, which I think that they are. It's a lot of folks there. Where do they go and what do they do?

David Sayen: Sure. Those folks, the Emeritus coverage would end on December 31st. They can go as late as the end of February in choosing a plan. If not until then, they will have a gap in coverage so we want them to come out before December 15th so we can have them enrolled for January 1st, actually they can go to the 31st but we want to make sure the paperwork is in shape. There are plans to choose from, and we know in the commercial marketplace, and employer health insurance places, people tend to change plans every couple of years, it's a competitive environment, and people need to look at that.

Ted Simons: Someone watching right now, either for themselves, family members, friends, they want more information, and they are afraid of insurance. They see the forms, and they are confused the minute they put a pen in their hand or in front of a screen. Where do they go to get help and what kind of help is -- do you think is best for them?

David Sayen: I think that the very best thing is we have an 800 number, 318-2596 that can direct you to local resources, and here in Arizona, the cover is a coalition of people that health facilities, communities health centers, they have volunteers and paid enrollment assisters and can help you walk through the claims.

Ted Simons: So Start there, and good luck to you. Good to see you again. Thanks for joining us.

David Sayen: Thank you.

David Sayen: Regional Administrator of the Centers for Medicare and Medicaid Services

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