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Health news and issues in the Ozarks.

Q&A on Marketplace Open Enrollment, How Likely Obamacare Repeal is Impacting Signup

Kate Cohn
Scott Harvey
/
KSMU

Jan. 31 marks the open enrollment deadline for citizens needing health insurance through the federal Marketplace. While the process has become more streamlined since it first launched, a likely repeal of the Affordable Care Act, known as Obamacare, is bringing many questions from enrollees.

“People aren’t sure if they should enroll, if their insurance is gonna go away if they do enroll, so we try our best to reassure them,” says Kate Cohn, a certified application counselor with CoxHealth. “As of right now, it is still the law to have health insurance so we encourage people to sign up now and then we will be here all year as changes happen to help with the transition, as needed.”

She says the same process by which people signed up during open enrollment in previous years still currently applies.

The amount of healthcare providers and insurance choices, however, is not the same. Major insurers have exited some states in recent months, citing lost revenue in part because not enough healthy people have signed up for insurance to counteract the costs of covering less healthy individuals.

In Greene County, says Cohn, just two insurance providers are offering coverage this year through the Marketplace, half of what was available last year. In neighboring Christian County, there’s just one option for consumers.

As of now, the lack of competition hasn’t driven up prices. Cohn says that’s because “insurance companies have to submit their plans and prices very early on in the year, and the other insurance companies actually dropped out after those were submitted. So I don’t think that has affected the pricing this year. Next year might be a different story.”

What Does it Cost to Get Insurance on the Marketplace?

It’s all based on income and family size, says Cohn. She offered an example of someone she recently helped enroll; a 26-year-old male making under $20,000.

“He had plan options ranging from $0 a month all the way up to $200 a month.”

Monthly premiums can be partially offset through subsidies. This year, an individual can quality if they make less than $12,000 per year. For a family of two, the threshold is about $16,000, and a family of three about $20,000.

What is the Fee for Not Signing Up for Health Insurance?

Cohn says the fee had been increasing “pretty drastically” each year, but that it’s “pretty much been stabled that out right now.”

Currently, the penalty is $695 per person, or 2.5 percent of total income, whichever is higher. She adds that officials have not seen any new information indicating those fees will increase moving forward.

Last year the $325 penalty per adult, or two percent of a household’s income.

Can I Sign Up After the Open Enrollment Period Ends?

Yes. But only if you have a qualifying life event. Criteria include having a child, getting married, and moving to a different city or state.

Cohn adds, “If you’ve lost your health insurance, if you’ve recently gained eligible immigration status, major life events like that will qualify you to enroll during the year.”

Where/How can I sign up?

Healthcare.gov is one way. There are also various in-person options, including a list of where you can find a certified application counselor through Cover Missouri, or you can sign up through the Marketplace’s 24-hour call center at 1-800-318-2596.

Certified application counselors with CoxHealth are located in the Medical Mile Plaza Shopping Center at 3318 S. National. Appointments can be made by calling 417-269-2945.

On Saturday, CoxHealth will hold enrollment events from 10 am to 2 pm throughout southwest Missouri. The hospital says nonpartisan, licensed counselors will be available to offer free assistance to individuals that need to enroll or re-enroll in a health insurance plan through the marketplace. Locations include:

- Cover Missouri Office (3318 S. National Ave., Springfield)

- Cox North Hospital (1423 N. Jefferson Ave., Springfield)

- Cox Medical Center Branson (525 Branson Landing Blvd., Branson)

- Cox Monett Hospital (801 Lincoln Ave., Monett) Help is available in Spanish.

- CMH Marketplace Office (2001 W. Broadway Ave., Bolivar)

- Joplin Public Library (300 S Main St., Joplin)

According to CoxHealth, walk-ins are welcome, but appointments are also available. Attendees should bring Social Security numbers and dates of birth for anyone to be included on the health plan. Recent tax records can be helpful when determining income, but are not required.

Hear the full conversation with Kate Cohn above. You can also find additional information and peruse other frequently asked questions at www.healthcare.gov.

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