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November 17. 2013 9:43PM

Area residents learn more about ACA options at Somersworth event

SOMERSWORTH — About a dozen area residents learned more about Obamacare and how the plan could cause some issues for those who travel across state lines to see a doctor.

A free presentation on the Affordable Care Act — also known as Obamacare — was a good opportunity for residents last week to learn about their options and available resources in the area, according to Mary Moynihan, an outreach and enrollment specialist for the ACA at Goodwin Community Health.

After a Maine resident asked whether he could continue to see his doctor in New Hampshire, Moynihan said medical personnel and facilities must be licensed by the Department of Insurance in their state, which wouldn't be transferrable across borders. She added this does not apply for emergencies.

MedEthics Consulting's Paul Drager, who's taught classes and testified about Obamacare, said the health care marketplaces are "state specific."

"That's going to be an issue with this — it's not a national plan," Drager said.

David Holt, who helped organize the session, said the United States is the only industrial nation without socialized medicine, also called a single-payer system.

While other states have different options, Moynihan, who works as a certified application counselor, said Anthem Blue Cross Blue Shield N.H. is the only health care provider in the state under Obamacare. She added it's possible Harvard Pilgrim or another network will offer plans next year.

Moynihan said state officials are still determining how to best use $2.5 billion in federal funds to expand Medicaid in New Hampshire. She added this could provide residents with more options.

"You really have to understand that this will reduce the health care deficit," Moynihan said.

Moynihan said options about health care plans and income-based subsidies are only available via the marketplace — the federal health care exchange in New Hampshire, which is accessible via phone at 1-800-318-2596, online at www.healthcare.gov, in person or through the mail.

"You can get your eligibility results quick," Moynihan said, adding applicants can learn of their options within two days , before they need to move onto evaluating plans and prices on the exchange.

"Don't get discouraged if you can't get in via the website; it is getting better," Moynihan said.

To have health care after Jan. 1, participants must enroll by Dec. 15. Afterward, applicants must wait until February based on the enrollment period, according to Moynihan.

"There is a six-month window to enroll. Next year will have a smaller window," Moynihan said, adding residents have until March 31 to purchase a plan.

"People are confusing enrolling and applying," Moynihan said, adding more people have applied to establish an account in the system than enrolled for a health plan.

In New Hampshire, Moynihan said residents can choose between several options — including bronze plans which require participants to pay 40 percent out-of-pocket, silver plans which pay for 70 percent, gold plans which have 20 percent out-of-pocket expenses. She added those under 30 are eligible for a catastrophic plan that pays for less than 60 percent of expenses.

"It takes time to evaluate the plans," Moynihan said.

Moynihan said businesses with up to 50 full-time employees can offer plans through the Small Business Health Options Program (SHOP) through the marketplace. She added these employees are not eligible for subsidies or tax credits if they choose to buy insurance outside the plan.

Based on the individual mandate, Moynihan said anyone who does not qualify for an exemption — including for being homeless, under foreclosure or being a Native American — will be taxed. For adults, the penalty — or the "shared responsibility payment" — is $95 or 1 percent of annual income, whichever is higher in 2014.

In 2015, the noncompliance penalty rises to $325, or 2 percent, per adult and increases to $695, or 2.5 percent, in the future, according to Moynihan.

"You have to pay the penalty, but you still don't have health insurance," Moynihan said, adding without applying, people will not learn what options for care or assistance are available.

jquinn@newstote.com


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