Massachusetts Health Connector open enrollment begins November 15

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File photo by Michael Cummo

Representatives from the Massachusetts Health Connector, Vineyard Health Care Access, and state representative Tim Madden held a joint press conference at the Dukes County administration building on Friday to hammer home one point — the time is now for uninsured Islanders to get insurance, and for insured Islanders to get a health insurance check-up. The next open enrollment period starts November 15, and everyone who is in Health Connector coverage, or was placed in temporary coverage over the last year needs to reapply if they still want to be covered by insurance through the Commonwealth.
“Our mission is to connect people to comprehensive and affordable health insurance,” said Ashley Hague, deputy executive director of Massachusetts Health Connector (MHC). “Our number one goal is to ensure our current members are able to transition without a gap in coverage.”
Ms. Hague stressed that everyone who has coverage through MHC, also known as “The Exchange” or “The Marketplace,” or who was placed in a temporary plan in the past year, needs to submit a new application. Open enrollment concludes February 15, 2015. Since 2006, by law, with some exceptions, all residents of Massachusetts were required to have health coverage that met state standards. For those residents not covered by an employer or commercial health plan, the state created an agency, the Massachusetts Health Connector, to act as a broker for qualifying insurance plans.

When the ACA, also known as Obamacare, went into effect on October 1, 2013, the Massachusetts health care plan was required to retool and offer ACA-compliant plans though ConnectorCare, a new website, which did not work.

Gov. Deval Patrick recently said the new website is being fixed at a total cost of $254 million, which is $80 million, or 46 percent, more than initially projected, according to a recent report in Commonwealth magazine.

Ms. Hague said the technological glitches that plagued the Commonwealth Health Insurance Connector Authority last year have been resolved, and the new website, MAhealthconnector.org, will have a simpler, shorter application that can be done in one sitting. The website also has a list of health insurance “navigators” and certified application counselors. Each state has a navigator program, which is required by the Affordable Care Act (ACA). Navigators work one-on-one with local residents to guide them through the stultifying requirements and shifting options in health insurance today.

Island navigators
Last May, Sarah Kuh, director of the Vineyard Health Care Access Program (VHCA), applied for a grant to fund VHCA navigator training and  and to subsequently qualify as a state navigator for Dukes County. In August, VHCA was selected as one of five new navigators in the state. There are 15 navigators statewide. Now, trained specialists at VHCA can advise the insured and the uninsured, small businesses owners, the self-employed, and seasonal workers. The multilingual staff can assist all Island residents, including members of the Wampanoag tribe. All four of the VHCA client services staff, Ms. Kuh, Mary Leddy, Maria Mouzinho, and Vani Pessoni, are Certified Massachusetts Navigators.
“I want to give a big shout-out to Sarah Kuh,” Representative Tim Madden said. “Her passion for the job, her commitment to the job, and her thoroughness on the job is incredible. A lot of people put in grant applications, but very few are awarded. Having someone on Island that people can actually sit with and help them through it, step-by step, makes a huge difference.”
“It’s very exciting to be included in the navigator program because we feel like we’ve been navigating for decades,” Ms. Kuh said. “It’s not just filling out a form. It’s understanding the implications that go along with it. We look at the different programs, their benefits, how to use the insurance, and what happens if you need to see a medical specialist or behavioral health professional. Hopefully the people in the community know they can come to us with any questions or problems: that is what we’re here for and we’re happy to help.” Ms. Kuh added that there are hundreds of Vineyarders who need to reapply to keep their insurance.

“While we encourage people to seek out assistance from navigators, we also encourage them to make appointments with them ahead of time,” Ms. Hague said. “We had situations where there were lines out the door, and while that’s a great thing, it’s probably not efficient for anybody.”

Mass outreach
Ms. Hague said in the coming months, the Health Connector program is launching an extensive outreach campaign. “We’ll be sending postcards and letters in the mail so we ask people to please read their mail from the Health Connector,” she said.

In addition to newspaper and radio advertisements, people will also be notified by phone, and some will be notified in person by outreach staff who are planning to make over 200,000 home visits. There are three groups the Health Connector is targeting with its outreach program. One group is the 100,000+ people in the Commonwealth Care or Medical Security plan.

“I am becoming more familiar with the Island and high percentage of seasonal employment here, so this plan is significant,” Ms. Hague said. “The plan was supposed to be closed last year but will be closed January 31, 2015. Subscribers in that group must submit a new application by January 23.”

Another group, individuals in temporary Medicaid, will have their coverage end in three phases. Coverage for the different sub-groups will end January 15, February 1, and February 15. Each group will be repeatedly notified of their respective deadline, Ms. Hague said. The third group being targeted is the 40,000 who successfully enrolled through the website and by phone last year.

“That group is probably the trickiest to help, because they already did this, and might not think they have to reapply,” Ms. Hague said. “But we need the most up-to-date information, address, age, and number of dependents, in order to get them the right benefits and to get the most generous benefits we can.”
Ms. Kuh said that for a single person to qualify for ACA subsidy, the income cutoff would be around $45,000 a year. “Sometimes people don’t know that they’re eligible for help and they’re paying way more for insurance than they can really afford,” she said.
“It’s really important for people to just check and see,” Ms. Hague said. “Even if you’re already insured through your employer, you might be able to take $50 a month off your commercial premium.” She added that people who weren’t eligible for Commonwealth Care last year may be eligible for subsidy under the ACA, which has a higher income cut-off.  Under the ACA, people earning below 400 percent of the federal poverty line may be eligible for assistance.

According the the Department of Health and Human services, the poverty line for an individual is $11,670, so an individual makingunder $46,680 is potentially eligible for health care subsidy. “Most of the people in our health care reform since 2007 are people working,” Ms. Hague said. “Just because you have access to employer sponsored insurance and you were previously crowded out from enrolling in a subsidized program through the state, doesn’t necessarily mean that’s the case now, so just check and see.”
“There’s also Mass Health Premium Assistance,” Ms. Kuh said. “For a family or person making under 300 percent of the poverty level, Mass Health can pay their share of their employer insurance premium. “It’s not easy to get but when you can, it’s a huge financial help for families,” she said.
Appointments at VHCA can be made by phone at 508-696-0020, or on the website mvhealthcareaccess.org or at the office at 114 New York Ave. in Oak Bluffs. To kick off the open enrollment period on Saturday, November 15, the VHCA office will be open from 12 noon to 2 pm to answer questions and to make consultation appointments.