Health care reforms explained

Published 12:00 am Saturday, October 12, 2013

By Kimberly Hopson

LAPLACE – Representatives of the Louisiana Healthcare Education Coalition invited St. John the Baptist Parish residents to sit in on a informative presentation about the key changes imposed by the Affordable Care Act, also known as Obamacare.
The health care reform law was actually passed in 2010, but changes that will go into effect January 2014 have thrown it into the spotlight more recently. The law is designed to ensure access to quality, affordable health care coverage and will require most Americans to have some form of health insurance. Insurance providers can no longer deny coverage to citizens with pre-existing conditions.
An online health care marketplace is designed to provide coverage options for those who do not receive insurance from an employer or are not enrolled on a government mandated health care plan, such as Medicaid, Medicare, CHIP or TriCare. Citizens who receive coverage from work or a government program do not need to worry about using the online marketplace. Subsidies are also available to help pay for health insurance premiums for those who earn between 100 and 400 percent of the federal poverty level projected income.
Open enrollment for the online marketplace officially began on Oct. 1. Citizens who wish for their coverage to take effect Jan. 1, must enroll by Dec. 15, though the enrollment period will last until March 31, 2014.
Incarcerated people, those who reside in the country unlawfully, those who are claimed as a dependent on someone’s taxes, those who earn more than 400 percent of the federal poverty level and those who are unable to prove residency in one state are not eligible for coverage under the ACA.
Thus far, four Lousiana insurers have applied to participate in the marketplace: Blue Cross and Blue Shield of Louisiana, Humana, Louisiana Health Cooperative and Vantage. Humana has limited its coverage to Jefferson Parish, while Vantage will be limited to northern Louisiana.
The federal government will reap a hefty fine from those who choose not to enroll when they do not already have a health care plan. According to Keith Ray, a representative of the Louisiana Healthcare Education Coalition, failure to comply means confiscation of tax refunds starting at $95, or 1 percent of a citizen’s total income for first year without health coverage. The fine can grow to up to $695, or 2.5 percent of income by 2017.
Ray said the online marketplace has experienced quite a few glitches and unanswered questions. He went on to speak of the website’s software and design defects.
“This is something that is really different. So when we say they are many unanswered questions, that’s just a fact. There are unanswered questions, and there are a lot of glitches,” said Ray, who added that LHEC did not intend to denigrate or promote the new health care act.
“As with any large-scale event of this magnitude, we expect to spend the first couple of weeks after the marketplace opens working with the government and other partners to identify and quickly resolve any issues so we can make the experience as smooth as possible,” said Blue Cross Blue Shield of Louisiana CEO Mike Reitz last week.
Ray warned citizens to be mindful of online scams when attempting to enroll. He also said that government-certified “navigators” are available to help citizens who are having problems trying to digest the complicated new system. These navigators can be found through four agencies: the Capital Area Agency on Aging, Martin Luther King Health Center, Southern United Neighborhoods and Southwest Louisiana Area Health Education Center. Citizens can also find assistance in their area online at
The application process is available online at, by phone at 1-800-318-2596, or on paper for those who do not have Internet access. Customer service representatives are also available 24/7 in more than 150 languages. For more information or to request a presentation from the Louisiana Healthcare Education Coalition, visit
The informational session was sponsored by River Parishes Hospital.