The Benicia Herald -- ACA plans detailed
October 18, 2013
By Donna Beth Weilenman
Residents of Benicia and Vallejo had anticipated hearing U.S. Rep. Mike Thompson as well as a panel of Solano County health care specialists explain the Affordable Care Act and the changes it will bring starting in January.
However, those attending Wednesday night's meeting in Vallejo learned their representative in the House was in Washington, voting to reopen the federal government. In fact, they learned of the successful vote directly from Thompson, who sent the message to staff members who read his note during the meeting.
In Thompson's absence Solano County Suervisor Erin Hannigan fielded questions directed to Keirsha Baron, enrollment specialist from Solano Coalition for Better Health; Anne Edwards, director of Solano County Health and Social Services; and Christina Calvo, Covered California representative and health enrollment specialist with Solano Coalition for Better Health.
They also described different aspects of the act, often called “Obamacare,” a term President Barack Obama, who pressed for health reform legislation, has embraced.
First, Baron said, those who receive insurance from their employers won't experience any change, so long as that insurance also complies with provisions of the act. What has changed is those who couldn't afford insurance, those whose illnesses, such as diabetes or asthma, have been denied insurance, and anyone else who have been uninsured will find it available.
In this state, Covered California is the insurance partnership that provides the marketplace where residents can compare plans and select the ones that fit best, they said.
Those whose income is so low that they qualify for Medi-Cal will find their options also improve next year. For instance, starting next year, low income individual individuals 19 to 64 who have no children will be able to enroll in Medi-Cal, Edwards said.
The program will be expanded to cover mental health and substance abuse treatments, she said.
Most who currently are eligible for Medi-Cal will continue with that program under the ACA. In Solano County, Medi-Cal is administered by Partnership Health Plan.
Those whose income makes them ineligible for Medi-Cal can choose from four tiers are labeled for metals. Bronze has the lowest premiums, but pays for 60 percent of the costs. As the plans go to silver, gold and platinum categories, the premiums rise, but the percentage of costs a subscriber pays and the co-payments required are lower
And in some cases, some may be able to get assistance with co-payments, too.
Premiums are based on such factors as zip code and income, rather than gender or whether someone smokes, Baron said.
Affordable Care Act has provisions for vision and dental care for children, but when the program becomes effective Jan. 1, those options won't be available for adults.
Those who refuse to enroll in health care will be penalized, and those penalties start at $95 a year, or 1 percent of the individual's income. Businesses that are required to provide appropriate health care who fail to do so also will be punished, panelists said.
The state's counties are trying to assure that Covered California works smoothly, and Edwards said those contacting the program won't find themselves “in the wrong door.”
Should someone expect to qualify for Medi-Cal, but fail to do so, they'll be connected with a Covered California contact. Should a Covered California inquirer be eligible for Medi-Cal, that individual would be connected to a Medi-Cal specialist, she said.
Solano County has specialists “from Vallejo to Dixon,” Calvo said. Those registering would need to provide their Social Security number, a pay stub, verification of their annual salary as shown on an income tax return, and a photo identification card.
Those attending the panel talk at Vallejo's Filipino Community Center heard more than just about health care Wednesday night. Thompson, who addressed the audience by video at the meeting's start, sent a message to staff members that a majority of the House of Representatives had joined him in voting to reopen the federal government and to raise the debt ceiling, to “make sure the United States pays its bills on time.”
The decision was a bipartisan vote of 285 to 144. Of the “for” votes, 198 were Democrats and 87 were Republicans.
“The legislation funds the government through Jan. 15, 2014, extends the debt ceiling until Feb. 7, 2014, requires income verification for recipients of subsidies under the Affordable Care Act's exchanges, and provides backpay to furloughed federal workers,” Thompson announced later in a news release.
“The agreement also requires a bipartisan, bicameral budget conference to come up with long-term spending plans by Dec. 13.”
Thompson said, “Today's bipartisan agreement will finally bring this reckless and unnecessary government shutdown and default crisis to an end.”
He blamed “tea party” advocates, describing them as “obsessed with derailing health care reform at any cost,” and said the strategy “has cost our economy $4.8 billion.”
He continued, “It has prevented Congress from focusing on important national issues such as job creation, gun violence prevention, immigration reform, the Farm Bill, a balanced budget, economic growth and fiscal responsibility. It has eroded the faith people have in our institution of representative government, both at home and around the world. And it achieved nothing.”
Thompson praised the U.S. Senate for coming to its own agreement, and the “responsible Republicans in the House” who voted with Democrats to reopen the government.
He acknowledged that the legislation is a compromise, “far from the best we could have done,” and he spoke out against “partisan brinkmanship and governing from crisis to crisis.”
He said he is urging a balanced approach that cuts spending, requires all to pay a fair share, creates jobs and protects the longevity of such programs as Social Security and Medicare.
“We can now get back to making sure seniors can apply for Social Security, veterans can have their benefits processed, small businesses can get loans, and life-saving medical research can continue,” Thompson said.
Those who want to learn more about the Affordable Care Act may call 800-300-1506, or visit the Covered California website, https://www.coveredca.com.
Solano County panelists assembled by the American Association of University Women will present a similar program at 7 p.m. Nov. 6 at Benicia First Baptist Church, 1055 Southampton Road.
Business people who want to learn how providing health care under the health care act may attend a meeting at 11:30 a.m. Nov. 6 at the USA World Classics Event Center, 1525 Sonoma Blvd., Vallejo. That presentation has been organized by Assemblymember Susan Bonilla, Benicia's representative in the state Assembly.
However, those attending Wednesday night's meeting in Vallejo learned their representative in the House was in Washington, voting to reopen the federal government. In fact, they learned of the successful vote directly from Thompson, who sent the message to staff members who read his note during the meeting.
In Thompson's absence Solano County Suervisor Erin Hannigan fielded questions directed to Keirsha Baron, enrollment specialist from Solano Coalition for Better Health; Anne Edwards, director of Solano County Health and Social Services; and Christina Calvo, Covered California representative and health enrollment specialist with Solano Coalition for Better Health.
They also described different aspects of the act, often called “Obamacare,” a term President Barack Obama, who pressed for health reform legislation, has embraced.
First, Baron said, those who receive insurance from their employers won't experience any change, so long as that insurance also complies with provisions of the act. What has changed is those who couldn't afford insurance, those whose illnesses, such as diabetes or asthma, have been denied insurance, and anyone else who have been uninsured will find it available.
In this state, Covered California is the insurance partnership that provides the marketplace where residents can compare plans and select the ones that fit best, they said.
Those whose income is so low that they qualify for Medi-Cal will find their options also improve next year. For instance, starting next year, low income individual individuals 19 to 64 who have no children will be able to enroll in Medi-Cal, Edwards said.
The program will be expanded to cover mental health and substance abuse treatments, she said.
Most who currently are eligible for Medi-Cal will continue with that program under the ACA. In Solano County, Medi-Cal is administered by Partnership Health Plan.
Those whose income makes them ineligible for Medi-Cal can choose from four tiers are labeled for metals. Bronze has the lowest premiums, but pays for 60 percent of the costs. As the plans go to silver, gold and platinum categories, the premiums rise, but the percentage of costs a subscriber pays and the co-payments required are lower
And in some cases, some may be able to get assistance with co-payments, too.
Premiums are based on such factors as zip code and income, rather than gender or whether someone smokes, Baron said.
Affordable Care Act has provisions for vision and dental care for children, but when the program becomes effective Jan. 1, those options won't be available for adults.
Those who refuse to enroll in health care will be penalized, and those penalties start at $95 a year, or 1 percent of the individual's income. Businesses that are required to provide appropriate health care who fail to do so also will be punished, panelists said.
The state's counties are trying to assure that Covered California works smoothly, and Edwards said those contacting the program won't find themselves “in the wrong door.”
Should someone expect to qualify for Medi-Cal, but fail to do so, they'll be connected with a Covered California contact. Should a Covered California inquirer be eligible for Medi-Cal, that individual would be connected to a Medi-Cal specialist, she said.
Solano County has specialists “from Vallejo to Dixon,” Calvo said. Those registering would need to provide their Social Security number, a pay stub, verification of their annual salary as shown on an income tax return, and a photo identification card.
Those attending the panel talk at Vallejo's Filipino Community Center heard more than just about health care Wednesday night. Thompson, who addressed the audience by video at the meeting's start, sent a message to staff members that a majority of the House of Representatives had joined him in voting to reopen the federal government and to raise the debt ceiling, to “make sure the United States pays its bills on time.”
The decision was a bipartisan vote of 285 to 144. Of the “for” votes, 198 were Democrats and 87 were Republicans.
“The legislation funds the government through Jan. 15, 2014, extends the debt ceiling until Feb. 7, 2014, requires income verification for recipients of subsidies under the Affordable Care Act's exchanges, and provides backpay to furloughed federal workers,” Thompson announced later in a news release.
“The agreement also requires a bipartisan, bicameral budget conference to come up with long-term spending plans by Dec. 13.”
Thompson said, “Today's bipartisan agreement will finally bring this reckless and unnecessary government shutdown and default crisis to an end.”
He blamed “tea party” advocates, describing them as “obsessed with derailing health care reform at any cost,” and said the strategy “has cost our economy $4.8 billion.”
He continued, “It has prevented Congress from focusing on important national issues such as job creation, gun violence prevention, immigration reform, the Farm Bill, a balanced budget, economic growth and fiscal responsibility. It has eroded the faith people have in our institution of representative government, both at home and around the world. And it achieved nothing.”
Thompson praised the U.S. Senate for coming to its own agreement, and the “responsible Republicans in the House” who voted with Democrats to reopen the government.
He acknowledged that the legislation is a compromise, “far from the best we could have done,” and he spoke out against “partisan brinkmanship and governing from crisis to crisis.”
He said he is urging a balanced approach that cuts spending, requires all to pay a fair share, creates jobs and protects the longevity of such programs as Social Security and Medicare.
“We can now get back to making sure seniors can apply for Social Security, veterans can have their benefits processed, small businesses can get loans, and life-saving medical research can continue,” Thompson said.
Those who want to learn more about the Affordable Care Act may call 800-300-1506, or visit the Covered California website, https://www.coveredca.com.
Solano County panelists assembled by the American Association of University Women will present a similar program at 7 p.m. Nov. 6 at Benicia First Baptist Church, 1055 Southampton Road.
Business people who want to learn how providing health care under the health care act may attend a meeting at 11:30 a.m. Nov. 6 at the USA World Classics Event Center, 1525 Sonoma Blvd., Vallejo. That presentation has been organized by Assemblymember Susan Bonilla, Benicia's representative in the state Assembly.
Issues:Health Care