As deadline approaches, Obamacare discussed at meeting

Peter Van Loon, COO of Access Health Connecticut, was on hand last week to discuss the facts of the Affordable Care Act as the March 31 deadline for the open enrollment period comes closer. —Ken Borsuk

Peter Van Loon, COO of Access Health Connecticut, was on hand last week to discuss the facts of the Affordable Care Act as the March 31 deadline for the open enrollment period comes closer. —Ken Borsuk

With a deadline looming, Greenwich’s delegation to the General Assembly got together last week for a presentation designed to answer questions about the Affordable Care Act (ACA).

But if anyone was expecting a debate about the pros and cons of the ACA, more commonly known as Obamacare, from the all-Republican delegation, they were disappointed. It was a “just the facts” meeting at Town Hall to try and answer questions about the law, which has a March 31 deadline set to end the open enrollment period for people looking to participate.

“Whether or not I personally like [the ACA] is not the issue,” State Rep. Fred Camillo (R-151st) said in his unofficial role as host of the event. “Our job as elected officials are to help people get their questions answered and get them all the information possible. People are very anxious and we know there are going to be bumps in the road with this but it’s hard to say that to someone who just had their premiums doubled and tripled. Hopefully this will ease those concerns but bear with us because we’re just getting started with this.”

Mr. Camillo was joined at the event by State Sen. L. Scott Frantz (R-36th) and State Reps. Livvy Floren (R-149th) and Stephen Walko (R-150th), but the politicians mostly stayed out of the way and let the panel do the talking. The discussion was led by Peter Van Loon COO of Access Health Connecticut, which handles the health care marketplace for Connecticut, Linda Ziac, president of the Caregiver Resource Association and James Brunetti II, a specialist in internal medicine with a practice in Greenwich who Mr. Camillo joked probably had most of the attendees as patients.

Mr. Van Loon focused on the upcoming March 31 deadline that will end the open enrollment period to go to Access Health Connecticut’s site online at Accesshealthct.com to use the exchange to find a health care plan. There will be a new enrollment period in the fall but when that specifically will be is still unknown, but Mr. Van Loon said there are circumstances people can still shop the state exchange to find a plan they like even after the deadline.

“This doesn’t mean you can’t get Medicaid,” Mr. Van Loon said. “You can keep coming to our site or using our call center and if you’re eligible we will put you on. It also doesn’t mean that you can’t sign up until next year for health care if you have a qualifying event.”

Mr. Van Loon said people those qualifying events include births, deaths, marriage, loss of a job or other circumstances. In that case people can still go to the site and see if they’re eligible to find insurance through it. Despite this, with the deadline coming soon, Mr. Van Loon said he anticipated a lot of activity at the site leading up to March 31.

Access Health Connecticut is a non-profit agency but it needs to be self-sustaining. By going to the site, people are evaluated and it’s determined if first they’re eligible for Medicaid. If they are, the person is redirected to the state’s Department of Social Services. If they’re not, then they’re eligible for insurance and it has to be determined if they’re eligible for a subsidy for that. Mr. Van Loon said each person is evaluated based on their circumstances and there are subsidies to provide cost-sharing reductions that will lower deductibles and advanced premium tax credits which allows for the federal government to help with health care costs through tax credits.

According to Mr. Van Loon, Access Health Connecticut is a “quasi-state agency” that reports to a board of directors chaired by Lt. Gov. Nancy Wyman. He said that going forward it would be looking to generate revenue through its own work or assessments on health care companies in the state.

Mr. Van Loon noted the years of work that went into establishing the site to feature the Connecticut health care plan marketplace so things could open smoothly last Oct. 1. While the national launch of the ACA at Healthcare.gov was plagued by technological glitches and website issues, Connecticut had a relatively smooth launch with its exchange.

“In October, November and December, people were saying, ‘Hey I can’t sign up in Connecticut because Healthcare.gov, but that’s a mistake,” Mr. Van Loon said. “We’ve been signing people up through our site at Accesshealthct.com since Oct. 1. Every day now we’re getting 2,000-3,000 people to sign up.”

As of the night of the meeting, March 5, Mr. Van Loon said more than 150,000 people had come through the system and signed up. But, like the federal site, Mr. Van Loon said there had been a little bit of underestimating how much interest there would be, leading to some issues. He said that the organization has quadrupled the number of people answering phones and there had also been increases in education and training for the call center, the brokers and in person assistance people.

“They have the knowledge, not just in the law, but how the system works and why the system needs the information it does,” Mr. Van Loon said.

Ms. Ziac, a licensed psychotherapist and case manager, spoke from the perspective of dealing with seniors, people with special needs and their families on health care issues and challenges. She discussed some of the changes that have come about since the ACA and the Mental Health Parity Act went into effect. Ms. Ziac said insurance companies were once allowed to set yearly and lifetime dollar limits on coverage and benefits, which she said was a particular problem for mental health and substance abuse treatment. She said the ACA is designed to end this as well as eliminate the ability of insurance companies to reimburse at a lower rate for mental health treatment and to stop companies from denying coverage because of preexisting conditions.

By eliminating these and by making sure preventative and wellness services are offered without a copay or a deductible, Ms. Ziac said more people can get access to services they need. She offered up several positive aspects of the law but stressed she was not there to advocate for it or speak against it, but rather to simply explain what’s going on with it.

Dr. Brunetti discussed some of the challenges facing doctors, particularly in internal medicine and general medicine.

“Hopefully this affordable care act will help us sort of chart the waters through the difficulties,” Dr. Brunetti said. “Some of the difficulties we’re finding so far is that the cost to run a practice is extremely exorbitant, especially in this area. Rules that apply to the health care act in Wisconsin or Georgia or even some places in the western part of the country don’t really apply to us. We’re a pretty unique area. Large practices and hospitals are really taking over the private practitioner because of the amount of cost and the amount of volume.”

Dr. Brunetti said the intent of many of the health care plans is good but that they have goals that are difficult to achieve such as lowering costs by getting people to quit smoking or change diets. He did praise parts of the ACA including not permitting insurance companies to deny coverage to people with preexisting conditions and making sure people can’t be dropped by insurance companies if they get sick.

However, he did express concerns about how all of this is being funded.

“The problem I’m finding at my practice and other practitioners are finding is that a lot of this is based on a young, healthy population of patients that are basically going to basically fund this,” Dr. Brunetti said. “This is a very unique structure that’s a big pyramid plan because you have the young people in the 18-35 range you’re basing the funding for this on. I can tell you from my practice that the last people that are going to fund this are the 18-35 range.”

Dr. Brunetti said these and other concerns would have to be dealt with as the law continued. He predicted that “increased patient responsibility” to not only live healthier but to understand their plans was going to be a big challenge going forward and that there was going to be a lot of patients and doctors working more as a team.

 

[email protected]

By participating in the comments section of this site you are agreeing to our Privacy Policy and User Agreement

© Hersam Acorn. All rights reserved. The Greenwich Post, 10 Corbin Drive, Floor 3, Darien, CT 06820

Designed by WPSHOWER

Powered by WordPress