The Edmond Sun

October 9, 2013

Law requires the purchase of health insurance

James Coburn
The Edmond Sun

EDMOND — Most Americans will be required to purchase health care insurance beginning January 1, according to mandates set forth by the Affordable Care Act. There will be a 90-day waiting period to obtain a private health insurance plan or face a tax penalty, the law states.

The objective of the AFC is to make health care more assessable, improve the quality of health care, increase consumer protection and to help control the rising cost of health care, said Patricia Rees, manager for Small Group Account Management for Blue Cross Blue Shield of Oklahoma.

Rees discussed this week how ongoing changes in health care insurance through the Affordable Care Act (AFC) with members of the Edmond Area Chamber of Commerce. Prevention and wellness is emphasized by the ACA, Rees said to a crowd of nearly 100 people.

The thought is that a larger pool of people with health care insurance will help to make the overall cost of health care lower, Rees said. Federal financial assistance will offer premium tax credits available.

“The cost sharing for the plans are lower,” Rees said. “We didn’t do this in Oklahoma, but some states chose to expand Medicaid to allow for some of that coverage.”

More than 650,000 Oklahomans are currently without health care insurance, according to the state. Sixty-five percent of those uninsured residents qualify for an health care subsidy, Rees said. Fifty-nine percent of the uninsured population do not realize open enrollment for the AFC began Oct. 1 and, that they are required by law to obtain health insurance by January 1 or face a fine, Rees added.

“Forty-two percent are currently unaware of the health care law,” Rees said.

All new plans will include coverage for essential health care benefits such as medical and emergency services, she said.

“One thing that is really huge is pediatric dental,” Rees said.

Health care insurance coverage cannot be denied based on age, gender or health status, Rees said. Pre-existing conditions will no longer determine or limit one’s eligibility for health care, according to the AFC.

“The intent is to reach out there and grab some of those people that maybe shied away from coverage,” Rees said.

The new law creates a health insurance market, or exchange to help consumers shop and compare insurance prices. Nobody is required to switch from their current insurance provider. Insurance agents as well as the ACA navigators will be able to assist individuals through the process.

Rees compared the new law to shopping at Travelocity.com. The intent of the insurance exchange is to make it easier to compare policies and choose a health insurance plan from among the carriers, Rees said.

“You can shop for policies that fit your needs if you want certain benefits and certain coverage,” Rees said. “And you can also find out if you qualify for assistance.”



TO LEARN more about the Health Insurance Marketplace, apply for health insurance or to see if you qualify for less expensive insurance than your current plan, visit healthcare.gov.



jcoburn@edmondsun.com | 341-2121