Tale of two health exchanges: 'Mad rush' in Kentucky & 'chase phase' in Ohio as 3/31 deadline nears

CINCINNATI - For those who haven’t enrolled in a healthcare plan as of yet, the clock is ticking.

Monday, March 31 marks the final day for uninsured Americans to sign up for the Affordable Care Act (ACA). Those who miss this week’s deadline may face costly treatment options, as well as escalating penalties for failing to register. The next official opportunity for those without special circumstances to sign up will be Nov 15, 2014

The cost of waiting

According to John Losey, kynector IPA (In Person Assistant) for the Boone County Office of Northern Kentucky Community Action, the mad rush started last week. His schedule is completely filled with appointments through the final day of registration. He said he’s expects to enroll about twice the number of people as last month.

“I think I had a total of 56 in February, and right now for March I’m probably looking at close to 60 already,” he said. ”I know the kynectors in Campbell County and Kenton County have been doing on average of 100 per month.”

For procrastinators, waiting to sign up can be a costly experience. Trey Daly, Director of Enroll America in Ohio, said the uninsured face two repercussions. Aside from the fines, the financial risk of incurring high medical debt is spurring people to register at the eleventh hour.

“Most Americans are now subject to what they call the individual mandate, they have to have health coverage and if they don’t qualify for one of the exceptions, they have to pay a tax fine next year when they file their tax return,” he said.

Fines imposed under the Affordable Care Act

"The penalty is calculated one of two ways. You’ll pay whichever of these amounts is higher"

  • 2014: 1% of yearly household income, not to exceed $285
    • OR $95 per person, $47.50 per child under 18
  • 2015: 2% of yearly household income
    • OR $325.00 per person
  • 2016 : 2.5% of yearly household income
    • OR $695.00 per person
  • MORE: What is someone doesn't have health coverage in 2014?

Gwenda Bond, spokesperson for the Kentucky cabinet, said Instead of focusing on the penalty, kynect has great success marketing the positive aspects of the program. She said while Kentucky does include information about the fine in marketing materials, official wills be more aggressive next year when the penalty increases.

“Our focus is more on people know what the program is, they can sign up and they at least start their application by the deadline so that they can have a choice,” Bond said “If they don’t qualify for Medicaid, they still may be able to get subsidies and discounts that will cover the cost. But otherwise, if they want to avoid the full-year penalty, they’ll have to shop in individual market where there are no subsidies available.”

On March 4, the Congressional Budget Office (CBO) revised its cost estimate for the first 10 years of the ACA , lowering it $9 million from $1,363 billion to $1,354 billion for 2014 to 2023.

The change in forecast is due to the anticipated receipt of approximately $517 billion in penalties from uninsured people and employers, as well as excise tax on high-premium insurance plans and other budgetary effects.

Rush to register in Kentucky

This is crunch time for kynectors, said Carrie Banahan, executive director of the Office of the Kentucky Health Benefit Exchange. She explained those who qualify for Medicaid or experience other circumstances such as job loss, pregnancy, marriage or young adults who lose health coverage after turning 26 all qualify throughout the year. Everyone else must register by the deadline to get coverage.

“The problem is a lot of folks might not understand what the income limits are fore the different programs,” she said. “So just to be on the safe side, everybody needs to try to apply by March 31.”

In addition to meeting with a kynector or speaking with a call center representative, Banahan said the kynect website features of great deal information to help people recognize if they qualify for Medicaid or payment assistance.

“If they can’t get in to see a kynector, they can apply online on their own if they feel comfortable and start an application,” Banahan said. “If they feel overwhelmed, they can call the call center during the application process and they’ll talk them through the rest of the process.”

Kentucky health exchange enrollment numbers remain impressive in comparison with the national average. Governor Steve Bashear has been a strong proponent for the program, expanding the income eligibility requirement for Medicaid to 138 percent of the federal poverty level, allowing many low-income Kentuckians access to health care. These include individuals making less than $15,856 a year and families of four with income below $32,499.

kynect by the numbers (Source: Kentucky Governor’s Office)

  • 1.3 million: visitors to kynect.ky.gov
  • 787,591:
    • people who qualified for subsidies, discounts or programs like Medicaid
    • 321,932: Kentuckians enrolled, including Medicaid and private insurance
    • 257,477: people who qualified for Medicaid coverage
    • 64,555: people who purchased private insurance
    • 49% of enrollees are under the age of 35
    • 32% of enrollees with private health plans under the age of 35 

    Original numbers from the CBO showed for the ACA to succeed in year one, an estimated 39 percent of people 35 year of age and younger needed to enroll. The exact figures were based on the prediction that 7 million people would sign up, with 2.7 million of those considered to be the "invincibles."

    Kentucky boasts high numbers in signing up the coveted group, consisting or those from the ages of 18 to 35 and considered to be healthy young adults. Banahan explained, they reached the demographic by targeting events attended by young adults as well as reaching out using social media.

    “Looking into the follow up enrollment, we’re planning to do some tweets to appeal to that demographic even more because we do have a large population that does fall into that under 35 demographic that are still uninsured,” she said.

    The Ohio picture

    In terms of signing up those under 35, Ohio is lagging behind Kentucky: 21 percent of health exchange enrollees are in the "invincibles" catergory. Ohio Lieutenant Governor Mary Taylor has a theory about why the state’s enrollment falls below the national average. With fewer of the group signing up, the potential looms for higher insurance premiums.

    In a written statement, Taylor said:

    "Obamacare continues to fail following its embarrassing launch on October 1 when just 6 Americans signed up for coverage. Since October 1, premiums are going up and millions of consumers have lost health plans that President Obama promised they could keep. That is why Governor Kasich and I said no to a state-run, Obamacare exchange that would have cost millions of taxpayer dollars without providing the choice and affordability Ohioans want and need."

    Ohio by the numbers (Source: Governor’s Office and U.S. Department of Health and Human Services)

    • 193,152: eligible Ohio residents 
    • 78,925: Ohio Residents Enrolled  
    • 59% of eligible people are not enrolled
    • 21% of those enrolled are aged 18-24, 4% below national average
    • 14% are aged 26-35
    • 7% are aged 18-24
    • 38% are aged 55-64

    Even with its positive numbers, Kentucky has its critics as well. On Wednesday, Senate Minority Leader Mitch McConnell said the law has "basically become the legal equivalent of Swiss cheese," due to extensions.

    "They said it would create jobs," McConnell said from the Senate floor. "They also said it would improve the economy, lower premiums, and insure the uninsured without causing Americans to lose their insurance, their doctors, or their hospitals. But now, Americans know better.”

    Signing up Cincinnati: The "chase phase"

    Daly said Enroll America in Ohio has been working around the clock to boosts its numbers. To reach local residents, the organization has hosted a number of events throughout the region. He explained the organization is in the "chase phase," following up with as many of the uninsured as possible.

    “We’re in the process of calling them back to see if they got enrolled yet,” Daly said. “If they haven’t, have they faced any barriers to the process? Do they need any help in the process? And then we try to connect them with enrollment assisters in the community. So there’s a lot going on.”

    While on the road, Daly said he's seen first-hand the positive impact obtaining health insurance can have on people. He said the experience itself is incredibly liberating for those who never thought they could receive healthcare because of a pre-existing condition or other circumstances.

    “The positive impact is multi-layered,” he said. “It’s not just an access to health coverage, it’s not just a question of financial security; people don’t have to be stuck in a job they hate anymore because the health coverage. They’re going to be able to look for new opportunities because of this law too.”


    For information about signing up in Kentucky:

    • Visit www.kynect.healthcare.com or call (855) 238-6179.
    • The call center will be open from 8 a.m. to 7 p.m. Friday and Monday, and 9 a.m. to 4 p.m., Saturday and Sunday.

    For information about signing up in Ohio:

    • Enroll America registration event:
      • Cincinnati Main Library, 800 Vine St.
      • March 30: 1 to 5 p.m.
    • Enroll-a-thon event
      • 1041 Foraker Ave., Walnut Hills
      • March 30 and 31: 9 a.m. to 9 p.m.
      • For more information call (513) 667-2304

    RELATED Tale of two health exchanges: How are consumers in Ohio and Kentucky faring?

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