Health insurance enrollment underway
Who qualifies for premium tax credits?
Those who apply for health insurance through the Affordable Care Act marketplace could qualify for tax credits to help pay for monthly premiums. Those who qualify can’t get health insurance through a job or government programs and fall within the income guidelines below.
Number in household and income range:
Individual $12,140 to $48,560
Family of 2 $16,460 to $65,840
Family of 3 $20,780 to $83,120
Family of 4 $25,100 to $100,400
Family of 5 $29,420 to $117,680
Family of 6 $33,740 to $134,960
About 350 area residents are expected to seek help getting health insurance this year, creating a bigger burden on the reduced number of Navigators who provide that help.
Reduced federal funding for the Affordable Care Act, commonly known as Obamacare, means Thrive Allen County hired just three Navigators this year, down from six last year, according to Kelli Frazell, director of health programs with Thrive.
The change means Thrive will offer help by appointment only at their office at 9 S. Jefferson Ave., with special hours on select Saturdays and at the Humboldt Library. Thrive’s phone is 620-365-8128.
Cindy Greenhagen of the Community Health Center of Southeast Kansas, 2051 N. State St., is also a local Navigator. She can be reached by calling 620-380-6600.
Joy Miller of the Southwind Extension District also works as a Navigator out of their Fort Scott office. She can be reached by calling 620-223-3720.
Appointments could fill up fast, so those looking for help should call immediately. The open enrollment period ends Dec. 15.
Thrive is offering extended and evening hours, including some Saturday appointments.
“We’re really flexible. We will work with your schedule,” Frazell said.
The Affordable Care Act offers health insurance through its Marketplace, with tax credits available to help offset the cost of premiums. Tax credits and cost of the monthly premium will vary, depending on the size of a household and its income.
Overall, premiums through Blue Cross Blue Shield of Kansas increased 8.28% this year compared to last year, Frazell said. Most Allen County and area residents who use the Marketplace obtain BCBS.
And though premiums may cost more, in many cases those increases could be offset by an increased tax credit. Thrive navigator Greta Ingle said she worked with one resident, a single man with an annual income of around $22,000, whose premium costs decreased to $17.69 this year from nearly $30 last year after receiving a monthly subsidy of more than $900.
But Frazell said one of her clients saw his premium increase about $45 a month, from $165 last year to $210. Without the subsidy, he would have paid $1,200 per month for the policy.
IT’S heartbreaking to tell someone they don’t qualify for affordable health insurance through the Marketplace, Frazell said. That’s because of the Medicaid gap, when someone makes too much money to qualify for Medicaid but doesn’t make enough to qualify for a tax credit through the Affordable Care Act.
For example, a family of three with dependent children can’t have an income of more than 33 percent of the federal poverty level, or $6,738 in 2017.
Last year, Thrive Navigators saw 53 people who fell into the gap, out of a total of 347 appointments.
“To have to look at a family or look someone in the eyes and say, ‘I’m sorry there’s nothing I can do for you,’ that’s the worst,” Frazell said.
In those instances, Navigators can look for other programs for which a family might qualify, such as food assistance or health care centers that base payments on a sliding scale based on income.
Even those who fall into the Medicaid gap still should apply for insurance through the Marketplace, Frazell said. Federal rule changes will require an existing enrollment on file if Kansas were to reverse course and expand Medicaid. With the recent election of Laura Kelly as governor, that could happen. The legislature last year voted to expand Medicaid, but was vetoed by then-Governor Sam Brownback. Kelly has promised to make Medicaid expansion a top priority, but it remains to be seen if the new legislature will support those efforts.
IT'S ALSO important to see a Navigator whenever you have a life change, like having a baby, marriage or divorce, or a job or income change. Thrive offers assistance throughout the year to help with those things, or just to answer questions about coverage or to print tax forms.
Last year, about 200 people visited Thrive for those types of issues after the enrollment period.
It’s not required to use a Navigator to obtain insurance through the Marketplace, but Thrive’s Navigators are trained to understand complicated situations and can help find the best policy for a particular need. They also provide education and offer tips such as what to expect after you receive an insurance card.
With the ACA entering its sixth year, most of those who come to Thrive for help know how the program works, Frazell said. Even so, Navigators saw 81 new visitors last year, including some who had a job change and were without insurance for the first time.
“It’s so rewarding to help someone get health insurance,” she said. “They can come to a safe place, sit down with someone they trust to provide personal information, and walk away covered with health insurance. These are things that some people take for granted.”