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"content": "\u003cfigure id=\"attachment_14905\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/160879474-e1378837663107.jpg\">\u003cimg class=\"size-large wp-image-14905\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/160879474-640x425.jpg\" alt=\"Choosing the right plan can mean keeping money in your pocket. (Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Choosing the right plan can mean keeping money in your pocket. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Michelle Andrews\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2013/09/10/220977210/why-more-expensive-insurance-can-pay-off\" target=\"_blank\">NPR and Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>One of the most far-reaching provisions of the federal health overhaul prohibits insurers from refusing to cover people who are sick or charging them more for policies.\u003c/p>\n\u003cp>Still, for people with serious medical conditions, the online health insurance marketplaces present new wrinkles that could have significant financial impact.\u003c/p>\n\u003cp>Obviously, premium costs will be an important consideration for consumers. But just as important will be a realistic assessment of what kinds of out-of-pocket costs they could expect with different types of policies and what subsidies they will be eligible for.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Even though the premium for a platinum plan will generally be higher, the out-of-pocket spending cap may be significantly lower than other coverage levels.\u003c/aside>\n\u003cp>The law requires new individual and small group plans sold on the online marketplaces, also called exchanges, and on the private market to cover a comprehensive set of 10 essential health benefits, including prescription drugs, hospitalization and doctor visits. The benefits covered will be similar in all plans, but the proportion of the costs that a consumer pays will vary.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There will be four different levels of plan coverage. Platinum plans will pay 90 percent of covered expenses, on average; gold plans will pay 80 percent; silver plans 70 percent; and bronze plans 60 percent.\u003c!--more-->\u003c/p>\n\u003cp>Tax credits to help cover the \u003ca href=\"http://www.kaiserhealthnews.org/stories/2013/july/24/interview-with-cathy-livingston-on-how-to-apply-for-tax-credit-subsidies-for-premiums.aspx\">cost of the premiums\u003c/a> for plans sold on the exchanges will be available to people with incomes up to 400 percent of the federal poverty level (about $46,000 for an individual; $94,000 for a family of four ), and \u003ca href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/070913-Michelle-Andrews-on-cost-sharing-subsidies.aspx\">cost-sharing subsidies\u003c/a> will reduce out-of-pocket costs for people with incomes up to 250 percent of poverty ($28,725 for an individual).\u003c/p>\n\u003cp>The maximum amount that consumers will owe out of pocket for in-network medical claims will generally be capped at about $6,400 for individuals and $12,700 for families in 2014. (Note that those figures don't include money spent on premiums.)\u003c/p>\n\u003cp>How all those variables come together can have a big effect on people with high medical expenses.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Don't Miss:\u003c/strong> \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained -- A Guide for Californians\u003c/a>]\u003c/p>\n\u003cp>For example, even though the premium for a platinum plan will generally be higher, the out-of-pocket spending cap may be significantly lower than other coverage levels since platinum plans must cover 90 percent of expenses. In California, for example, the \u003ca href=\"http://www.healthexchange.ca.gov/Solicitations/Documents/022513CA%20HBEX%20Standardized%20Designs%20%20w%20final%20av%20calc.pdf\">out-of-pocket spending limit\u003c/a> on a platinum plan is $4,000, compared with $6,400 for other plans.\u003c/p>\n\u003cp>For people who expect to hit their spending cap, buying a pricier platinum plan may actually result in lower total spending, says Marc Boutin, executive vice president and chief operating officer at the \u003ca href=\"http://www.nationalhealthcouncil.org/pages/page-content.php?pageid=88\">National Health Council\u003c/a>, a patient advocacy organization.\u003c/p>\n\u003cp>\"It's counterintuitive,\" he says.\u003c/p>\n\u003cp>Insurers anticipate that people with high medical costs will gravitate toward platinum and, to a lesser extent, gold plans, and they're pricing those plans accordingly, say experts.\u003c/p>\n\u003cp>If only one member of a family has high medical expenses, families may want to consider splitting coverage between different plans.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Many insurers are expecting that savvy families will enroll a sick family member in a platinum plan and the rest in lower level plans,\" says Jennifer Tolbert, director of state health reform with the Kaiser Family Foundation.\u003c/p>\n\n",
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"headline": "How More Expensive Health Insurance Might Actually Save You Money",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14905\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/160879474-e1378837663107.jpg\">\u003cimg class=\"size-large wp-image-14905\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/160879474-640x425.jpg\" alt=\"Choosing the right plan can mean keeping money in your pocket. (Getty Images)\" width=\"640\" height=\"425\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Choosing the right plan can mean keeping money in your pocket. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Michelle Andrews\u003c/strong>, \u003ca href=\"http://www.npr.org/blogs/health/2013/09/10/220977210/why-more-expensive-insurance-can-pay-off\" target=\"_blank\">NPR and Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>One of the most far-reaching provisions of the federal health overhaul prohibits insurers from refusing to cover people who are sick or charging them more for policies.\u003c/p>\n\u003cp>Still, for people with serious medical conditions, the online health insurance marketplaces present new wrinkles that could have significant financial impact.\u003c/p>\n\u003cp>Obviously, premium costs will be an important consideration for consumers. But just as important will be a realistic assessment of what kinds of out-of-pocket costs they could expect with different types of policies and what subsidies they will be eligible for.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Even though the premium for a platinum plan will generally be higher, the out-of-pocket spending cap may be significantly lower than other coverage levels.\u003c/aside>\n\u003cp>The law requires new individual and small group plans sold on the online marketplaces, also called exchanges, and on the private market to cover a comprehensive set of 10 essential health benefits, including prescription drugs, hospitalization and doctor visits. The benefits covered will be similar in all plans, but the proportion of the costs that a consumer pays will vary.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There will be four different levels of plan coverage. Platinum plans will pay 90 percent of covered expenses, on average; gold plans will pay 80 percent; silver plans 70 percent; and bronze plans 60 percent.\u003c!--more-->\u003c/p>\n\u003cp>Tax credits to help cover the \u003ca href=\"http://www.kaiserhealthnews.org/stories/2013/july/24/interview-with-cathy-livingston-on-how-to-apply-for-tax-credit-subsidies-for-premiums.aspx\">cost of the premiums\u003c/a> for plans sold on the exchanges will be available to people with incomes up to 400 percent of the federal poverty level (about $46,000 for an individual; $94,000 for a family of four ), and \u003ca href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/070913-Michelle-Andrews-on-cost-sharing-subsidies.aspx\">cost-sharing subsidies\u003c/a> will reduce out-of-pocket costs for people with incomes up to 250 percent of poverty ($28,725 for an individual).\u003c/p>\n\u003cp>The maximum amount that consumers will owe out of pocket for in-network medical claims will generally be capped at about $6,400 for individuals and $12,700 for families in 2014. (Note that those figures don't include money spent on premiums.)\u003c/p>\n\u003cp>How all those variables come together can have a big effect on people with high medical expenses.\u003c/p>\n\u003cp style=\"text-align: center\">[\u003cstrong>Don't Miss:\u003c/strong> \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained -- A Guide for Californians\u003c/a>]\u003c/p>\n\u003cp>For example, even though the premium for a platinum plan will generally be higher, the out-of-pocket spending cap may be significantly lower than other coverage levels since platinum plans must cover 90 percent of expenses. In California, for example, the \u003ca href=\"http://www.healthexchange.ca.gov/Solicitations/Documents/022513CA%20HBEX%20Standardized%20Designs%20%20w%20final%20av%20calc.pdf\">out-of-pocket spending limit\u003c/a> on a platinum plan is $4,000, compared with $6,400 for other plans.\u003c/p>\n\u003cp>For people who expect to hit their spending cap, buying a pricier platinum plan may actually result in lower total spending, says Marc Boutin, executive vice president and chief operating officer at the \u003ca href=\"http://www.nationalhealthcouncil.org/pages/page-content.php?pageid=88\">National Health Council\u003c/a>, a patient advocacy organization.\u003c/p>\n\u003cp>\"It's counterintuitive,\" he says.\u003c/p>\n\u003cp>Insurers anticipate that people with high medical costs will gravitate toward platinum and, to a lesser extent, gold plans, and they're pricing those plans accordingly, say experts.\u003c/p>\n\u003cp>If only one member of a family has high medical expenses, families may want to consider splitting coverage between different plans.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"Many insurers are expecting that savvy families will enroll a sick family member in a platinum plan and the rest in lower level plans,\" says Jennifer Tolbert, director of state health reform with the Kaiser Family Foundation.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Obamacare FAQ: How Will the Individual Mandate Work?",
"title": "Obamacare FAQ: How Will the Individual Mandate Work?",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_14711\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/Screen-Shot-2013-09-03-at-11.11.50-AM.png\">\u003cimg class=\"size-large wp-image-14711\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/Screen-Shot-2013-09-03-at-11.11.50-AM-640x426.png\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alvin Tran\u003c/strong>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/September/03/FAQ-on-individual-insurance-mandate-ACA.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>It's one of the key building blocks of the insurance overhaul: the individual mandate. It requires most people to obtain health insurance or pay a tax penalty.\u003c/p>\n\u003cp>If you already have insurance through work or a government health insurance program like Medicare or Medi-Cal, you're set. If not, you can shop on a new online marketplace, such as Covered California here in the Golden State.\u003c/p>\n\u003cp>Yet 26 percent of Americans aren't aware of the requirement or didn't think the law included it, according to a \u003ca href=\"http://www.kff.org/health-reform/poll-finding/march-2013-tracking-poll/\" target=\"_blank\">March 2013 Kaiser Family Foundation poll\u003c/a>.\u003c/p>\n\u003cp>Here are some basic questions and answers about mandate.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Q. What is the individual mandate?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">“This individual mandate is to keep premiums low for everyone. If you don’t have incentives for everyone to sign up then only the sick people will enroll.\"\u003c/aside>\n\u003cp>A. The individual mandate is a provision of the federal health law (i.e. \"Obamacare\") that requires you, your children and anyone else that you claim as a dependent on your taxes to have health insurance in 2014 or pay a penalty. That coverage can be supplied through your job, public programs such as Medicare or Medicaid, or an individual policy that you purchase. The health law is setting up online health insurance marketplaces, also known as exchanges, to help you shop for plans.\u003c/p>\n\u003cp>\u003cstrong>Q. Who is affected by the mandate?\u003c/strong>\u003c/p>\n\u003cp>A. The mandate is aimed at some of the 57 million people younger than 65 who now do not have insurance. Roughly 7 million of those without insurance live in California.\u003c/p>\n\u003cp>\u003cstrong>Q. Are there any exceptions to the mandate?\u003c/strong>\u003c/p>\n\u003cp>A. Yes, the government has \u003ca href=\"http://healthaffairs.org/blog/2013/06/27/implementing-health-reform-exemptions-from-the-individual-mandate/\" target=\"_blank\">identified exemptions\u003c/a>. Individuals who cannot afford coverage because the cost of premiums exceed 8 percent of their household income or those whose household incomes are below the minimum threshold for filing a tax return are exempt.\u003c!--more-->\u003c/p>\n\u003cp>Other exempt groups include prisoners, Native Americans eligible for care through the Indian Health Care service, immigrants who are in the country illegally, people whose religion objects to having insurance coverage, members of a \u003ca href=\"http://www.kaiserhealthnews.org/features/insuring-your-health/michelle-andrews-on-health-care-religious-cooperatives.aspx\" target=\"_blank\">health care sharing ministry\u003c/a> and individuals who experience a short coverage gap of less than three consecutive months.\u003c/p>\n\u003cp>\u003ca href=\"http://cbo.gov/sites/default/files/cbofiles/attachments/09-19-12-Indiv_Mandate_Penalty.pdf\" target=\"_blank\">CBO estimates\u003c/a> that in 2016, after the major provisions of the health law are implemented, 24 million people will be exempted from the mandate's penalties.\u003c/p>\n\u003cp>\u003cstrong>Q. What happens if I don't get coverage?\u003c/strong>\u003c/p>\n\u003cp>A. If you do not have the minimum level of coverage and do not qualify for an exemption, you must pay a penalty to the IRS at the end of the tax year. The penalty for the first year is up to $95 per adult and $47.50 per child, or 1 percent of family income, whichever is greater.\u003c/p>\n\u003cp>The fine, however, increases over time and in 2016 will be as much as $695 per adult and $347 per child (up to $2,085 for a family) or 2.5 percent of family income, whichever is greater.\u003c/p>\n\u003cp>The amount you owe will be pro-rated to reflect the number of months you were without coverage.\u003c/p>\n\u003cp>\u003ca href=\"http://cbo.gov/sites/default/files/cbofiles/attachments/09-19-12-Indiv_Mandate_Penalty.pdf\" target=\"_blank\">CBO estimates\u003c/a> that 6 million people, about 2 percent of the population, will be assessed a penalty in 2016.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I satisfy the mandate and how does the law help me afford insurance?\u003c/strong>\u003c/p>\n\u003cp>A. Again, if you have employer-based health insurance, Medicare or Medicaid (in California, Medi-Cal), you are set.\u003c/p>\n\u003cp>If you are uninsured or thinking about switching plans, you can shop for coverage through the online marketplaces beginning Oct. 1. The Covered California marketplace is scheduled to open at that time.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more about the health law in KQED's guide, \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained\u003c/a>, just for Californians.\u003c/aside>\n\u003cp>The marketplaces will also offer tax subsidies to help reduce the cost of premiums. If your income is less than 400 percent of the federal poverty level ($45,960 for an individual and $94,200 for a family of four in 2013), you likely will qualify for a subsidy.\u003c/p>\n\u003cp>People with incomes up to 250 percent of the federal poverty level ($28,725 for an individual and $58,875 for a family of four in 2013) are also eligible for cost-sharing subsidies. These additional subsidies will substantially reduce the deductibles, copayments, coinsurance and total out-of-pocket spending limits.\u003c/p>\n\u003cp>Although the law takes effect Jan. 1, the initial enrollment period continues through March 31. Since people are exempted for a short coverage gap – less than three months – individuals that obtain coverage before the end of March will be exempt from the payment for that period.\u003c/p>\n\u003cp>\u003cstrong>Q. Why is there a mandate anyway?\u003c/strong>\u003c/p>\n\u003cp>A. The health law was designed to extend insurance to nearly all people, including those who have medical conditions that require expensive care and are often denied coverage today. But to pay for their care, insurance companies need to have a large enrollment of consumers, especially young and healthy people who use fewer services. The mandate was adopted to guarantee a broad base.\u003c/p>\n\u003cp>\u003ca href=\"http://www.americanprogress.org/about/staff/spiro-topher/bio/\" target=\"_blank\">Topher Spiro\u003c/a>, the vice president of health policy at the Center for American Progress, a left-leaning nonprofit that supports the law, says Obamacare will be more effective with the mandate than without it. \"This individual mandate is to keep premiums low for everyone,\" he said, noting that \"if you don’t have incentives for everyone to sign up for coverage then only the sick people will enroll,\" and that drives up premiums.\u003c/p>\n\u003cp>But others suggest the mandate won't be effective because the penalties are set so much lower than the cost of coverage.\u003c/p>\n\u003cp>\"The mandate was an attempt to get around the fact that insurance is going to become a lot more expensive for a lot of people even with the subsidies,\" said \u003ca href=\"http://www.aei.org/scholar/joseph-antos/\" target=\"_blank\">Joseph Antos\u003c/a>, an economist with the conservative American Enterprise Institute. Antos believes the tax penalty for remaining uninsured is too low and questions the government’s ability to identify those who end up not filing taxes. \"I would argue that the individual mandate is largely unenforceable and does not turn out to be this solution to the other problems that raise insurance costs for that particular group of people,\" he added.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I report my coverage or exemptions to the government?\u003c/strong>\u003c/p>\n\u003cp>A. You will not have to report your coverage or exemptions until you file your 2014 income tax return, which won't be due until April 15, 2015. Insurance providers will also be required to help their clients report their health coverage. The Internal Revenue Service says it will put out details later about how the reporting will work.\u003c/p>\n\u003cp>If your income is so low that you do not file a tax return, you are exempt from paying the penalty.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I apply for an exemption?\u003c/strong>\u003c/p>\n\u003cp>If you are seeking an exemption for incarceration, membership in an Indian tribe or health care sharing ministry, you can apply through the health insurance exchanges or make a claim when you file taxes, according to a final rule issued by the U.S. Department of Health and Human Services. If you are claiming economic hardship or a religious exemption, you must get an exemption certificate from the online insurance exchange. If you are claiming that coverage is unaffordable, you are in the United States without proper documentation or have a coverage gap of less than three months, you can make the claim when you file your 2014 taxes in 2015.\u003c/p>\n\u003cp>\u003cstrong>Q. Where did the idea of the mandate originate?\u003c/strong>\u003c/p>\n\u003cp>A. The origins of the individual mandate have been controversial. Many Democrats who support the law suggest it was originally a conservative idea developed in 1989 by the Heritage Foundation's Stuart Butler to counter liberals' efforts to establish a single payer system and impose a mandate on employers to provide insurance. Several years afterward, Republicans used the individual mandate in a bill they offered as an alternative to Bill Clinton's proposal to overhaul health insurance. The mandate also was incorporated as part of the Massachusetts overhaul of health insurance in 2006 under then-Gov. Mitt Romney.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Democrats later adapted the concept and pushed it as part of the congressional debate over the Affordable Care Act, despite President Barack Obama's initial reluctance to embrace it. Whatever their prior views, most conservatives opposed the health law's version of the mandate, and Butler made a\u003ca href=\"http://usatoday30.usatoday.com/news/opinion/forum/story/2012-02-03/health-individual-mandate-reform-heritage/52951140/1\" target=\"_blank\"> spirited argument \u003c/a>that the current mandate is not what he was endorsing years ago.\u003c/p>\n\n",
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"excerpt": "It's one of the key building blocks of the insurance overhaul: the individual mandate. The mandate requires most people to obtain health insurance or pay a tax penalty.\r\n\r\nIf you already have insurance through work or a government health insurance program like Medicare or Medi-Cal, you're set. If not, you can shop on a new online marketplace, such as Covered California here in the Golden State.\r\n\r\nYet 26 percent of Americans aren't aware of the requirement or didn't think the law included it, according to a March 2013 Kaiser Family Foundation poll.",
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"description": "It's one of the key building blocks of the insurance overhaul: the individual mandate. The mandate requires most people to obtain health insurance or pay a tax penalty.\r\n\r\nIf you already have insurance through work or a government health insurance program like Medicare or Medi-Cal, you're set. If not, you can shop on a new online marketplace, such as Covered California here in the Golden State.\r\n\r\nYet 26 percent of Americans aren't aware of the requirement or didn't think the law included it, according to a March 2013 Kaiser Family Foundation poll.",
"title": "Obamacare FAQ: How Will the Individual Mandate Work? | KQED",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14711\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/Screen-Shot-2013-09-03-at-11.11.50-AM.png\">\u003cimg class=\"size-large wp-image-14711\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/09/Screen-Shot-2013-09-03-at-11.11.50-AM-640x426.png\" alt=\"(Getty Images)\" width=\"640\" height=\"426\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Alvin Tran\u003c/strong>, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/September/03/FAQ-on-individual-insurance-mandate-ACA.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>It's one of the key building blocks of the insurance overhaul: the individual mandate. It requires most people to obtain health insurance or pay a tax penalty.\u003c/p>\n\u003cp>If you already have insurance through work or a government health insurance program like Medicare or Medi-Cal, you're set. If not, you can shop on a new online marketplace, such as Covered California here in the Golden State.\u003c/p>\n\u003cp>Yet 26 percent of Americans aren't aware of the requirement or didn't think the law included it, according to a \u003ca href=\"http://www.kff.org/health-reform/poll-finding/march-2013-tracking-poll/\" target=\"_blank\">March 2013 Kaiser Family Foundation poll\u003c/a>.\u003c/p>\n\u003cp>Here are some basic questions and answers about mandate.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Q. What is the individual mandate?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignleft\">“This individual mandate is to keep premiums low for everyone. If you don’t have incentives for everyone to sign up then only the sick people will enroll.\"\u003c/aside>\n\u003cp>A. The individual mandate is a provision of the federal health law (i.e. \"Obamacare\") that requires you, your children and anyone else that you claim as a dependent on your taxes to have health insurance in 2014 or pay a penalty. That coverage can be supplied through your job, public programs such as Medicare or Medicaid, or an individual policy that you purchase. The health law is setting up online health insurance marketplaces, also known as exchanges, to help you shop for plans.\u003c/p>\n\u003cp>\u003cstrong>Q. Who is affected by the mandate?\u003c/strong>\u003c/p>\n\u003cp>A. The mandate is aimed at some of the 57 million people younger than 65 who now do not have insurance. Roughly 7 million of those without insurance live in California.\u003c/p>\n\u003cp>\u003cstrong>Q. Are there any exceptions to the mandate?\u003c/strong>\u003c/p>\n\u003cp>A. Yes, the government has \u003ca href=\"http://healthaffairs.org/blog/2013/06/27/implementing-health-reform-exemptions-from-the-individual-mandate/\" target=\"_blank\">identified exemptions\u003c/a>. Individuals who cannot afford coverage because the cost of premiums exceed 8 percent of their household income or those whose household incomes are below the minimum threshold for filing a tax return are exempt.\u003c!--more-->\u003c/p>\n\u003cp>Other exempt groups include prisoners, Native Americans eligible for care through the Indian Health Care service, immigrants who are in the country illegally, people whose religion objects to having insurance coverage, members of a \u003ca href=\"http://www.kaiserhealthnews.org/features/insuring-your-health/michelle-andrews-on-health-care-religious-cooperatives.aspx\" target=\"_blank\">health care sharing ministry\u003c/a> and individuals who experience a short coverage gap of less than three consecutive months.\u003c/p>\n\u003cp>\u003ca href=\"http://cbo.gov/sites/default/files/cbofiles/attachments/09-19-12-Indiv_Mandate_Penalty.pdf\" target=\"_blank\">CBO estimates\u003c/a> that in 2016, after the major provisions of the health law are implemented, 24 million people will be exempted from the mandate's penalties.\u003c/p>\n\u003cp>\u003cstrong>Q. What happens if I don't get coverage?\u003c/strong>\u003c/p>\n\u003cp>A. If you do not have the minimum level of coverage and do not qualify for an exemption, you must pay a penalty to the IRS at the end of the tax year. The penalty for the first year is up to $95 per adult and $47.50 per child, or 1 percent of family income, whichever is greater.\u003c/p>\n\u003cp>The fine, however, increases over time and in 2016 will be as much as $695 per adult and $347 per child (up to $2,085 for a family) or 2.5 percent of family income, whichever is greater.\u003c/p>\n\u003cp>The amount you owe will be pro-rated to reflect the number of months you were without coverage.\u003c/p>\n\u003cp>\u003ca href=\"http://cbo.gov/sites/default/files/cbofiles/attachments/09-19-12-Indiv_Mandate_Penalty.pdf\" target=\"_blank\">CBO estimates\u003c/a> that 6 million people, about 2 percent of the population, will be assessed a penalty in 2016.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I satisfy the mandate and how does the law help me afford insurance?\u003c/strong>\u003c/p>\n\u003cp>A. Again, if you have employer-based health insurance, Medicare or Medicaid (in California, Medi-Cal), you are set.\u003c/p>\n\u003cp>If you are uninsured or thinking about switching plans, you can shop for coverage through the online marketplaces beginning Oct. 1. The Covered California marketplace is scheduled to open at that time.\u003c/p>\n\u003caside class=\"pullquote alignright\">Learn more about the health law in KQED's guide, \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained\u003c/a>, just for Californians.\u003c/aside>\n\u003cp>The marketplaces will also offer tax subsidies to help reduce the cost of premiums. If your income is less than 400 percent of the federal poverty level ($45,960 for an individual and $94,200 for a family of four in 2013), you likely will qualify for a subsidy.\u003c/p>\n\u003cp>People with incomes up to 250 percent of the federal poverty level ($28,725 for an individual and $58,875 for a family of four in 2013) are also eligible for cost-sharing subsidies. These additional subsidies will substantially reduce the deductibles, copayments, coinsurance and total out-of-pocket spending limits.\u003c/p>\n\u003cp>Although the law takes effect Jan. 1, the initial enrollment period continues through March 31. Since people are exempted for a short coverage gap – less than three months – individuals that obtain coverage before the end of March will be exempt from the payment for that period.\u003c/p>\n\u003cp>\u003cstrong>Q. Why is there a mandate anyway?\u003c/strong>\u003c/p>\n\u003cp>A. The health law was designed to extend insurance to nearly all people, including those who have medical conditions that require expensive care and are often denied coverage today. But to pay for their care, insurance companies need to have a large enrollment of consumers, especially young and healthy people who use fewer services. The mandate was adopted to guarantee a broad base.\u003c/p>\n\u003cp>\u003ca href=\"http://www.americanprogress.org/about/staff/spiro-topher/bio/\" target=\"_blank\">Topher Spiro\u003c/a>, the vice president of health policy at the Center for American Progress, a left-leaning nonprofit that supports the law, says Obamacare will be more effective with the mandate than without it. \"This individual mandate is to keep premiums low for everyone,\" he said, noting that \"if you don’t have incentives for everyone to sign up for coverage then only the sick people will enroll,\" and that drives up premiums.\u003c/p>\n\u003cp>But others suggest the mandate won't be effective because the penalties are set so much lower than the cost of coverage.\u003c/p>\n\u003cp>\"The mandate was an attempt to get around the fact that insurance is going to become a lot more expensive for a lot of people even with the subsidies,\" said \u003ca href=\"http://www.aei.org/scholar/joseph-antos/\" target=\"_blank\">Joseph Antos\u003c/a>, an economist with the conservative American Enterprise Institute. Antos believes the tax penalty for remaining uninsured is too low and questions the government’s ability to identify those who end up not filing taxes. \"I would argue that the individual mandate is largely unenforceable and does not turn out to be this solution to the other problems that raise insurance costs for that particular group of people,\" he added.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I report my coverage or exemptions to the government?\u003c/strong>\u003c/p>\n\u003cp>A. You will not have to report your coverage or exemptions until you file your 2014 income tax return, which won't be due until April 15, 2015. Insurance providers will also be required to help their clients report their health coverage. The Internal Revenue Service says it will put out details later about how the reporting will work.\u003c/p>\n\u003cp>If your income is so low that you do not file a tax return, you are exempt from paying the penalty.\u003c/p>\n\u003cp>\u003cstrong>Q. How do I apply for an exemption?\u003c/strong>\u003c/p>\n\u003cp>If you are seeking an exemption for incarceration, membership in an Indian tribe or health care sharing ministry, you can apply through the health insurance exchanges or make a claim when you file taxes, according to a final rule issued by the U.S. Department of Health and Human Services. If you are claiming economic hardship or a religious exemption, you must get an exemption certificate from the online insurance exchange. If you are claiming that coverage is unaffordable, you are in the United States without proper documentation or have a coverage gap of less than three months, you can make the claim when you file your 2014 taxes in 2015.\u003c/p>\n\u003cp>\u003cstrong>Q. Where did the idea of the mandate originate?\u003c/strong>\u003c/p>\n\u003cp>A. The origins of the individual mandate have been controversial. Many Democrats who support the law suggest it was originally a conservative idea developed in 1989 by the Heritage Foundation's Stuart Butler to counter liberals' efforts to establish a single payer system and impose a mandate on employers to provide insurance. Several years afterward, Republicans used the individual mandate in a bill they offered as an alternative to Bill Clinton's proposal to overhaul health insurance. The mandate also was incorporated as part of the Massachusetts overhaul of health insurance in 2006 under then-Gov. Mitt Romney.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Democrats later adapted the concept and pushed it as part of the congressional debate over the Affordable Care Act, despite President Barack Obama's initial reluctance to embrace it. Whatever their prior views, most conservatives opposed the health law's version of the mandate, and Butler made a\u003ca href=\"http://usatoday30.usatoday.com/news/opinion/forum/story/2012-02-03/health-individual-mandate-reform-heritage/52951140/1\" target=\"_blank\"> spirited argument \u003c/a>that the current mandate is not what he was endorsing years ago.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>Oregon really threw down the gauntlet \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/07/08/oregon-launches-quirky-obamacare-videos/\" target=\"_blank\">earlier this summer\u003c/a> when Cover Oregon launched its quirky and highly entertaining TV ads.\u003c/p>\n\u003cp>Thursday, Covered California fired its first volleys. Peter Lee, executive director of Covered California, assured reporters during a press conference that \"you won't be seeing movie stars, you won't be seeing rock stars.\"\u003c/p>\n\u003cp>That's right, we won't see movie stars or rock stars. Instead, we see signs. Yes, signs. That's what the ad is titled: \"signs.\"\u003c/p>\n\u003cp>To be fair, Lee completed his \"you won't be seeing rock stars\" thought with \"you'll be seeing real people.\" But mostly we see signs at the beginning of the ad. There's a lot of somewhat wonky voiceover about \"equal access to quality health insurance,\" \"financial assistance\" and \"pre-existing conditions.\" We heard none of those things in the Cover Oregon ads -- instead the ads left me with a wonderful feeling about how great Oregon is -- and therefore how great Cover Oregon must be. Cover Oregon seemed to embrace the concept of branding. Is it too late to call in Don Draper of \"Mad Men\"? Or maybe Peggy Olson?\u003c/p>\n\u003cp>But not everyone is reacting the way I am. Larry Levitt, senior vice president at the Kaiser Family Foundation, said in an email that he appreciated that \"these ads emphasized actual protections and the subsidies, in contrast, for example, to the Vermont ads that don't really mention anything.\" Like Oregon, Vermont also took a \u003ca href=\"https://www.youtube.com/watch?v=yulTgIUERo4\" target=\"_blank\">more generic approach\u003c/a>. Anthony Wright of Health Access liked the ads, too. \"You can have the beautiful textures of the California coast and Central Valley, while also providing concrete information consumers need,\" he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Judge for yourself:\u003c/p>\n\u003cp>[youtube //www.youtube.com/watch?v=97WvAIH6ER4]\u003c/p>\n\u003cp>\u003c!--more-->In addition, here at KQED, we're not sure if we're flattered or concerned that Covered California's tagline appears to be \"Welcome to a new state of health.\" Full disclaimer that this blog has had nothing to do with the Covered California marketing campaign, nor do we endorse Covered California. Hey, since we're busy covering Covered California, will they return the favor by \u003ca href=\"http://ww2.kqed.org/stateofhealth/\" target=\"_blank\">pointing back to us\u003c/a> every now and then? We're always looking for new sources of traffic.\u003c/p>\n\u003cp>Covered California also released a Spanish-language ad.\u003c/p>\n\u003cp>Now, if I could speak Spanish, I could critique the Spanish version more competently. But even with only two years of middle-school Spanish, I can tell I like this one better. Smiling real people -- as Lee promised -- at every turn saying \"Bienvenidos!\" People are welcoming Covered California into their homes and businesses. This ad made me feel much better about Covered California. No signs.\u003c/p>\n\u003cp>[youtube //www.youtube.com/watch?v=rOuyJLtUfOk?list=UU0FISFbEaHFc5ccrIgkZ3mg]\u003c/p>\n\u003cp>These ads will roll out in limited markets (San Diego, Sacramento and Chico/Redding) starting Monday and statewide after Oct. 1, the day the Covered California marketplace opens. Lee says Covered California has $80 million to spend on media and marketing between now and December 2014. Don Draper, I bet you'd like a bit of that.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The ads and other materials are to help with outreach to the state's 7 million uninsured. Some of the uninsured are undocumented immigrants, who are not eligible for benefits under the Affordable Care Act. Some 5.6 million people could buy health insurance through the marketplace, and about half of those people are eligible for subsidies to help them afford insurance. Lee said their goal for the first year is to enroll 1.4 million of those \"subsidy-eligible\" individuals.\u003c/p>\n\n",
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"excerpt": "Oregon really threw down the gauntlet earlier this summer when Cover Oregon launched its quirky and highly entertaining TV ads.\r\n\r\nThursday, Covered California fired its first volleys. Peter Lee, executive director of Covered California assured reporters during a press conference that \"you won't be seeing movie stars, you won't be seeing rock stars.\"\r\n\r\nThat's right we won't see movie stars or rock stars. Instead we see signs. Yes, signs. That's what the ad is titled: \"signs.\"\r\n",
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"description": "Oregon really threw down the gauntlet earlier this summer when Cover Oregon launched its quirky and highly entertaining TV ads.\r\n\r\nThursday, Covered California fired its first volleys. Peter Lee, executive director of Covered California assured reporters during a press conference that "you won't be seeing movie stars, you won't be seeing rock stars."\r\n\r\nThat's right we won't see movie stars or rock stars. Instead we see signs. Yes, signs. That's what the ad is titled: "signs."\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Oregon really threw down the gauntlet \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/07/08/oregon-launches-quirky-obamacare-videos/\" target=\"_blank\">earlier this summer\u003c/a> when Cover Oregon launched its quirky and highly entertaining TV ads.\u003c/p>\n\u003cp>Thursday, Covered California fired its first volleys. Peter Lee, executive director of Covered California, assured reporters during a press conference that \"you won't be seeing movie stars, you won't be seeing rock stars.\"\u003c/p>\n\u003cp>That's right, we won't see movie stars or rock stars. Instead, we see signs. Yes, signs. That's what the ad is titled: \"signs.\"\u003c/p>\n\u003cp>To be fair, Lee completed his \"you won't be seeing rock stars\" thought with \"you'll be seeing real people.\" But mostly we see signs at the beginning of the ad. There's a lot of somewhat wonky voiceover about \"equal access to quality health insurance,\" \"financial assistance\" and \"pre-existing conditions.\" We heard none of those things in the Cover Oregon ads -- instead the ads left me with a wonderful feeling about how great Oregon is -- and therefore how great Cover Oregon must be. Cover Oregon seemed to embrace the concept of branding. Is it too late to call in Don Draper of \"Mad Men\"? Or maybe Peggy Olson?\u003c/p>\n\u003cp>But not everyone is reacting the way I am. Larry Levitt, senior vice president at the Kaiser Family Foundation, said in an email that he appreciated that \"these ads emphasized actual protections and the subsidies, in contrast, for example, to the Vermont ads that don't really mention anything.\" Like Oregon, Vermont also took a \u003ca href=\"https://www.youtube.com/watch?v=yulTgIUERo4\" target=\"_blank\">more generic approach\u003c/a>. Anthony Wright of Health Access liked the ads, too. \"You can have the beautiful textures of the California coast and Central Valley, while also providing concrete information consumers need,\" he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Judge for yourself:\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/97WvAIH6ER4'\n title='//www.youtube.com/embed/97WvAIH6ER4'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c!--more-->In addition, here at KQED, we're not sure if we're flattered or concerned that Covered California's tagline appears to be \"Welcome to a new state of health.\" Full disclaimer that this blog has had nothing to do with the Covered California marketing campaign, nor do we endorse Covered California. Hey, since we're busy covering Covered California, will they return the favor by \u003ca href=\"http://ww2.kqed.org/stateofhealth/\" target=\"_blank\">pointing back to us\u003c/a> every now and then? We're always looking for new sources of traffic.\u003c/p>\n\u003cp>Covered California also released a Spanish-language ad.\u003c/p>\n\u003cp>Now, if I could speak Spanish, I could critique the Spanish version more competently. But even with only two years of middle-school Spanish, I can tell I like this one better. Smiling real people -- as Lee promised -- at every turn saying \"Bienvenidos!\" People are welcoming Covered California into their homes and businesses. This ad made me feel much better about Covered California. No signs.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/rOuyJLtUfOk?list=UU0FISFbEaHFc5ccrIgkZ3mg'\n title='//www.youtube.com/embed/rOuyJLtUfOk?list=UU0FISFbEaHFc5ccrIgkZ3mg'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>These ads will roll out in limited markets (San Diego, Sacramento and Chico/Redding) starting Monday and statewide after Oct. 1, the day the Covered California marketplace opens. Lee says Covered California has $80 million to spend on media and marketing between now and December 2014. Don Draper, I bet you'd like a bit of that.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The ads and other materials are to help with outreach to the state's 7 million uninsured. Some of the uninsured are undocumented immigrants, who are not eligible for benefits under the Affordable Care Act. Some 5.6 million people could buy health insurance through the marketplace, and about half of those people are eligible for subsidies to help them afford insurance. Lee said their goal for the first year is to enroll 1.4 million of those \"subsidy-eligible\" individuals.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Obamacare to Force Millions to Upgrade Insurance",
"title": "Obamacare to Force Millions to Upgrade Insurance",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_14506\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14506\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/hall_photo2-640x480.jpg\" alt=\"Darren Hall will have to choose a new health insurance plan after Obamacare is fully implemented in January. His policy today doesn’t meet the standards outlined in the law. (Kelley Weiss/ CHCF Center for Health Reporting)\" width=\"640\" height=\"480\">\u003cfigcaption class=\"wp-caption-text\">Darren Hall will have to choose a new health insurance plan after Obamacare is fully implemented in January. His policy today doesn’t meet the standards outlined in the law. (Kelley Weiss/ CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kelley Weiss\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/obamacare-force-millions-upgrade-insurance1152\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Despite promises by President Obama that people can keep the insurance they have once Obamacare is in full effect in January, millions of people nationally will have to upgrade their policies.\u003c/p>\n\u003cp>That’s because these people have “bare bones” plans that don’t meet the Affordable Care Act benefit standards.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more about Obamacare in KQED's guide, specifically for Californians\u003c/a>\u003c/aside>\n\u003cp>Darren Hall is one of those people. He runs a pool service company in Sacramento. Since he’s self-employed he doesn’t get health insurance through his job, but buys it on his own.\u003c/p>\n\u003cp>He says it’s worked out pretty well until this spring when his monthly premium spiked from $250 a month to $300 dollars overnight.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>So he says he looked for a better deal and found another health insurance policy for half as much.\u003c/p>\n\u003cp>“As a small business you have your ups and downs and so every dollar does count,” Hall says. “Another $150, that’s half a truck payment right there.\"\u003c!--more-->\u003c/p>\n\u003cp>Hall got this new policy in April and it’s another high-deductible health plan. He pays for the first $1,500 of medical care out-of-pocket to meet his deductible. He doesn’t get coverage for certain benefits but that leaves him with a lower monthly premium.\u003c/p>\n\u003cp>Since he’s hardly needed any medical care in the last 14 years, Hall says it’s been just fine.\u003c/p>\n\u003cp>“The amount of times I’ve been to see a doctor I can probably count on one hand,” he says.\u003c/p>\n\u003cp>But Hall says now there’s a problem. He’s going to have to choose another insurance policy soon because his doesn’t meet the standards under the Affordable Care Act.\u003c/p>\n\u003cp>“Folks are going to have to buy more comprehensive policies, generally, in 2014,” says Micah Weinberg, a senior policy consultant with the Bay Area Council.\u003c/p>\n\u003cp>He says a small portion of people might be able to \u003ca href=\"https://www.healthcare.gov/what-if-i-have-a-grandfathered-health-plan/\" target=\"_blank\">keep their policy if they have a grandfathered plan\u003c/a>, meaning they had it on March 23, 2010. But he says Hall and millions of other people have individual health plans today that won’t cut it.\u003c/p>\n\u003cp>“Most of the policies sold in the individual market are much skinnier than the policies provided by employers,” he says.\u003c/p>\n\u003cp>Weinberg says the Affordable Care Act \u003ca href=\"https://www.healthcare.gov/what-does-marketplace-health-insurance-cover/\">requires all insurance policies to cover 10 benefits\u003c/a>, including things like hospitalizations, maternity care or prescription drugs. The idea, he says, is to protect people with a high deductible plan, like Darren Hall, from financial calamity.\u003c/p>\n\u003cp>“A lot of what the Affordable Care Act does is prevent moments of terror, panic, bankruptcy that we didn’t anticipate were even going to happen,” Weinberg says.\u003c/p>\n\u003cp>Obamacare will do this, he says, by making insurers pick up at least 60 percent of medical costs. And it caps out-of-pocket spending for individuals to around $6,400 per year.\u003c/p>\n\u003cp>People can also get help if they buy a plan on the newly formed health care marketplaces and qualify for a subsidy. But this won’t help everyone. Take, for example, the two million people in California who buy insurance on their own today. Only about a third will qualify for tax subsidies. Darren Hall makes too much money to qualify.\u003c/p>\n\u003cp>Sarah Aquino, of Integrated Benefits and Insurance Services Inc., says those who don’t qualify for a subsidy will likely see their premiums increase.\u003c/p>\n\u003cp>\u003ca href=\"http://kff.org/interactive/subsidy-calculator/\">To qualify for a tax subsidy\u003c/a> an individual has to make less than $46,000 a year, or 400 percent of the Federal Poverty Level.\u003c/p>\n\u003cp>But Aquino says most of her clients make more than that. Regardless, almost everyone has to have insurance or pay a fee come January. And Aquino says if that insurance is going to be more expensive, people will have a choice to make.\u003c/p>\n\u003cp>“The penalty for the individual mandate is $95 or one percent of your income,” she says. “So the question is will people who are healthy and don’t qualify for a subsidy come into the system?”\u003c/p>\n\u003cp>Aquino says the most important thing is for people to learn what their options are. And, she adds, it’s not a bad idea to start now.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced in collaboration with the \u003ca href=\"http://centerforhealthreporting.org/\">\u003cstrong>California HealthCare Foundation Center for Health Reporting\u003c/strong>\u003c/a>\u003cstrong>,\u003c/strong> a nonprofit news organization that focuses on California health issues. Based at the \u003ca href=\"http://annenberg.usc.edu/\">\u003cstrong>USC Annenberg School for Communication and Journalism\u003c/strong>\u003c/a>, the center is funded by the nonpartisan \u003cstrong>\u003ca href=\"http://www.chcf.org/\">California HealthCare Foundation.\u003c/a> \u003c/strong>The story first appeared on \u003ca href=\"http://www.npr.org/2013/08/23/214723180/obamacare-to-force-millions-to-upgrade-insurance\" target=\"_blank\">NPR\u003c/a>.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Despite promises by President Obama that people can keep the insurance they have once Obamacare is in full effect in January, millions will have to upgrade their policies.\r\nThat’s because these people have “bare bones” plans that don’t meet the Affordable Care Act benefit standards.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14506\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14506\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/hall_photo2-640x480.jpg\" alt=\"Darren Hall will have to choose a new health insurance plan after Obamacare is fully implemented in January. His policy today doesn’t meet the standards outlined in the law. (Kelley Weiss/ CHCF Center for Health Reporting)\" width=\"640\" height=\"480\">\u003cfigcaption class=\"wp-caption-text\">Darren Hall will have to choose a new health insurance plan after Obamacare is fully implemented in January. His policy today doesn’t meet the standards outlined in the law. (Kelley Weiss/ CHCF Center for Health Reporting)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Kelley Weiss\u003c/strong>, \u003ca href=\"http://centerforhealthreporting.org/article/obamacare-force-millions-upgrade-insurance1152\" target=\"_blank\">CHCF Center for Health Reporting\u003c/a>\u003c/p>\n\u003cp>Despite promises by President Obama that people can keep the insurance they have once Obamacare is in full effect in January, millions of people nationally will have to upgrade their policies.\u003c/p>\n\u003cp>That’s because these people have “bare bones” plans that don’t meet the Affordable Care Act benefit standards.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more about Obamacare in KQED's guide, specifically for Californians\u003c/a>\u003c/aside>\n\u003cp>Darren Hall is one of those people. He runs a pool service company in Sacramento. Since he’s self-employed he doesn’t get health insurance through his job, but buys it on his own.\u003c/p>\n\u003cp>He says it’s worked out pretty well until this spring when his monthly premium spiked from $250 a month to $300 dollars overnight.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>So he says he looked for a better deal and found another health insurance policy for half as much.\u003c/p>\n\u003cp>“As a small business you have your ups and downs and so every dollar does count,” Hall says. “Another $150, that’s half a truck payment right there.\"\u003c!--more-->\u003c/p>\n\u003cp>Hall got this new policy in April and it’s another high-deductible health plan. He pays for the first $1,500 of medical care out-of-pocket to meet his deductible. He doesn’t get coverage for certain benefits but that leaves him with a lower monthly premium.\u003c/p>\n\u003cp>Since he’s hardly needed any medical care in the last 14 years, Hall says it’s been just fine.\u003c/p>\n\u003cp>“The amount of times I’ve been to see a doctor I can probably count on one hand,” he says.\u003c/p>\n\u003cp>But Hall says now there’s a problem. He’s going to have to choose another insurance policy soon because his doesn’t meet the standards under the Affordable Care Act.\u003c/p>\n\u003cp>“Folks are going to have to buy more comprehensive policies, generally, in 2014,” says Micah Weinberg, a senior policy consultant with the Bay Area Council.\u003c/p>\n\u003cp>He says a small portion of people might be able to \u003ca href=\"https://www.healthcare.gov/what-if-i-have-a-grandfathered-health-plan/\" target=\"_blank\">keep their policy if they have a grandfathered plan\u003c/a>, meaning they had it on March 23, 2010. But he says Hall and millions of other people have individual health plans today that won’t cut it.\u003c/p>\n\u003cp>“Most of the policies sold in the individual market are much skinnier than the policies provided by employers,” he says.\u003c/p>\n\u003cp>Weinberg says the Affordable Care Act \u003ca href=\"https://www.healthcare.gov/what-does-marketplace-health-insurance-cover/\">requires all insurance policies to cover 10 benefits\u003c/a>, including things like hospitalizations, maternity care or prescription drugs. The idea, he says, is to protect people with a high deductible plan, like Darren Hall, from financial calamity.\u003c/p>\n\u003cp>“A lot of what the Affordable Care Act does is prevent moments of terror, panic, bankruptcy that we didn’t anticipate were even going to happen,” Weinberg says.\u003c/p>\n\u003cp>Obamacare will do this, he says, by making insurers pick up at least 60 percent of medical costs. And it caps out-of-pocket spending for individuals to around $6,400 per year.\u003c/p>\n\u003cp>People can also get help if they buy a plan on the newly formed health care marketplaces and qualify for a subsidy. But this won’t help everyone. Take, for example, the two million people in California who buy insurance on their own today. Only about a third will qualify for tax subsidies. Darren Hall makes too much money to qualify.\u003c/p>\n\u003cp>Sarah Aquino, of Integrated Benefits and Insurance Services Inc., says those who don’t qualify for a subsidy will likely see their premiums increase.\u003c/p>\n\u003cp>\u003ca href=\"http://kff.org/interactive/subsidy-calculator/\">To qualify for a tax subsidy\u003c/a> an individual has to make less than $46,000 a year, or 400 percent of the Federal Poverty Level.\u003c/p>\n\u003cp>But Aquino says most of her clients make more than that. Regardless, almost everyone has to have insurance or pay a fee come January. And Aquino says if that insurance is going to be more expensive, people will have a choice to make.\u003c/p>\n\u003cp>“The penalty for the individual mandate is $95 or one percent of your income,” she says. “So the question is will people who are healthy and don’t qualify for a subsidy come into the system?”\u003c/p>\n\u003cp>Aquino says the most important thing is for people to learn what their options are. And, she adds, it’s not a bad idea to start now.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was produced in collaboration with the \u003ca href=\"http://centerforhealthreporting.org/\">\u003cstrong>California HealthCare Foundation Center for Health Reporting\u003c/strong>\u003c/a>\u003cstrong>,\u003c/strong> a nonprofit news organization that focuses on California health issues. Based at the \u003ca href=\"http://annenberg.usc.edu/\">\u003cstrong>USC Annenberg School for Communication and Journalism\u003c/strong>\u003c/a>, the center is funded by the nonpartisan \u003cstrong>\u003ca href=\"http://www.chcf.org/\">California HealthCare Foundation.\u003c/a> \u003c/strong>The story first appeared on \u003ca href=\"http://www.npr.org/2013/08/23/214723180/obamacare-to-force-millions-to-upgrade-insurance\" target=\"_blank\">NPR\u003c/a>.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Challenges in Implementing Obamacare on California Farms",
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"content": "\u003cfigure id=\"attachment_6829\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-full wp-image-6829\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/farmlabor20120427-e1377116327759.jpg\" alt=\"Loli Mohen & her family worked the fields in Modesto. Three of her family members had undiagnosed and untreated mental health problems. (Sandy Huffaker/Getty Images)\" width=\"640\" height=\"350\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/06/farmlabor20120427-e1377116327759.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/farmlabor20120427-e1377116327759-400x219.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/farmlabor20120427-e1377116327759-320x175.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Farmworkers in the fields near Modesto, CA. Experts estimate that meeting the requirements of the Affordable Care Act's minimum health plan requirement will cost about $1 per hour per employee in the field. (Sandy Huffaker/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cdiv>\n\u003cdiv>\n\u003cp>\u003cstrong>By Sarah Varney,\u003c/strong>\u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/August/21/health-insurance-for-farm-workers.aspx\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003cp>Farm labor contractors across California -- the nation's biggest agricultural engine -- are anxiously studying a provision of the Affordable Care Act, which will require hundreds of thousands of field workers to be covered by health insurance.\u003c/p>\n\u003cdiv>\n\u003cdiv>\n\u003cp>Insurance brokers and health providers estimate that meeting the Affordable Care Act’s minimum health plan will cost about $1 per hour per employee in the field.\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more about Obamacare; check out KQED's guide, specifically for Californians\u003c/a>\u003c/aside>\n\u003cp>And while the requirement to cover workers was recently delayed until 2015, the contractors, who provide farmers with armies of field workers, say they are already preparing for the potential cost, inconvenience, and liability the new law will bring to their business, which typically operates on a slender profit margin.\u003c/p>\n\u003cp>\"I've been to at least a dozen seminars on the Affordable Care Act since February,\" said Chuck Herrin, owner of Sunrise Farm Labor, a contractor based here. \"If you don't take the right approach, you're wiped out.\"\u003c!--more-->\u003c/p>\n\u003cp>The effects of the new law could be profound. Insurance brokers and health providers familiar with California's $43.5 billion agricultural industry estimate that meeting the law's minimum health plan will cost about $1 per hour per employee worked in the field.\u003c/p>\n\u003cp>\"Everybody is afraid of the cost,\" said J. Edward McClements, Jr., a senior vice president at Barkley Insurance and Risk Management, based in Oxnard, about 60 miles west of Los Angeles. \"It's difficult when you've got 1,000 workers who've never had health insurance before, to get an idea of what their costs will be.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The concern is felt from vineyards in Napa County to the almond orchards outside Coalinga, a Central Valley town best known for its state prison and mental hospital. Farm labor contractors generally rely on a 2 percent profit, and they say they will have to pass the added health care costs required by the new law on to growers. Mr. Herrin, who can employ up to 2,000 farmworkers -- many of them long-time employees -- has been warning his customers of the coming price increase due to health insurance costs.\u003c/p>\n\u003cp>\"It's made for some heated battles,\" Mr. Herrin said, of his talks with growers who include his father-in-law, the owner of a Central Valley farm.\u003c/p>\n\u003cp>Some farmers seem resigned to higher labor costs, and to the fact that that increase will be passed on to the consumers of everything from leafy greens to crunchy nuts. \"That cost is going to be borne by us at the end of the day,\" said Scott Deardorff, a partner at Oxnard-based Deardorff Family Farms, which grows strawberries, cauliflower and chard, among other salad bar staples.\u003c/p>\n\u003cp>Across the country, employers in many other kinds of businesses are devising strategies to comply with or, in some cases, sidestep a new requirement to provide insurance for those who work 30 hours or more. Some are breaking their businesses into smaller companies, for instance, or even laying off workers. Some companies plan to shift workers to part-time status.\u003c/p>\n\u003cp>But in the vast, fertile fields of California’s Central Valley, farmers and the contractors who supply them with work crews must prune, pick and pack produce when it is ready, nearly year round. Ripe cantaloupe will not wait.\u003c/p>\n\u003cp>\"You can't put your ag workers on a 28-hour work week like Starbucks, Denny's and Wal-Mart are considering,\" said Mr. McClements.\u003c/p>\n\u003cp>California farmers produce half of all fruits, nuts and vegetables grown in the nation, according to the California Department of Food and Agriculture. But Guadalupe Sandoval, executive director of the California Farm Labor Contractor Association, said the state's farmers must compete for supermarket shelf space against agricultural producers worldwide, most of whom are not paying for worker health care.\u003c/p>\n\u003cp>\"What does this do when I want to sell a product to Wal-Mart or Costco?\" Mr. Sandoval said growers have asked him.\u003c/p>\n\u003cp>In places like Huron, meanwhile, a Central Valley town surrounded by thousands of acres of farmland, there are other, practical concerns. On a recent morning, Jose Romero pulled weeds from a row of lush, redolent tomato plants. Mr. Romero, 36, arrived at the field around 5 a.m., and worked until sunset. He has been working in the fields, Mr. Romero says, for nearly two decades.\u003c/p>\n\u003cp>Like many of the workers in this tomato field, he was surprised to learn that his employer, Chuck Herrin at Sunrise Farm Labor, will have to offer him health coverage, and that he could be asked to contribute up to 9.5 percent of his wages to cover the costs. \"We eat, we pay rent and no more,\" Mr. Romero said in Spanish. \"The salary that they give you here, to pay insurance for the family, it wouldn't be enough.\" Farmworkers like Romero, though, may end up being individually exempt from coverage. If the amount any employee -- of any company -- has to pay is greater than 8 percent of income, they are not required to participate in an employer's plan. In this situation, the employee is also exempt from the so-called \"individual mandate.\"\u003c/p>\n\u003cp>There seems to be widespread agreement among agricultural employers, insurance brokers and health plans in California that low-wage farmworkers cannot be asked to pay health insurance premiums. \"He's making $8 to $9 an hour, and you're asking him to pay for something that's he's not going to use?\" Mr. Herrin asked.\u003c/p>\n\u003cp>The minimum compliant health plan for employee coverage under the new law will cost about $250 a month in California's growing regions, according to insurance brokers, and includes a $5,000 deductible for medical care, although insurers cannot charge co-pays for preventive visits. \"It's unacceptable,\" Mr. Herrin added.\u003c/p>\n\u003cp>The situation is complicated by the reality that many farmworkers apply for jobs with questionable identification, and that farmers and farm labor contractors hire them anyway. (Employers say they must accept documents that look legitimate and can be penalized for directly asking if a potential employee is in the country illegally.)\u003c/p>\n\u003cp>Employers are trying to spread the word, a tricky process in places where the mere mention of government oversight can stir fear. Oscar Renteria, owner of Renteria Vineyard Management, a farm labor contractor based in Napa, has held meetings in Spanish to explain the health law to his 380 employees, some of whom may be in the country illegally.\u003c/p>\n\u003cp>\"They're really nervous,\" Mr. Renteria said. \"Nervous they'll be tracked and then somehow the possibility of being identified, and the fear of being deported or not being allowed to work. It comes up all the time in conversations when we outline the choices.\"\u003c/p>\n\u003cp>Even agricultural employers that already offer health coverage are bracing for major changes. One preferred option were so-called \"mini-meds,\" bare-bones plans with coverage limits as low as $5,000. But those are now banned under the federal health law, and while the Obama administration decision gives larger employers another year to comply, even that reprieve doesn't offer much time for California farmers to figure out an alternative.\u003c/p>\n\u003cp>Uncertainty is a constant on the farm: crops fail, prices fall, plows go dull. Indeed, in Huron, where farmers have complained bitterly about water shortages, there is a force more powerful than the health law and more vexing than the stalled immigration overhaul: the weather.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"If we don’t get a lot of snow and rain this year, none of this will matter,\" Mr. Herrin said. \"We’ll be out of business.\"\u003c/p>\n\n",
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"excerpt": "Farm labor contractors across California -- the nation's biggest agricultural engine -- are anxiously studying a provision of the Affordable Care Act, which will require hundreds of thousands of field workers to be covered by health insurance.\r\n\r\nIn the Central Valley of California, farm workers in a tomato field. Insurance brokers and health providers estimate that meeting the Affordable Care Act’s minimum health plan will cost about $1 per hour per employee in the field.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_6829\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-full wp-image-6829\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2012/06/farmlabor20120427-e1377116327759.jpg\" alt=\"Loli Mohen & her family worked the fields in Modesto. Three of her family members had undiagnosed and untreated mental health problems. (Sandy Huffaker/Getty Images)\" width=\"640\" height=\"350\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2012/06/farmlabor20120427-e1377116327759.jpg 640w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/farmlabor20120427-e1377116327759-400x219.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2012/06/farmlabor20120427-e1377116327759-320x175.jpg 320w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Farmworkers in the fields near Modesto, CA. Experts estimate that meeting the requirements of the Affordable Care Act's minimum health plan requirement will cost about $1 per hour per employee in the field. (Sandy Huffaker/Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cdiv>\n\u003cdiv>\n\u003cp>\u003cstrong>By Sarah Varney,\u003c/strong>\u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/August/21/health-insurance-for-farm-workers.aspx\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003cp>Farm labor contractors across California -- the nation's biggest agricultural engine -- are anxiously studying a provision of the Affordable Care Act, which will require hundreds of thousands of field workers to be covered by health insurance.\u003c/p>\n\u003cdiv>\n\u003cdiv>\n\u003cp>Insurance brokers and health providers estimate that meeting the Affordable Care Act’s minimum health plan will cost about $1 per hour per employee in the field.\u003c/p>\n\u003c/div>\n\u003c/div>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more about Obamacare; check out KQED's guide, specifically for Californians\u003c/a>\u003c/aside>\n\u003cp>And while the requirement to cover workers was recently delayed until 2015, the contractors, who provide farmers with armies of field workers, say they are already preparing for the potential cost, inconvenience, and liability the new law will bring to their business, which typically operates on a slender profit margin.\u003c/p>\n\u003cp>\"I've been to at least a dozen seminars on the Affordable Care Act since February,\" said Chuck Herrin, owner of Sunrise Farm Labor, a contractor based here. \"If you don't take the right approach, you're wiped out.\"\u003c!--more-->\u003c/p>\n\u003cp>The effects of the new law could be profound. Insurance brokers and health providers familiar with California's $43.5 billion agricultural industry estimate that meeting the law's minimum health plan will cost about $1 per hour per employee worked in the field.\u003c/p>\n\u003cp>\"Everybody is afraid of the cost,\" said J. Edward McClements, Jr., a senior vice president at Barkley Insurance and Risk Management, based in Oxnard, about 60 miles west of Los Angeles. \"It's difficult when you've got 1,000 workers who've never had health insurance before, to get an idea of what their costs will be.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The concern is felt from vineyards in Napa County to the almond orchards outside Coalinga, a Central Valley town best known for its state prison and mental hospital. Farm labor contractors generally rely on a 2 percent profit, and they say they will have to pass the added health care costs required by the new law on to growers. Mr. Herrin, who can employ up to 2,000 farmworkers -- many of them long-time employees -- has been warning his customers of the coming price increase due to health insurance costs.\u003c/p>\n\u003cp>\"It's made for some heated battles,\" Mr. Herrin said, of his talks with growers who include his father-in-law, the owner of a Central Valley farm.\u003c/p>\n\u003cp>Some farmers seem resigned to higher labor costs, and to the fact that that increase will be passed on to the consumers of everything from leafy greens to crunchy nuts. \"That cost is going to be borne by us at the end of the day,\" said Scott Deardorff, a partner at Oxnard-based Deardorff Family Farms, which grows strawberries, cauliflower and chard, among other salad bar staples.\u003c/p>\n\u003cp>Across the country, employers in many other kinds of businesses are devising strategies to comply with or, in some cases, sidestep a new requirement to provide insurance for those who work 30 hours or more. Some are breaking their businesses into smaller companies, for instance, or even laying off workers. Some companies plan to shift workers to part-time status.\u003c/p>\n\u003cp>But in the vast, fertile fields of California’s Central Valley, farmers and the contractors who supply them with work crews must prune, pick and pack produce when it is ready, nearly year round. Ripe cantaloupe will not wait.\u003c/p>\n\u003cp>\"You can't put your ag workers on a 28-hour work week like Starbucks, Denny's and Wal-Mart are considering,\" said Mr. McClements.\u003c/p>\n\u003cp>California farmers produce half of all fruits, nuts and vegetables grown in the nation, according to the California Department of Food and Agriculture. But Guadalupe Sandoval, executive director of the California Farm Labor Contractor Association, said the state's farmers must compete for supermarket shelf space against agricultural producers worldwide, most of whom are not paying for worker health care.\u003c/p>\n\u003cp>\"What does this do when I want to sell a product to Wal-Mart or Costco?\" Mr. Sandoval said growers have asked him.\u003c/p>\n\u003cp>In places like Huron, meanwhile, a Central Valley town surrounded by thousands of acres of farmland, there are other, practical concerns. On a recent morning, Jose Romero pulled weeds from a row of lush, redolent tomato plants. Mr. Romero, 36, arrived at the field around 5 a.m., and worked until sunset. He has been working in the fields, Mr. Romero says, for nearly two decades.\u003c/p>\n\u003cp>Like many of the workers in this tomato field, he was surprised to learn that his employer, Chuck Herrin at Sunrise Farm Labor, will have to offer him health coverage, and that he could be asked to contribute up to 9.5 percent of his wages to cover the costs. \"We eat, we pay rent and no more,\" Mr. Romero said in Spanish. \"The salary that they give you here, to pay insurance for the family, it wouldn't be enough.\" Farmworkers like Romero, though, may end up being individually exempt from coverage. If the amount any employee -- of any company -- has to pay is greater than 8 percent of income, they are not required to participate in an employer's plan. In this situation, the employee is also exempt from the so-called \"individual mandate.\"\u003c/p>\n\u003cp>There seems to be widespread agreement among agricultural employers, insurance brokers and health plans in California that low-wage farmworkers cannot be asked to pay health insurance premiums. \"He's making $8 to $9 an hour, and you're asking him to pay for something that's he's not going to use?\" Mr. Herrin asked.\u003c/p>\n\u003cp>The minimum compliant health plan for employee coverage under the new law will cost about $250 a month in California's growing regions, according to insurance brokers, and includes a $5,000 deductible for medical care, although insurers cannot charge co-pays for preventive visits. \"It's unacceptable,\" Mr. Herrin added.\u003c/p>\n\u003cp>The situation is complicated by the reality that many farmworkers apply for jobs with questionable identification, and that farmers and farm labor contractors hire them anyway. (Employers say they must accept documents that look legitimate and can be penalized for directly asking if a potential employee is in the country illegally.)\u003c/p>\n\u003cp>Employers are trying to spread the word, a tricky process in places where the mere mention of government oversight can stir fear. Oscar Renteria, owner of Renteria Vineyard Management, a farm labor contractor based in Napa, has held meetings in Spanish to explain the health law to his 380 employees, some of whom may be in the country illegally.\u003c/p>\n\u003cp>\"They're really nervous,\" Mr. Renteria said. \"Nervous they'll be tracked and then somehow the possibility of being identified, and the fear of being deported or not being allowed to work. It comes up all the time in conversations when we outline the choices.\"\u003c/p>\n\u003cp>Even agricultural employers that already offer health coverage are bracing for major changes. One preferred option were so-called \"mini-meds,\" bare-bones plans with coverage limits as low as $5,000. But those are now banned under the federal health law, and while the Obama administration decision gives larger employers another year to comply, even that reprieve doesn't offer much time for California farmers to figure out an alternative.\u003c/p>\n\u003cp>Uncertainty is a constant on the farm: crops fail, prices fall, plows go dull. Indeed, in Huron, where farmers have complained bitterly about water shortages, there is a force more powerful than the health law and more vexing than the stalled immigration overhaul: the weather.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"If we don’t get a lot of snow and rain this year, none of this will matter,\" Mr. Herrin said. \"We’ll be out of business.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Why One Insurer Quit Covered California",
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"content": "\u003cfigure id=\"attachment_14362\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14362 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/78779048_crop1-640x417.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\">\u003cfigcaption class=\"wp-caption-text\">After initial enthusiasm, Ventura County Health Care Plan withdrew its application from the Covered California marketplace. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Dan Diamond\u003c/strong>, \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/why-one-insurer-quit-covered-california\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Ventura County Health Care Plan administrators won't soon forget May 23, 2013.\u003c/p>\n\u003cp>That was the day that Covered California announced that VCHCP -- a small, county-run plan -- would join Anthem Blue Cross, Kaiser Permanente and 10 other insurers in next year's marketplace.\u003c/p>\n\u003cp>VCHCP put out a \u003ca href=\"http://www.vchca.org/docs/public-info-office/healthexchangevchcp-press-release.pdf?sfvrsn=0\" target=\"_blank\">press release\u003c/a> declaring it was \"honored\" to be part of Covered California's inaugural crop of insurers. There was a celebratory \u003ca href=\"https://www.facebook.com/VCHCA/posts/663589527001069\" target=\"_blank\">Facebook post\u003c/a>.\u003c/p>\n\u003cp>\"This is a monumental day,\" the county's health care director, Robert Gonzalez, said at the time.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Behind the scenes, the plan’s leaders kept coming back to their concerns about the number of potential enrollees next year, and whether VCHCP could truly handle the influx.\u003c/aside>\n\u003cp>But 10 weeks later, Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">has signed contracts \u003c/a>with a dozen insurers -- and Ventura County Health Care Plan isn't one of them. Instead, the plan announced last week that it had withdrawn from the health benefits exchange for next year; a \u003ca href=\"http://www.vchca.org/docs/public-info-office/covered-california-pr0807_2.pdf?sfvrsn=0\">terse press release\u003c/a> alluded to \"ongoing analysis of enrollment projections, start-up costs and certain factors whose outcome and impact are difficult to predict.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There was no Facebook post.\u003c!--more-->Officials in Ventura County, at Covered California and at other organizations have stressed that uninsured county residents will still have a range of choices when seeking health coverage next year. And VCHCP plans to apply to Covered California in hopes of joining the exchange in 2015.\u003c/p>\n\u003cp>\"We didn't withdraw completely,\" Barry Fisher, chief deputy director for the Ventura County Health Care Agency, told \u003cem>California Healthline\u003c/em>.\u003c/p>\n\u003cp>\"The opportunity to participate with Covered California -- we were ... well, still are excited about it\u003cem>.\u003c/em>\"\u003c/p>\n\u003cp>\u003cstrong>Putting the plan in context\u003c/strong>\u003c/p>\n\u003cp>VCHCP's flirtation with Covered California will ultimately be a footnote in the exchange's success or failure; the plan currently covers about 13,000 government workers and affiliates, and was expected to add 10,000 beneficiaries or so in 2014. (Note that's a small number in the overall uninsured, but a big increase for VCHCP, an increase that ultimately mattered quite a bit.)\u003c/p>\n\u003cp>\"Covered California remains partners with [VCHCP] and will lay the groundwork for negotiations next year,\" Peter Lee, executive director of the state exchange, said in a statement last week.\u003c/p>\n\u003cp>And while Ventura County (region 12 in Covered California) will have about 95,000 exchange-eligible individuals, state officials say they will be amply served by the region's three remaining plans: Anthem, Blue Shield of California and Kaiser. (Not so coincidentally, the three plans that essentially have a statewide footprint in the individual health coverage market.)\u003c/p>\n\u003cp>But with California leading the way -- no state has moved faster to implement its exchange -- VCHCP's experience may be illustrative of the challenges that are looming for small plans around the nation.\u003c/p>\n\u003cp>Observers previously told \"Road to Reform\" that Ventura County's participation in Covered California was a sign of reform's promise; an example of a small insurer that was boldly stepping into the gap when plans like Aetna and United \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/aetna-and-united-are-out-of-california-whos-moving-in\" target=\"_blank\">didn't even bother to apply\u003c/a>.\u003c/p>\n\u003cp>But turning the Affordable Care Act's promise into reality will be a sometimes-bumpy ride\u003cem>. \u003c/em>And that's to be expected, experts say.\u003c/p>\n\u003cp>\"From the perspective of where California was in 2010 to where it is approaching 2014, change is\u003cem>dramatic\u003c/em>,\" said Patrick Johnston, CEO of the California Association of Health Plans. \"It's such an enormous undertaking ... [like] we're in a raft going down a fast-moving river.\"\u003c/p>\n\u003cp>\u003cstrong>\"\u003c/strong>There are rocks and shoals and eddies, and plenty of details that can have everybody scratching their heads.\"\u003c/p>\n\u003cp>\u003cstrong>Why Ventura County geared up to participate ...\u003c/strong>\u003c/p>\n\u003cp>VCHCP signaled its interest in applying for Covered California at a \u003ca href=\"http://ventura.granicus.com/MediaPlayer.php?view_id=&clip_id=3072&meta_id=\" target=\"_blank\">county board of supervisors meeting\u003c/a> back in January -- a hearing that played as a microcosm of the tensions facing local legislators and health care leaders around the nation.\u003c/p>\n\u003cp>Gonzalez \u003ca href=\"http://bosagenda.countyofventura.org/sirepub/cache/2/mbhklq5515aelc55b40th4i5/45064208132013051905445.PDF\" target=\"_blank\">laid out\u003c/a> the case for participating in the exchange: It would allow currently uninsured county residents who used Ventura County health care facilities to obtain coverage through VCHCP too, and offer financial benefits for the county plan given that so many current patients lacked insurance.\u003c/p>\n\u003cp>\"Why are we doing this?\" Gonzalez asked rhetorically. \"A lot of this is based on our experience of what we do ... [And] we do a good job of it,\" Gonzalez added, noting that VCHCP had about one-third the number of emergency visits and roughly 40 percent of the inpatient utilization of comparable low-income plans. \"Our system does work,\" he stressed.\u003c/p>\n\u003cp>And if Ventura County decided not to bother applying this year, Gonzalez warned, the plan would essentially be locked out of the next three years of the exchange.\u003c/p>\n\u003cp>Gonzalez found a mostly sympathetic audience.\u003c/p>\n\u003cp>But the board's chair -- Peter Foy -- confessed that he had doubts about the exchange, mostly about the potential trade-offs over cost and quality. \"I still struggle with the whole idea of this issue,\" he said, wondering aloud if joining the exchange and expanding VCHCP's obligations would weaken the county health system and open it up to new financial obligations.\u003c/p>\n\u003cp>The supervisors ultimately voted 4-1 to allow the plan's application, with only Foy dissenting.\u003c/p>\n\u003cp>\u003cstrong>... and why leaders had second thoughts\u003c/strong>\u003c/p>\n\u003cp>In subsequent months, VCHCP \u003ca href=\"http://www.vcstar.com/news/2013/mar/26/ventura-county-adds-staff-to-gear-up-for-health/\" target=\"_blank\">staffed up\u003c/a> to prepare for the exchange; had its proposed rates \u003ca href=\"http://www.californiahealthline.org/articles/2013/7/16/state-approves-covered-california-rates-following-actuarial-review\" target=\"_blank\">checked and approved\u003c/a>; and returned to the board of supervisors to ask for additional resources to help with its exchange participation.\u003c/p>\n\u003cp>But behind the scenes, the plan's leaders kept coming back to their concerns about the number of potential enrollees next year, and whether VCHCP could truly handle the influx -- especially if it turned out to be more than the original predictions.\u003c/p>\n\u003cp>\"When you're looking at having to invest $3.8 million in various new systems,\" Ventura County's Fisher said ruefully, \"the option of delaying entry into [Covered California]\" to further prepare for the expansion and exchange became increasingly appealing.\u003c/p>\n\u003cp>And unlike some of the other participants in Covered California, VCHCP has significantly smaller operations and margins -- which translates to less margin for error.\u003c/p>\n\u003cp>\"The big plans don't have some of the things that we have to worry about,\" said Fisher. For example, the larger health care insurers already have agreements in place with brokers and can easily afford the new technology systems they'll need for next year.\u003c/p>\n\u003cp>\"We feel that we can compete with them,\" Fisher added. \"Looking at the rates we were right in there with them.\"\u003c/p>\n\u003cp>But when going through the final calculus, \"we [had] to look hard at where we stand in the marketplace.\"\u003c/p>\n\u003cp>\u003cstrong>After the plan's withdrawal\u003c/strong>\u003c/p>\n\u003cp>Fisher said that VCHCP leaders kept \"working and working\" with Covered California to make the numbers work, but reached the conclusion -- several days before last week's announcement -- that it just wouldn't be feasible for 2014.\u003c/p>\n\u003cp>\"We want to remain a financially viable plan,\" Fisher added. And by taking the option to delay a year, \"that little bit of extra time is beneficial to us and the current members of the plan.\"\u003c/p>\n\u003cp>But looking back now at January's county board meeting -- when Gonzalez made his pitch, when local leaders eagerly signed on -- is like watching a dream deferred.\u003c/p>\n\u003cp>\"If there's any county that's most prepared for this, it's us,\" Supervisor Long said back at the January hearing, when Ventura County made the decision to apply to Covered California.\u003c/p>\n\u003cp>\"While other [county's] hospitals are closing, we actually opened up a new hospital,\" Supervisor Linda Parks agreed, pointing to Ventura County's relative strengths in delivering health care.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"If we can't do it, I don't think anyone can.\"\u003c/p>\n\n",
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"excerpt": "Ventura County Health Care Plan administrators won't soon forget May 23, 2013.\r\n\r\nThat was the day that Covered California announced that VCHCP -- a small, county-run plan -- would join Anthem Blue Cross, Kaiser Permanente and 10 other insurers in next year's marketplace.\r\n\r\nVCHCP put out a press release declaring it was \"honored\" to be part of Covered California's inaugural crop of insurers. There was a celebratory Facebook post.\r\n\r\n\"This is a monumental day,\" the county's health care director, Robert Gonzalez, said at the time.\r\n\r\nBut 10 weeks later, Covered California has signed contracts with a dozen insurers -- and Ventura County Health Care Plan isn't one of them. Instead, the plan announced last week that it had withdrawn from the health benefits exchange for next year.",
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"description": "Ventura County Health Care Plan administrators won't soon forget May 23, 2013.\r\n\r\nThat was the day that Covered California announced that VCHCP -- a small, county-run plan -- would join Anthem Blue Cross, Kaiser Permanente and 10 other insurers in next year's marketplace.\r\n\r\nVCHCP put out a press release declaring it was "honored" to be part of Covered California's inaugural crop of insurers. There was a celebratory Facebook post.\r\n\r\n"This is a monumental day," the county's health care director, Robert Gonzalez, said at the time.\r\n\r\nBut 10 weeks later, Covered California has signed contracts with a dozen insurers -- and Ventura County Health Care Plan isn't one of them. Instead, the plan announced last week that it had withdrawn from the health benefits exchange for next year.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14362\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14362 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/78779048_crop1-640x417.jpg\" alt=\"(Getty Images)\" width=\"640\" height=\"417\">\u003cfigcaption class=\"wp-caption-text\">After initial enthusiasm, Ventura County Health Care Plan withdrew its application from the Covered California marketplace. (Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Dan Diamond\u003c/strong>, \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/why-one-insurer-quit-covered-california\" target=\"_blank\">California Healthline\u003c/a>\u003c/p>\n\u003cp>Ventura County Health Care Plan administrators won't soon forget May 23, 2013.\u003c/p>\n\u003cp>That was the day that Covered California announced that VCHCP -- a small, county-run plan -- would join Anthem Blue Cross, Kaiser Permanente and 10 other insurers in next year's marketplace.\u003c/p>\n\u003cp>VCHCP put out a \u003ca href=\"http://www.vchca.org/docs/public-info-office/healthexchangevchcp-press-release.pdf?sfvrsn=0\" target=\"_blank\">press release\u003c/a> declaring it was \"honored\" to be part of Covered California's inaugural crop of insurers. There was a celebratory \u003ca href=\"https://www.facebook.com/VCHCA/posts/663589527001069\" target=\"_blank\">Facebook post\u003c/a>.\u003c/p>\n\u003cp>\"This is a monumental day,\" the county's health care director, Robert Gonzalez, said at the time.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Behind the scenes, the plan’s leaders kept coming back to their concerns about the number of potential enrollees next year, and whether VCHCP could truly handle the influx.\u003c/aside>\n\u003cp>But 10 weeks later, Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/23/californias-health-insurance-exchange-sets-plans-premiums-no-apparent-rate-shock/\" target=\"_blank\">has signed contracts \u003c/a>with a dozen insurers -- and Ventura County Health Care Plan isn't one of them. Instead, the plan announced last week that it had withdrawn from the health benefits exchange for next year; a \u003ca href=\"http://www.vchca.org/docs/public-info-office/covered-california-pr0807_2.pdf?sfvrsn=0\">terse press release\u003c/a> alluded to \"ongoing analysis of enrollment projections, start-up costs and certain factors whose outcome and impact are difficult to predict.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There was no Facebook post.\u003c!--more-->Officials in Ventura County, at Covered California and at other organizations have stressed that uninsured county residents will still have a range of choices when seeking health coverage next year. And VCHCP plans to apply to Covered California in hopes of joining the exchange in 2015.\u003c/p>\n\u003cp>\"We didn't withdraw completely,\" Barry Fisher, chief deputy director for the Ventura County Health Care Agency, told \u003cem>California Healthline\u003c/em>.\u003c/p>\n\u003cp>\"The opportunity to participate with Covered California -- we were ... well, still are excited about it\u003cem>.\u003c/em>\"\u003c/p>\n\u003cp>\u003cstrong>Putting the plan in context\u003c/strong>\u003c/p>\n\u003cp>VCHCP's flirtation with Covered California will ultimately be a footnote in the exchange's success or failure; the plan currently covers about 13,000 government workers and affiliates, and was expected to add 10,000 beneficiaries or so in 2014. (Note that's a small number in the overall uninsured, but a big increase for VCHCP, an increase that ultimately mattered quite a bit.)\u003c/p>\n\u003cp>\"Covered California remains partners with [VCHCP] and will lay the groundwork for negotiations next year,\" Peter Lee, executive director of the state exchange, said in a statement last week.\u003c/p>\n\u003cp>And while Ventura County (region 12 in Covered California) will have about 95,000 exchange-eligible individuals, state officials say they will be amply served by the region's three remaining plans: Anthem, Blue Shield of California and Kaiser. (Not so coincidentally, the three plans that essentially have a statewide footprint in the individual health coverage market.)\u003c/p>\n\u003cp>But with California leading the way -- no state has moved faster to implement its exchange -- VCHCP's experience may be illustrative of the challenges that are looming for small plans around the nation.\u003c/p>\n\u003cp>Observers previously told \"Road to Reform\" that Ventura County's participation in Covered California was a sign of reform's promise; an example of a small insurer that was boldly stepping into the gap when plans like Aetna and United \u003ca href=\"http://www.californiahealthline.org/road-to-reform/2013/aetna-and-united-are-out-of-california-whos-moving-in\" target=\"_blank\">didn't even bother to apply\u003c/a>.\u003c/p>\n\u003cp>But turning the Affordable Care Act's promise into reality will be a sometimes-bumpy ride\u003cem>. \u003c/em>And that's to be expected, experts say.\u003c/p>\n\u003cp>\"From the perspective of where California was in 2010 to where it is approaching 2014, change is\u003cem>dramatic\u003c/em>,\" said Patrick Johnston, CEO of the California Association of Health Plans. \"It's such an enormous undertaking ... [like] we're in a raft going down a fast-moving river.\"\u003c/p>\n\u003cp>\u003cstrong>\"\u003c/strong>There are rocks and shoals and eddies, and plenty of details that can have everybody scratching their heads.\"\u003c/p>\n\u003cp>\u003cstrong>Why Ventura County geared up to participate ...\u003c/strong>\u003c/p>\n\u003cp>VCHCP signaled its interest in applying for Covered California at a \u003ca href=\"http://ventura.granicus.com/MediaPlayer.php?view_id=&clip_id=3072&meta_id=\" target=\"_blank\">county board of supervisors meeting\u003c/a> back in January -- a hearing that played as a microcosm of the tensions facing local legislators and health care leaders around the nation.\u003c/p>\n\u003cp>Gonzalez \u003ca href=\"http://bosagenda.countyofventura.org/sirepub/cache/2/mbhklq5515aelc55b40th4i5/45064208132013051905445.PDF\" target=\"_blank\">laid out\u003c/a> the case for participating in the exchange: It would allow currently uninsured county residents who used Ventura County health care facilities to obtain coverage through VCHCP too, and offer financial benefits for the county plan given that so many current patients lacked insurance.\u003c/p>\n\u003cp>\"Why are we doing this?\" Gonzalez asked rhetorically. \"A lot of this is based on our experience of what we do ... [And] we do a good job of it,\" Gonzalez added, noting that VCHCP had about one-third the number of emergency visits and roughly 40 percent of the inpatient utilization of comparable low-income plans. \"Our system does work,\" he stressed.\u003c/p>\n\u003cp>And if Ventura County decided not to bother applying this year, Gonzalez warned, the plan would essentially be locked out of the next three years of the exchange.\u003c/p>\n\u003cp>Gonzalez found a mostly sympathetic audience.\u003c/p>\n\u003cp>But the board's chair -- Peter Foy -- confessed that he had doubts about the exchange, mostly about the potential trade-offs over cost and quality. \"I still struggle with the whole idea of this issue,\" he said, wondering aloud if joining the exchange and expanding VCHCP's obligations would weaken the county health system and open it up to new financial obligations.\u003c/p>\n\u003cp>The supervisors ultimately voted 4-1 to allow the plan's application, with only Foy dissenting.\u003c/p>\n\u003cp>\u003cstrong>... and why leaders had second thoughts\u003c/strong>\u003c/p>\n\u003cp>In subsequent months, VCHCP \u003ca href=\"http://www.vcstar.com/news/2013/mar/26/ventura-county-adds-staff-to-gear-up-for-health/\" target=\"_blank\">staffed up\u003c/a> to prepare for the exchange; had its proposed rates \u003ca href=\"http://www.californiahealthline.org/articles/2013/7/16/state-approves-covered-california-rates-following-actuarial-review\" target=\"_blank\">checked and approved\u003c/a>; and returned to the board of supervisors to ask for additional resources to help with its exchange participation.\u003c/p>\n\u003cp>But behind the scenes, the plan's leaders kept coming back to their concerns about the number of potential enrollees next year, and whether VCHCP could truly handle the influx -- especially if it turned out to be more than the original predictions.\u003c/p>\n\u003cp>\"When you're looking at having to invest $3.8 million in various new systems,\" Ventura County's Fisher said ruefully, \"the option of delaying entry into [Covered California]\" to further prepare for the expansion and exchange became increasingly appealing.\u003c/p>\n\u003cp>And unlike some of the other participants in Covered California, VCHCP has significantly smaller operations and margins -- which translates to less margin for error.\u003c/p>\n\u003cp>\"The big plans don't have some of the things that we have to worry about,\" said Fisher. For example, the larger health care insurers already have agreements in place with brokers and can easily afford the new technology systems they'll need for next year.\u003c/p>\n\u003cp>\"We feel that we can compete with them,\" Fisher added. \"Looking at the rates we were right in there with them.\"\u003c/p>\n\u003cp>But when going through the final calculus, \"we [had] to look hard at where we stand in the marketplace.\"\u003c/p>\n\u003cp>\u003cstrong>After the plan's withdrawal\u003c/strong>\u003c/p>\n\u003cp>Fisher said that VCHCP leaders kept \"working and working\" with Covered California to make the numbers work, but reached the conclusion -- several days before last week's announcement -- that it just wouldn't be feasible for 2014.\u003c/p>\n\u003cp>\"We want to remain a financially viable plan,\" Fisher added. And by taking the option to delay a year, \"that little bit of extra time is beneficial to us and the current members of the plan.\"\u003c/p>\n\u003cp>But looking back now at January's county board meeting -- when Gonzalez made his pitch, when local leaders eagerly signed on -- is like watching a dream deferred.\u003c/p>\n\u003cp>\"If there's any county that's most prepared for this, it's us,\" Supervisor Long said back at the January hearing, when Ventura County made the decision to apply to Covered California.\u003c/p>\n\u003cp>\"While other [county's] hospitals are closing, we actually opened up a new hospital,\" Supervisor Linda Parks agreed, pointing to Ventura County's relative strengths in delivering health care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"If we can't do it, I don't think anyone can.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "People with Disabilities Face Complex Choices under Obamacare",
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"content": "\u003cp>We've heard a lot about how Obamacare will allow \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/13/aca-updates-covered-california-benefit-plans-and-calculate-your-subsidy-online/\" target=\"_blank\">apples-to-apples\u003c/a>\" comparisons of health plans. The Affordable Care Act requires insurers to meet what are called \u003ca href=\"https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/ehb-2-20-2013.html\" target=\"_blank\">essential health benefits\u003c/a> which outline what \u003ca href=\"http://www.npr.org/blogs/health/2012/11/20/165580705/administration-lays-down-rules-for-future-health-insurance\">health insurance companies must now cover\u003c/a>. But there's a catch: Insurance firms still have some wiggle room as to specific therapies they'll cover within some of those essential health benefits categories. And the way insurers interpret the rules could turn out to be a big deal for people with disabilities who need ongoing therapy to improve their day-to-day lives.\u003c/p>\n\u003caside class=\"pullquote alignleft\">People who want to have specific therapies covered are going to have to slog through some fine print.\u003c/aside>\n\u003cp>Take a look, for example, at Bryce Vernon. He is a 20-year-old film student in Los Angeles who has cerebral palsy. He\u003cstrong> \u003c/strong>speaks only with the aid of a special computer mounted to his wheelchair that tracks his eye movements. Using his eyes, Vernon can indicate on a screen what letters and words he wants the computer's voice to say.\u003c/p>\n\u003cp>It's amazing technology, and Vernon gets a lot more out of it with help from speech-language pathologist Jill Tullman.\u003c/p>\n\u003cp>\"Now Bryce, I want to show you this super cool random button I think you're going to love,\" Tullman tells him during a therapy session at a special camp for young people who use the technology. Vernon's parents paid out-of-pocket for him to attend the camp.\u003c!--more-->\u003c/p>\n\u003cp>Tullman helps him pre-load several different ways of saying goodbye.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Bye, later dude, later. Bye, I'm out of here, see ya later,\" Vernon directs the computer's voice to say, testing it out.\u003c/p>\n\u003cfigure id=\"attachment_14302\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-14302\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/vernon-90efc629e9e2f0dfeb1fded30d338ff58bc7133c-s3-300x224.jpg\" alt=\"Speech-language pathologists Jill Tullman (left) and Mendi Carroll (right) work with Bryce Vernon at Talking with Technology Camp in Empire, Colo. (Kristen Kidd/KCFR).\" width=\"300\" height=\"224\">\u003cfigcaption class=\"wp-caption-text\">Speech-language pathologists Jill Tullman (left) and Mendi Carroll (right) work with Bryce Vernon at Talking with Technology Camp in Empire, Colo. (Kristen Kidd/KCFR).\u003c/figcaption>\u003c/figure>\n\u003cp>In the parlance of health policy, the work Tullman is doing with Vernon is called \"habilitative services.\" It's different from the more familiar \"rehabilitation services\" people often get after an injury or surgery. Habilitative services are for people who can benefit from one-on-one time with a therapist to improve daily living skills. But such services can be expensive, and not all insurance plans have covered them.\u003c/p>\n\u003cp>The Affordable Care Act is changing that, says health economist Lisa Clemans-Cope with the Urban Institute. She says that consumers will be \"much more likely to find these benefits in a plan [starting in] 2014 in the individual market than you would be today. Far more likely.\"\u003c/p>\n\u003cp>This is because habilitative services are included within the 10 categories of essential health benefits the ACA will require in those new plans. Still, while some categories are straightforward — such as maternity care and preventive care — the category including habilitative services leaves more room for interpretation.\u003c/p>\n\u003cp>For instance, insurers could choose to cover physical therapy for someone with a broken bone, but not cover long-term support services for chronic conditions, such as speech therapy for kids with developmental delays.\u003c/p>\n\u003cp>Clemans-Cope says some insurers may arrange their benefits in a way that discourages people with expensive chronic conditions from signing up with them. And, she says, people who want to have specific therapies covered are going to have to slog through some fine print to figure out if they'll actually benefit from a particular policy.\u003c/p>\n\u003cp>\"This is a big improvement, but we should emphasize that it's not totally fixed,\" Clemans-Cope says. \"And people are really going to have to get help to decide which plans cover the benefits they need.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more about Obamacare: Check out KQED's guide for Californians\u003c/a>\u003c/aside>\n\u003cp>In California, people can begin formally comparing plans when the Covered California marketplace opens Oct. 1. Plans go into effect Jan. 1, 2014. Covered California has also awarded millions of dollars in grants\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/14/californias-health-insurance-exchange-builds-critical-outreach-network/\" target=\"_blank\"> to help educate consumers\u003c/a> about the Affordable Care Act and is certifying \"navigators\" who will help people understand the differences among plans available to them.\u003c/p>\n\u003cp>Barbara Vernon, Bryce's mother, says Bryce is now covered by Medi-Cal, California's Medicaid program. His primary insurance had been her employer-sponsored plan until she was laid off in 2009. She searched for private coverage for Bryce, but says, \"Private was so unbelievably expensive, it was unaffordable.\"\u003c/p>\n\u003cp>Barbara says her family's insurance is \"a patchwork,\" with Bryce likely to stay on Medi-Cal even after his 21st birthday. She and her other son have an individual plan they have purchased, and her husband has an employer-sponsored plan -- but it covers only the employee, not the family.\u003c/p>\n\u003cp>For his part, Bryce Vernon says his life is a lot better since getting the kind of help that many others may be able to get from the health law, starting in 2014. He works hard to get the most out of the technology and the therapy that lets him speak. His advice to others, delivered by the computer-generated voice: \"Never, ever give up.\"\u003c/p>\n\u003cp>The new rules for what health insurance companies have to cover may still change. Federal regulators plan to review them as the health law rolls out and could make changes in 2016.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This piece is part of a reporting partnership among \u003ca href=\"http://www.npr.org/\">NPR\u003c/a>, \u003ca href=\"http://www.cpr.org/\">Colorado Public Radio\u003c/a> and \u003c/em>\u003cem>Kaiser Health News\u003c/em>.\u003c/p>\n\n",
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"excerpt": "We've heard a lot about how Obamacare will allow \"apples-to-apples\" comparisons of health plans. The Affordable Care Act requires insurers to meet what are called essential health benefits which outline what health insurance companies must now cover. But there's a catch: Insurance firms still have some wiggle room as to specific therapies they'll cover within some of those essential health benefits categories. And the way insurers interpret the rules could turn out to be a big deal for people with disabilities who need ongoing therapy to improve their day-to-day lives.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>We've heard a lot about how Obamacare will allow \"\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/02/13/aca-updates-covered-california-benefit-plans-and-calculate-your-subsidy-online/\" target=\"_blank\">apples-to-apples\u003c/a>\" comparisons of health plans. The Affordable Care Act requires insurers to meet what are called \u003ca href=\"https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/ehb-2-20-2013.html\" target=\"_blank\">essential health benefits\u003c/a> which outline what \u003ca href=\"http://www.npr.org/blogs/health/2012/11/20/165580705/administration-lays-down-rules-for-future-health-insurance\">health insurance companies must now cover\u003c/a>. But there's a catch: Insurance firms still have some wiggle room as to specific therapies they'll cover within some of those essential health benefits categories. And the way insurers interpret the rules could turn out to be a big deal for people with disabilities who need ongoing therapy to improve their day-to-day lives.\u003c/p>\n\u003caside class=\"pullquote alignleft\">People who want to have specific therapies covered are going to have to slog through some fine print.\u003c/aside>\n\u003cp>Take a look, for example, at Bryce Vernon. He is a 20-year-old film student in Los Angeles who has cerebral palsy. He\u003cstrong> \u003c/strong>speaks only with the aid of a special computer mounted to his wheelchair that tracks his eye movements. Using his eyes, Vernon can indicate on a screen what letters and words he wants the computer's voice to say.\u003c/p>\n\u003cp>It's amazing technology, and Vernon gets a lot more out of it with help from speech-language pathologist Jill Tullman.\u003c/p>\n\u003cp>\"Now Bryce, I want to show you this super cool random button I think you're going to love,\" Tullman tells him during a therapy session at a special camp for young people who use the technology. Vernon's parents paid out-of-pocket for him to attend the camp.\u003c!--more-->\u003c/p>\n\u003cp>Tullman helps him pre-load several different ways of saying goodbye.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Bye, later dude, later. Bye, I'm out of here, see ya later,\" Vernon directs the computer's voice to say, testing it out.\u003c/p>\n\u003cfigure id=\"attachment_14302\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003cimg class=\"size-medium wp-image-14302\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/vernon-90efc629e9e2f0dfeb1fded30d338ff58bc7133c-s3-300x224.jpg\" alt=\"Speech-language pathologists Jill Tullman (left) and Mendi Carroll (right) work with Bryce Vernon at Talking with Technology Camp in Empire, Colo. (Kristen Kidd/KCFR).\" width=\"300\" height=\"224\">\u003cfigcaption class=\"wp-caption-text\">Speech-language pathologists Jill Tullman (left) and Mendi Carroll (right) work with Bryce Vernon at Talking with Technology Camp in Empire, Colo. (Kristen Kidd/KCFR).\u003c/figcaption>\u003c/figure>\n\u003cp>In the parlance of health policy, the work Tullman is doing with Vernon is called \"habilitative services.\" It's different from the more familiar \"rehabilitation services\" people often get after an injury or surgery. Habilitative services are for people who can benefit from one-on-one time with a therapist to improve daily living skills. But such services can be expensive, and not all insurance plans have covered them.\u003c/p>\n\u003cp>The Affordable Care Act is changing that, says health economist Lisa Clemans-Cope with the Urban Institute. She says that consumers will be \"much more likely to find these benefits in a plan [starting in] 2014 in the individual market than you would be today. Far more likely.\"\u003c/p>\n\u003cp>This is because habilitative services are included within the 10 categories of essential health benefits the ACA will require in those new plans. Still, while some categories are straightforward — such as maternity care and preventive care — the category including habilitative services leaves more room for interpretation.\u003c/p>\n\u003cp>For instance, insurers could choose to cover physical therapy for someone with a broken bone, but not cover long-term support services for chronic conditions, such as speech therapy for kids with developmental delays.\u003c/p>\n\u003cp>Clemans-Cope says some insurers may arrange their benefits in a way that discourages people with expensive chronic conditions from signing up with them. And, she says, people who want to have specific therapies covered are going to have to slog through some fine print to figure out if they'll actually benefit from a particular policy.\u003c/p>\n\u003cp>\"This is a big improvement, but we should emphasize that it's not totally fixed,\" Clemans-Cope says. \"And people are really going to have to get help to decide which plans cover the benefits they need.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more about Obamacare: Check out KQED's guide for Californians\u003c/a>\u003c/aside>\n\u003cp>In California, people can begin formally comparing plans when the Covered California marketplace opens Oct. 1. Plans go into effect Jan. 1, 2014. Covered California has also awarded millions of dollars in grants\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/14/californias-health-insurance-exchange-builds-critical-outreach-network/\" target=\"_blank\"> to help educate consumers\u003c/a> about the Affordable Care Act and is certifying \"navigators\" who will help people understand the differences among plans available to them.\u003c/p>\n\u003cp>Barbara Vernon, Bryce's mother, says Bryce is now covered by Medi-Cal, California's Medicaid program. His primary insurance had been her employer-sponsored plan until she was laid off in 2009. She searched for private coverage for Bryce, but says, \"Private was so unbelievably expensive, it was unaffordable.\"\u003c/p>\n\u003cp>Barbara says her family's insurance is \"a patchwork,\" with Bryce likely to stay on Medi-Cal even after his 21st birthday. She and her other son have an individual plan they have purchased, and her husband has an employer-sponsored plan -- but it covers only the employee, not the family.\u003c/p>\n\u003cp>For his part, Bryce Vernon says his life is a lot better since getting the kind of help that many others may be able to get from the health law, starting in 2014. He works hard to get the most out of the technology and the therapy that lets him speak. His advice to others, delivered by the computer-generated voice: \"Never, ever give up.\"\u003c/p>\n\u003cp>The new rules for what health insurance companies have to cover may still change. Federal regulators plan to review them as the health law rolls out and could make changes in 2016.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This piece is part of a reporting partnership among \u003ca href=\"http://www.npr.org/\">NPR\u003c/a>, \u003ca href=\"http://www.cpr.org/\">Colorado Public Radio\u003c/a> and \u003c/em>\u003cem>Kaiser Health News\u003c/em>.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Kids' Dental Plans Cost Extra in Obamacare Marketplace",
"title": "Kids' Dental Plans Cost Extra in Obamacare Marketplace",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_14224\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14224\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/3525527232_b1e234c35a_b-copy1-640x439.jpg\" alt=\"(emrank/Flickr)\" width=\"640\" height=\"439\">\u003cfigcaption class=\"wp-caption-text\">(emrank/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Small, KPCC\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>UPDATE 5:00PM\u003c/strong>\u003c/p>\n\u003cp>After listening to comments from interested parties ranging from insurance executives to children's health advocates, the board of Covered California voted to hold off making changes to the types of children's dental coverage they will sell starting Oct. 1 in the new marketplace.\u003c/p>\n\u003cp>\u003cstrong>ORIGINAL POST:\u003c/strong>\u003c/p>\n\u003cp>The board of California's new health care exchange meets Thursday in Sacramento. On the agenda is what kind of children's dental coverage to offer under the Affordable Care Act. Covered California is required to sell pediatric dentistry plans, but the exchange has made those plans an optional extra.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Check out KQED's Obamacare Guide for Californians.\u003c/a>\u003c/aside>\n\u003cp>While pediatric dental care is an \u003ca href=\"https://www.healthcare.gov/glossary/essential-health-benefits/\" target=\"_blank\">Essential Health Benefit\u003c/a> under the Affordable Care Act, there's a big exception.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The law allows state-run health care exchanges to sell medical insurance without pediatric dental care as long as they also sell stand-alone plans. The federal law made that exception because nearly all people who have dental insurance today have stand-alone plans. This way they’ll be able to keep their same dentists, even after federal reforms take effect.\u003c/p>\n\u003cp>But Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/07/02/covered-california-to-sell-childrens-dental-plans-separately/\" target=\"_blank\">went a step further\u003c/a> and chose to only offer stand-alone dental plans for children \u003cem>and\u003c/em> make the purchase optional.\u003c!--more-->\u003c/p>\n\u003cp>That decision drew the ire of consumer advocates who say parents will have to pay more for their children’s dental care. There are concerns parents may opt out entirely.\u003c/p>\n\u003cdiv>“Hopefully it won’t be a big black eye,” said Betsy Imholz with Consumers Union.\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>While they will discuss the issue today, the board of the exchange has told advocates it’s probably too late to reverse the decision for this year.\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cp>“Basically what the exchange did was to tell qualified health plan bidders on the medical side that they could not include pediatric dental,\" Imholz said. \"Some wanted to. Some were ready to. Some weren’t, but as it stands now the only bids they’ve got don’t have the dental as a part of it.”\u003c/p>\n\u003cp>Imholz and other advocates say offering children’s dental care only as a stand-alone policy will push up the cost for as many as 250,000 children who are expected to get insurance next year through the exchange.\u003c/p>\n\u003cp>Imholz says families will have to pay from $10 to $30 extra a month for dental care for each of their kids. “If you’re really watching your budget,\" she notes, \"and just barely making rent and food, health insurance could be tough to pay for.”\u003c/p>\n\u003cp>Families that purchase stand-alone dental care will also have to pay a separate deductible from their medical deductible, and fulfill a separate out-of-pocket maximum.\u003c/p>\n\u003cp>But Covered California spokesman Dana Howard says its approach could actually benefit consumers.\u003c/p>\n\u003cp>“It depends on how you look at it,\" he said. \"You can slice it and dice it in whole different ways depending on each individual’s particular scenario.”\u003c/p>\n\u003cp>Howard says a stand-alone dental plan enables parents to hit a $1,000 out-of-pocket maximum sooner than if the coverage was included in a comprehensive health plan, where that maximum is more than $12,000 for a family.\u003c/p>\n\u003cp>“You could easily reach your maximum out-of-pocket maximum of a thousand dollars or so for your dental coverage, and then you’re done!”\u003c/p>\n\u003cp>\u003cstrong>Pediatric dental care need is great\u003c/strong>\u003c/p>\n\u003cp>An estimated 1.1 million children in California lack dental insurance and often go untreated until their problems are so severe they require hospitalization.\u003c/p>\n\u003cp>“An infection in the mouth can affect the entire body,” explains Dr. Elizabeth Johnson, who treats hundreds of children a year at the WellSpace Health dental clinic in Sacramento. “We see children with infection, decay and abscesses in almost every tooth by the age three, from neglect.”\u003c/p>\n\u003cp>The California Society of Pediatric Dentistry reports that tooth decay is the most prevalent childhood disease. More children miss school because of dental pain than any other reason.\u003c/p>\n\u003cp>WellSpace's Clinic administrator Tanya Burgos says it’s often schools that get parents to make an appointment because the child is in so much pain they cannot sit in their chairs.\u003c/p>\n\u003cp>But Burgos says the issue is not one of parent neglect, it's more a matter of money.\u003c/p>\n\u003cp>“When you ask parents 'Why haven’t the kids been to the dentist?' they say they don’t have the insurance,\" Burgos says. \"They’re either between jobs or waiting for coverage to kick in or they just couldn’t afford it.”\u003c/p>\n\u003cp>Nearly all the clinic’s patients are on a state subsidized health program called Denti-Cal. WellSpace Health enrolls eligible children who come to the clinic for care. Those that don’t qualify pay a sliding-scale fee based on income.\u003c/p>\n\u003cp>Burgos thinks including pediatric dental care in all insurance plans would “definitely make it more accessible for families to get care for their kids and make sure that they are seen in a timely manner.”\u003c/p>\n\u003cp>Dr. Sharine Thenard, a pediatric dentist in Alameda, said she’s not so worried about the exchange’s choice to offer stand-alone plans.\u003c/p>\n\u003cp>To her -- and to many child health care advocates -- the bigger problem is that parents who purchase insurance through the exchange can opt-out of dental insurance for their kids.\u003c/p>\n\u003cp>“If you don’t mandate the families to buy it,\" she says, \"then it’s the first thing that gets chopped off their list. Because they think it’s just a disposable kind of thing. They think, ‘I’m just going to save a few bucks and I’m not going to get the dental portion of it.’”\u003c/p>\n\u003cp>The board of California Covered could address that problem by making pediatric dental coverage mandatory next year or in the future.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201308080850a.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201308080850a.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n",
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"excerpt": "The board of California's new health care exchange meets Thursday in Sacramento. On the agenda is what kind of children's dental coverage to offer under the Affordable Care Act. Covered California is required to sell pediatric dentistry plans, but the exchange has made those plans an optional extra.\r\n\r\nWhile pediatric dental care is an Essential Health Benefit under the Affordable Care Act, there's a big exception.",
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"description": "The board of California's new health care exchange meets Thursday in Sacramento. On the agenda is what kind of children's dental coverage to offer under the Affordable Care Act. Covered California is required to sell pediatric dentistry plans, but the exchange has made those plans an optional extra.\r\n\r\nWhile pediatric dental care is an Essential Health Benefit under the Affordable Care Act, there's a big exception.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14224\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"size-large wp-image-14224\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/3525527232_b1e234c35a_b-copy1-640x439.jpg\" alt=\"(emrank/Flickr)\" width=\"640\" height=\"439\">\u003cfigcaption class=\"wp-caption-text\">(emrank/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>By Julie Small, KPCC\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>UPDATE 5:00PM\u003c/strong>\u003c/p>\n\u003cp>After listening to comments from interested parties ranging from insurance executives to children's health advocates, the board of Covered California voted to hold off making changes to the types of children's dental coverage they will sell starting Oct. 1 in the new marketplace.\u003c/p>\n\u003cp>\u003cstrong>ORIGINAL POST:\u003c/strong>\u003c/p>\n\u003cp>The board of California's new health care exchange meets Thursday in Sacramento. On the agenda is what kind of children's dental coverage to offer under the Affordable Care Act. Covered California is required to sell pediatric dentistry plans, but the exchange has made those plans an optional extra.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Check out KQED's Obamacare Guide for Californians.\u003c/a>\u003c/aside>\n\u003cp>While pediatric dental care is an \u003ca href=\"https://www.healthcare.gov/glossary/essential-health-benefits/\" target=\"_blank\">Essential Health Benefit\u003c/a> under the Affordable Care Act, there's a big exception.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The law allows state-run health care exchanges to sell medical insurance without pediatric dental care as long as they also sell stand-alone plans. The federal law made that exception because nearly all people who have dental insurance today have stand-alone plans. This way they’ll be able to keep their same dentists, even after federal reforms take effect.\u003c/p>\n\u003cp>But Covered California \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/07/02/covered-california-to-sell-childrens-dental-plans-separately/\" target=\"_blank\">went a step further\u003c/a> and chose to only offer stand-alone dental plans for children \u003cem>and\u003c/em> make the purchase optional.\u003c!--more-->\u003c/p>\n\u003cp>That decision drew the ire of consumer advocates who say parents will have to pay more for their children’s dental care. There are concerns parents may opt out entirely.\u003c/p>\n\u003cdiv>“Hopefully it won’t be a big black eye,” said Betsy Imholz with Consumers Union.\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cdiv>While they will discuss the issue today, the board of the exchange has told advocates it’s probably too late to reverse the decision for this year.\u003c/div>\n\u003cdiv>\u003c/div>\n\u003cp>“Basically what the exchange did was to tell qualified health plan bidders on the medical side that they could not include pediatric dental,\" Imholz said. \"Some wanted to. Some were ready to. Some weren’t, but as it stands now the only bids they’ve got don’t have the dental as a part of it.”\u003c/p>\n\u003cp>Imholz and other advocates say offering children’s dental care only as a stand-alone policy will push up the cost for as many as 250,000 children who are expected to get insurance next year through the exchange.\u003c/p>\n\u003cp>Imholz says families will have to pay from $10 to $30 extra a month for dental care for each of their kids. “If you’re really watching your budget,\" she notes, \"and just barely making rent and food, health insurance could be tough to pay for.”\u003c/p>\n\u003cp>Families that purchase stand-alone dental care will also have to pay a separate deductible from their medical deductible, and fulfill a separate out-of-pocket maximum.\u003c/p>\n\u003cp>But Covered California spokesman Dana Howard says its approach could actually benefit consumers.\u003c/p>\n\u003cp>“It depends on how you look at it,\" he said. \"You can slice it and dice it in whole different ways depending on each individual’s particular scenario.”\u003c/p>\n\u003cp>Howard says a stand-alone dental plan enables parents to hit a $1,000 out-of-pocket maximum sooner than if the coverage was included in a comprehensive health plan, where that maximum is more than $12,000 for a family.\u003c/p>\n\u003cp>“You could easily reach your maximum out-of-pocket maximum of a thousand dollars or so for your dental coverage, and then you’re done!”\u003c/p>\n\u003cp>\u003cstrong>Pediatric dental care need is great\u003c/strong>\u003c/p>\n\u003cp>An estimated 1.1 million children in California lack dental insurance and often go untreated until their problems are so severe they require hospitalization.\u003c/p>\n\u003cp>“An infection in the mouth can affect the entire body,” explains Dr. Elizabeth Johnson, who treats hundreds of children a year at the WellSpace Health dental clinic in Sacramento. “We see children with infection, decay and abscesses in almost every tooth by the age three, from neglect.”\u003c/p>\n\u003cp>The California Society of Pediatric Dentistry reports that tooth decay is the most prevalent childhood disease. More children miss school because of dental pain than any other reason.\u003c/p>\n\u003cp>WellSpace's Clinic administrator Tanya Burgos says it’s often schools that get parents to make an appointment because the child is in so much pain they cannot sit in their chairs.\u003c/p>\n\u003cp>But Burgos says the issue is not one of parent neglect, it's more a matter of money.\u003c/p>\n\u003cp>“When you ask parents 'Why haven’t the kids been to the dentist?' they say they don’t have the insurance,\" Burgos says. \"They’re either between jobs or waiting for coverage to kick in or they just couldn’t afford it.”\u003c/p>\n\u003cp>Nearly all the clinic’s patients are on a state subsidized health program called Denti-Cal. WellSpace Health enrolls eligible children who come to the clinic for care. Those that don’t qualify pay a sliding-scale fee based on income.\u003c/p>\n\u003cp>Burgos thinks including pediatric dental care in all insurance plans would “definitely make it more accessible for families to get care for their kids and make sure that they are seen in a timely manner.”\u003c/p>\n\u003cp>Dr. Sharine Thenard, a pediatric dentist in Alameda, said she’s not so worried about the exchange’s choice to offer stand-alone plans.\u003c/p>\n\u003cp>To her -- and to many child health care advocates -- the bigger problem is that parents who purchase insurance through the exchange can opt-out of dental insurance for their kids.\u003c/p>\n\u003cp>“If you don’t mandate the families to buy it,\" she says, \"then it’s the first thing that gets chopped off their list. Because they think it’s just a disposable kind of thing. They think, ‘I’m just going to save a few bucks and I’m not going to get the dental portion of it.’”\u003c/p>\n\u003cp>The board of California Covered could address that problem by making pediatric dental coverage mandatory next year or in the future.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cobject width=\"335\" height=\"85\" classid=\"d27cdb6e-ae6d-11cf-96b8-444553540000\" codebase=\"http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=6,0,40,0\">\u003cparam name=\"flashvars\" value=\"file=http://www.kqed.org/radio/archives/R201308080850a.xml\">\u003cparam name=\"src\" value=\"http://www.kqed.org/assets/flash/kqedplayer.swf\">\u003cembed width=\"335\" height=\"85\" type=\"application/x-shockwave-flash\" src=\"http://www.kqed.org/assets/flash/kqedplayer.swf\" flashvars=\"file=http://www.kqed.org/radio/archives/R201308080850a.xml\">\u003c/embed>\u003c/object>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "In Oakland, Sen. Boxer Bullish on Obamacare",
"title": "In Oakland, Sen. Boxer Bullish on Obamacare",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_14131\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-14131\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/IMG_4554-620x413.jpg\" alt=\"Sen. Barbara Boxer (D-CA) talks about the benefits of the Affordable Care Act at a press conference in Oakland. (Chase Thomas/KQED)\" width=\"620\" height=\"413\">\u003cfigcaption class=\"wp-caption-text\">Sen. Barbara Boxer (D-Calif.) talks about the benefits of the Affordable Care Act at a press conference in Oakland. (Chase Thomas/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>It's August. Congress is in recess, and that means your representatives and senators are hitting the home turf. With just two months until the Obamacare marketplaces open, across the country elected leaders are either talking up or trashing the Affordable Care Act. In the Bay Area, you can bet it will be the former.\u003c/p>\n\u003caside class=\"pullquote alignleft\">People should become \"ambassadors\" for the health law, Boxer said.\u003c/aside>\n\u003cp>So when Sen. Barbara Boxer (D-Calif.) spoke at Oakland's La Clinica de la Raza on Monday, she was full of praise for the health law. She recapped the reforms already in effect and then listed health insurance changes coming Jan. 1: no more denials for pre-existing conditions, no more lifetime limits on coverage, women can no longer be charged more than men of the same age.\u003c/p>\n\u003cp>Then she got to the heart of her message: People need to sign up. \"It's critical we tell California to take advantage\" of these changes, Boxer said. People should become \"ambassadors\" for the health law, she continued. Because of California's huge population -- 38 million -- and large number of uninsured -- 7 million -- the state is critical to the success of the health law. \"Everything we do here is important for the whole nation,\" Boxer said.\u003c!--more-->\u003c/p>\n\u003cp>A quick review of some stats: On Jan. 1, most people will need to have health insurance or pay a fine, and subsidies are available for people who cannot afford it. About half of Californians uninsured and eligible for benefits under the health law are 18 to 35 years old, the so-called \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/24/young-adults-key-to-obamacare-in-california/\" target=\"_blank\">young invincibles\u003c/a>. This young population tends to be healthier, and they're needed in the insurance pool to spread risk -- to offset the high costs of people who are sick. About half of those eligible for subsidies are Latino\u003c/p>\n\u003cp>Jane Garcia, CEO of La Clinica de la Raza, noted a need to \"create a culture of insurance\" in this young population. La Clinica is a community health center with 32 sites in Alameda, Contra Costa and Solano counties. It's \"going to be a challenge,\" she said, to get people to pay for insurance when many of the people they serve already get health care for free at one of La Clinica's sites.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>La Clinica has already subtly shifted some of its terminology to get people on board. They no longer serve \"patients,\" Garcia said. Patients are now \"members.\" The organization has been awarded large grants to help educate people and get them to sign up for insurance. \"It won't happen overnight,\" she said, but it's \"in their best interest to make sure we stay healthy and well.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>She spoke of a need to get people to think about health insurance the way they think about car insurance. Boxer agreed and was largely optimistic. \"Once young people see the advantages, just as they do when they get auto insurance, they wouldn't think twice about getting behind the wheel without insurance. I think we're going to be OK.\"\u003c/p>\n\n",
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"excerpt": "It's August. Congress is in recess, and that means your representatives and senators are hitting the home turf. With just two months until the Obamacare marketplaces open, across the country elected leaders are either talking up or trashing the Affordable Care Act. In the Bay Area, you can bet it will be the former.\r\n\r\nSo, when Senator Barbara Boxer spoke at Oakland's La Clinica de la Raza on Monday, she was full of praise for the health law. She recapped the reforms already in effect and then listed health insurance changes coming Jan. 1: no more denials for pre-existing conditions, no more lifetime limits on coverage, women can no longer be charged more than men of the same age.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14131\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\"size-large wp-image-14131\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/IMG_4554-620x413.jpg\" alt=\"Sen. Barbara Boxer (D-CA) talks about the benefits of the Affordable Care Act at a press conference in Oakland. (Chase Thomas/KQED)\" width=\"620\" height=\"413\">\u003cfigcaption class=\"wp-caption-text\">Sen. Barbara Boxer (D-Calif.) talks about the benefits of the Affordable Care Act at a press conference in Oakland. (Chase Thomas/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>It's August. Congress is in recess, and that means your representatives and senators are hitting the home turf. With just two months until the Obamacare marketplaces open, across the country elected leaders are either talking up or trashing the Affordable Care Act. In the Bay Area, you can bet it will be the former.\u003c/p>\n\u003caside class=\"pullquote alignleft\">People should become \"ambassadors\" for the health law, Boxer said.\u003c/aside>\n\u003cp>So when Sen. Barbara Boxer (D-Calif.) spoke at Oakland's La Clinica de la Raza on Monday, she was full of praise for the health law. She recapped the reforms already in effect and then listed health insurance changes coming Jan. 1: no more denials for pre-existing conditions, no more lifetime limits on coverage, women can no longer be charged more than men of the same age.\u003c/p>\n\u003cp>Then she got to the heart of her message: People need to sign up. \"It's critical we tell California to take advantage\" of these changes, Boxer said. People should become \"ambassadors\" for the health law, she continued. Because of California's huge population -- 38 million -- and large number of uninsured -- 7 million -- the state is critical to the success of the health law. \"Everything we do here is important for the whole nation,\" Boxer said.\u003c!--more-->\u003c/p>\n\u003cp>A quick review of some stats: On Jan. 1, most people will need to have health insurance or pay a fine, and subsidies are available for people who cannot afford it. About half of Californians uninsured and eligible for benefits under the health law are 18 to 35 years old, the so-called \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/24/young-adults-key-to-obamacare-in-california/\" target=\"_blank\">young invincibles\u003c/a>. This young population tends to be healthier, and they're needed in the insurance pool to spread risk -- to offset the high costs of people who are sick. About half of those eligible for subsidies are Latino\u003c/p>\n\u003cp>Jane Garcia, CEO of La Clinica de la Raza, noted a need to \"create a culture of insurance\" in this young population. La Clinica is a community health center with 32 sites in Alameda, Contra Costa and Solano counties. It's \"going to be a challenge,\" she said, to get people to pay for insurance when many of the people they serve already get health care for free at one of La Clinica's sites.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>La Clinica has already subtly shifted some of its terminology to get people on board. They no longer serve \"patients,\" Garcia said. Patients are now \"members.\" The organization has been awarded large grants to help educate people and get them to sign up for insurance. \"It won't happen overnight,\" she said, but it's \"in their best interest to make sure we stay healthy and well.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>She spoke of a need to get people to think about health insurance the way they think about car insurance. Boxer agreed and was largely optimistic. \"Once young people see the advantages, just as they do when they get auto insurance, they wouldn't think twice about getting behind the wheel without insurance. I think we're going to be OK.\"\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Univision Obamacare Deal Could Put WellPoint Ahead Of Competitors",
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"content": "\u003cp>By Jenny Gold,\u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/August/02/univision-obamacare-deal-could-help-insurers-ahead.aspx\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Some 10 million Latinos nationally -- including nearly 3 million in California -- stand to gain health insurance under the Affordable Care Act, and the Spanish-language media network Univision is positioning itself as a direct path to this potentially lucrative market.\u003c/p>\n\u003cp>WellPoint and other Blue insurers in six states, including California, have signed deals with Univision for undisclosed sums to be the exclusive health insurance sponsor of the network’s Peabody-award winning health initiative, \"Salud Es Vida,\" which means Health Is Life. WellPoint is the parent company of Anthem Blue Cross in California.\u003c/p>\n\u003caside class=\"pullquote alignleft\">A spokesman for Covered California, confirmed that the agency is finalizing guidelines for \"plan-based enrollment.\"\u003c/aside>\n\u003cp>The deals include a special plan-sponsored Univision website that will be able to connect Latinos with coverage on the online markets, or exchanges, that will serve individuals beginning in October. But it's a path that could take a detour around some competitors who are offering plans: Because of a \u003ca href=\"http://www.gpo.gov/fdsys/pkg/FR-2013-06-19/pdf/2013-14540.pdf\" target=\"_blank\">little-known rule\u003c/a> proposed by the administration in June, customers will be able to buy their subsidized Obamacare insurance directly from the insurer.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The rule allows a customer to be sent briefly to a special section of the federal or state-run marketplaces only to see if their income qualifies them for subsidized coverage, and then can go right back to the WellPoint or Blues site to buy their coverage. These customers may not necessarily see the other options for insurance available on the exchange, and the other plans may cost less or include a wider provider network.\u003c/p>\n\u003cp>Santiago Lucero, a spokesman for Covered California, confirmed that the agency is finalizing guidelines for such \"plan-based enrollment.\" He said that agents will be required to read consumers a disclaimer at the beginning of the call, informing them that other options may be available.\u003c/p>\n\u003cp>Steve Mandala, Univision's executive vice president of sales and marketing, says that any insurer material on the plan-sponsored sites will be clearly labeled as advertisements or sponsored content and will not impact the editorial independence of Univision's news coverage.\u003c/p>\n\u003cp>The deals are one of the most concrete ways to date that insurers have invested in the marketing of Obamacare, but they also could skirt a key principle of the law: that it should foster insurer competition and consumer choice.\u003c/p>\n\u003cp>Latinos tend to be younger than the general population, so \u003ca href=\"http://www.kaiserhealthnews.org/stories/2013/june/25/administration-outreach-to-hispanics-on-marketplaces.aspx?referrer=search\" target=\"_blank\">they are just the sort of consumers\u003c/a> that insurers (and the Obama administration) hope will sign up. Because young, healthy people need fewer medical services, insurance companies can use their premiums to balance the costs of care for older or sicker patients.\u003c/p>\n\u003cp>\"If I were Health Med or Kaiser Permanente or any of the other health plans, I might think, 'Wow, we just got out-maneuvered,'\" says Daniel Zingale of the California Endowment in reference to the WellPoint partnership in California. The foundation has given Univision $20 million for a separate ACA campaign.\u003c/p>\n\u003cp>Consumer advocates had a mixed reaction to the rule and the Univision deals.\u003c/p>\n\u003cp>In San Francisco, Betsy Imholz with Consumers Union said she had concerns about \"massive arrangements that are exclusive and will tend not to get people into the full array of choices.\" She was skeptical that the required consumer disclaimer would make much difference. She speculated that consumers would be more likely to stay with the \"nice people they're talking to currently,\" as opposed to heading off to another site and starting the process over again.\u003c/p>\n\u003cp>But Imholz also said she recognized the \"tough balance to strike.\" Signing up qualified people for insurance is a daunting challenge, she and other advocates noted.\u003c/p>\n\u003cp>\"We really do need any boot on the ground. At the end of the day, the government will never have the money to have the kind of media campaign we need, so we need the carriers to get involved,\" says Elisabeth Benjamin, an advocate at the Community Service Society of New York. She says her organization and other groups working on consumer outreach \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2013/07/survey-latino-groups-worry-about-money-for-aca-enrollment/?referrer=search\" target=\"_blank\">can use all the help they can get\u003c/a> to spread the word about the ACA. \"My hat's off to WellPoint -- it's very clever.\"\u003c/p>\n\u003cp>In addition to the insurance sales, WellPoint, Florida Blue and Horizon BCBS will be the sole health insurance sponsor of Salud Es Vida in their respective states, which includes programming on television, radio and online.\u003c/p>\n\u003cp>They will also be the exclusive sponsor for a series of health newsletters that are distributed to a database of millions of Latinos. The database has some detailed health information people provided as they signed up for the newsletter, including whether or not they have insurance and if they suffer from conditions such as diabetes, hypertension and obesity.\u003c/p>\n\u003cp>Anthem Blue Cross is also sponsoring a \u003ca href=\"http://www.telemundo52.com/secciones-especiales/a-tu-salud\" target=\"_blank\">health site on Telemundo\u003c/a>, Univision's rival. It includes video content jointly created by the two companies and a link to Anthem’s site.\u003c/p>\n\u003cp>Lisa Rubino, a senior vice president at Molina Healthcare Inc., which is offering health plans on the California and Florida exchanges, says she’s not overly concerned about other plans having exclusive sponsorship arrangements with Univision.\u003c/p>\n\u003cp>Enrolling Latinos in coverage is about \"more than just a media position,\" says Rubino. Molina already has a majority Latino customer base in California. The company's strategy is to focus on engaging with community partners such as churches, schools, markets and physicians -- the trusted advisers that Latinos generally go to for help with coverage.\u003c/p>\n\u003cp>Ultimately, she says, the real competition is going to be on price and network, not who has the best media buy. \"When it comes down to actually enrolling, there are relationships that have been established for years beyond WellPoint and Florida Blue,\" Rubino says.\u003c/p>\n\u003cp>Lynn Quincy who works in the Washington office of Consumers Union says that despite her concerns, partnerships between insurers and other private companies like Univision may be inevitable. \"Someone got into the insurance market and yelled, 'Free money! New demand!' They're all trying to figure out how to be the place where people spend their tax credit dollars,\" she says.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Lisa Aliferis contributed to this report.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Some 10 million Latinos nationally -- including more than one million in California -- stand to gain health insurance under the Affordable Care Act, and the Spanish-language media network Univision is positioning itself as a direct path to this potentially lucrative market.\n\nWellpoint and other Blues insurers in six states including California have signed deals with Univision for undisclosed sums to be the exclusive health insurance sponsor of the network’s Peabody-award winning health initiative, \"Salud Es Vida,\" which means Health Is Life. Wellpoint is the parent company of Anthem Blue Cross in California.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Jenny Gold,\u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/August/02/univision-obamacare-deal-could-help-insurers-ahead.aspx\" target=\"_blank\"> Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>Some 10 million Latinos nationally -- including nearly 3 million in California -- stand to gain health insurance under the Affordable Care Act, and the Spanish-language media network Univision is positioning itself as a direct path to this potentially lucrative market.\u003c/p>\n\u003cp>WellPoint and other Blue insurers in six states, including California, have signed deals with Univision for undisclosed sums to be the exclusive health insurance sponsor of the network’s Peabody-award winning health initiative, \"Salud Es Vida,\" which means Health Is Life. WellPoint is the parent company of Anthem Blue Cross in California.\u003c/p>\n\u003caside class=\"pullquote alignleft\">A spokesman for Covered California, confirmed that the agency is finalizing guidelines for \"plan-based enrollment.\"\u003c/aside>\n\u003cp>The deals include a special plan-sponsored Univision website that will be able to connect Latinos with coverage on the online markets, or exchanges, that will serve individuals beginning in October. But it's a path that could take a detour around some competitors who are offering plans: Because of a \u003ca href=\"http://www.gpo.gov/fdsys/pkg/FR-2013-06-19/pdf/2013-14540.pdf\" target=\"_blank\">little-known rule\u003c/a> proposed by the administration in June, customers will be able to buy their subsidized Obamacare insurance directly from the insurer.\u003c/p>\n\u003cp>\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The rule allows a customer to be sent briefly to a special section of the federal or state-run marketplaces only to see if their income qualifies them for subsidized coverage, and then can go right back to the WellPoint or Blues site to buy their coverage. These customers may not necessarily see the other options for insurance available on the exchange, and the other plans may cost less or include a wider provider network.\u003c/p>\n\u003cp>Santiago Lucero, a spokesman for Covered California, confirmed that the agency is finalizing guidelines for such \"plan-based enrollment.\" He said that agents will be required to read consumers a disclaimer at the beginning of the call, informing them that other options may be available.\u003c/p>\n\u003cp>Steve Mandala, Univision's executive vice president of sales and marketing, says that any insurer material on the plan-sponsored sites will be clearly labeled as advertisements or sponsored content and will not impact the editorial independence of Univision's news coverage.\u003c/p>\n\u003cp>The deals are one of the most concrete ways to date that insurers have invested in the marketing of Obamacare, but they also could skirt a key principle of the law: that it should foster insurer competition and consumer choice.\u003c/p>\n\u003cp>Latinos tend to be younger than the general population, so \u003ca href=\"http://www.kaiserhealthnews.org/stories/2013/june/25/administration-outreach-to-hispanics-on-marketplaces.aspx?referrer=search\" target=\"_blank\">they are just the sort of consumers\u003c/a> that insurers (and the Obama administration) hope will sign up. Because young, healthy people need fewer medical services, insurance companies can use their premiums to balance the costs of care for older or sicker patients.\u003c/p>\n\u003cp>\"If I were Health Med or Kaiser Permanente or any of the other health plans, I might think, 'Wow, we just got out-maneuvered,'\" says Daniel Zingale of the California Endowment in reference to the WellPoint partnership in California. The foundation has given Univision $20 million for a separate ACA campaign.\u003c/p>\n\u003cp>Consumer advocates had a mixed reaction to the rule and the Univision deals.\u003c/p>\n\u003cp>In San Francisco, Betsy Imholz with Consumers Union said she had concerns about \"massive arrangements that are exclusive and will tend not to get people into the full array of choices.\" She was skeptical that the required consumer disclaimer would make much difference. She speculated that consumers would be more likely to stay with the \"nice people they're talking to currently,\" as opposed to heading off to another site and starting the process over again.\u003c/p>\n\u003cp>But Imholz also said she recognized the \"tough balance to strike.\" Signing up qualified people for insurance is a daunting challenge, she and other advocates noted.\u003c/p>\n\u003cp>\"We really do need any boot on the ground. At the end of the day, the government will never have the money to have the kind of media campaign we need, so we need the carriers to get involved,\" says Elisabeth Benjamin, an advocate at the Community Service Society of New York. She says her organization and other groups working on consumer outreach \u003ca href=\"http://capsules.kaiserhealthnews.org/index.php/2013/07/survey-latino-groups-worry-about-money-for-aca-enrollment/?referrer=search\" target=\"_blank\">can use all the help they can get\u003c/a> to spread the word about the ACA. \"My hat's off to WellPoint -- it's very clever.\"\u003c/p>\n\u003cp>In addition to the insurance sales, WellPoint, Florida Blue and Horizon BCBS will be the sole health insurance sponsor of Salud Es Vida in their respective states, which includes programming on television, radio and online.\u003c/p>\n\u003cp>They will also be the exclusive sponsor for a series of health newsletters that are distributed to a database of millions of Latinos. The database has some detailed health information people provided as they signed up for the newsletter, including whether or not they have insurance and if they suffer from conditions such as diabetes, hypertension and obesity.\u003c/p>\n\u003cp>Anthem Blue Cross is also sponsoring a \u003ca href=\"http://www.telemundo52.com/secciones-especiales/a-tu-salud\" target=\"_blank\">health site on Telemundo\u003c/a>, Univision's rival. It includes video content jointly created by the two companies and a link to Anthem’s site.\u003c/p>\n\u003cp>Lisa Rubino, a senior vice president at Molina Healthcare Inc., which is offering health plans on the California and Florida exchanges, says she’s not overly concerned about other plans having exclusive sponsorship arrangements with Univision.\u003c/p>\n\u003cp>Enrolling Latinos in coverage is about \"more than just a media position,\" says Rubino. Molina already has a majority Latino customer base in California. The company's strategy is to focus on engaging with community partners such as churches, schools, markets and physicians -- the trusted advisers that Latinos generally go to for help with coverage.\u003c/p>\n\u003cp>Ultimately, she says, the real competition is going to be on price and network, not who has the best media buy. \"When it comes down to actually enrolling, there are relationships that have been established for years beyond WellPoint and Florida Blue,\" Rubino says.\u003c/p>\n\u003cp>Lynn Quincy who works in the Washington office of Consumers Union says that despite her concerns, partnerships between insurers and other private companies like Univision may be inevitable. \"Someone got into the insurance market and yelled, 'Free money! New demand!' They're all trying to figure out how to be the place where people spend their tax credit dollars,\" she says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Lisa Aliferis contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Covered California Sets Plans, Premiums for Small Business Marketplace",
"title": "Covered California Sets Plans, Premiums for Small Business Marketplace",
"headTitle": "State of Health | KQED News",
"content": "\u003cfigure id=\"attachment_14038\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\" wp-image-14038\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/RS5161_78770400-scr-620x356.jpg\" alt=\"Health Insurance\" width=\"620\" height=\"356\">\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Covered California, the state's health insurance exchange, \u003ca href=\"http://www.coveredca.com/news/PDFs/Covered-California-SHOP-booklet.pdf\" target=\"_blank\">announced plans and premiums\u003c/a> for its Small Business Health Options Program -- or SHOP -- Thursday afternoon. Six health insurers were selected for the marketplace. While some are regional insurers only, Covered California Executive Director Peter Lee said businesses in many parts of California should have a choice of four or more plans.\u003c/p>\n\u003cp>Lee said rates for the plans, starting in 2014, will be comparable with current rates or \"in many cases\" lower than they are now. \"With the SHOP program,\" Lee told reporters in a conference call, \"we're offering ... a combination of choice and standard benefits for small businesses to offer (health insurance) on par with what large employers do, but without paying additional fees. This is a game leveler.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more: KQED's Obamacare Guide\u003c/a>\u003c/aside>\n\u003cp>Lee noted that small businesses -- defined as fewer than 50 employees -- are not required to provide health insurance under the Affordable Care Act. But businesses that wish to provide insurance may be eligible for subsidies to purchase it. That subsidy is\u003ca href=\"http://www.coveredca.com/PDFs/English/Covered_California_Small_Business_Tax_Credit_fact_sheet_English.pdf\" target=\"_blank\"> available now\u003c/a>. It's currently 35 percent and goes up to 50 percent of the premium on Jan. 1. Small business owners who want to take advantage must purchase health insurance through the SHOP marketplace.\u003c!--more-->\u003c/p>\n\u003cp>Larry Levitt, senior vice president at the Kaiser Family Foundation and an expert on the health insurance marketplace, said he wasn't surprised that the rates are fairly comparable to today. That's because many market reforms already have been instituted, such as guaranteed issue, where insurers are required to take all applicants, regardless of health status.\u003c/p>\n\u003cp>Still, Levitt was surprised by the variation in premiums for employees of different ages in different regions of California. \"Premiums can vary by, easily, 20 percent across insurers,\" he noted. But, SHOP \"will offer more choice to workers and small business, and hopefully put more price pressure on insurers as well,\" he said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>John Arensmeyer, founder of Small Business Majority, said the major advantage of SHOP is that it will give small businesses access to more plans. Under SHOP, the employer will pick a level of coverage and employees can pick any plan at that level. \"That's something you can't get today and you can't get on the outside market,\" Arensmeyer said. \"That's something that big business employees get where there's a whole range of products. ... Employees will be able to have choice and employers won't have to worry about which employees are going to choose which products.\u003c/p>\n\u003cp>The six carriers offered on SHOP are:\u003c/p>\n\u003cul>\n\u003cli>Blue Shield of California\u003c/li>\n\u003cli>Chinese Community Health Plan\u003c/li>\n\u003cli>Health Net\u003c/li>\n\u003cli>Kaiser Permanente\u003c/li>\n\u003cli>Sharp Health Plan\u003c/li>\n\u003cli>Western Health Advantage\u003c/li>\n\u003c/ul>\n\u003cp>Small business owners may enroll in health insurance on the SHOP marketplace starting Oct. 1. Coverage will take effect Jan. 1.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Polly Stryker contributed to this report.\u003c/em>\u003c/p>\n\n",
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"excerpt": "Covered California, the state's health insurance exchange, announced plans and premiums [PDF] for its Small Business Health Options Program -- or SHOP -- Thursday afternoon. Six health insurers were selected for the marketplace. While some are regional insurers only, Covered California executive director Peter Lee said businesses in many parts of California should have a choice of four or more plans.\r\n\r\nLee says rates for the plans starting in 2014 will be comparable to current rates or \"in many cases\" lower than they are now. \"With the SHOP program,\" Lee told reporters in a conference call, \"we're offering ... a combination of choice and standard benefits for small businesses to offer (health insurance) on par with what large employers do, but without paying additional fees. This is a game leveler.\"",
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"description": "Covered California, the state's health insurance exchange, announced plans and premiums for its Small Business Health Options Program -- or SHOP -- Thursday afternoon. Six health insurers were selected for the marketplace. While some are regional insurers only, Covered California executive director Peter Lee said businesses in many parts of California should have a choice of four or more plans.\r\n\r\nLee says rates for the plans starting in 2014 will be comparable to current rates or "in many cases" lower than they are now. "With the SHOP program," Lee told reporters in a conference call, "we're offering ... a combination of choice and standard benefits for small businesses to offer (health insurance) on par with what large employers do, but without paying additional fees. This is a game leveler."",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_14038\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003cimg class=\" wp-image-14038\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/08/RS5161_78770400-scr-620x356.jpg\" alt=\"Health Insurance\" width=\"620\" height=\"356\">\u003cfigcaption class=\"wp-caption-text\">(Getty Images)\u003c/figcaption>\u003c/figure>\n\u003cp>Covered California, the state's health insurance exchange, \u003ca href=\"http://www.coveredca.com/news/PDFs/Covered-California-SHOP-booklet.pdf\" target=\"_blank\">announced plans and premiums\u003c/a> for its Small Business Health Options Program -- or SHOP -- Thursday afternoon. Six health insurers were selected for the marketplace. While some are regional insurers only, Covered California Executive Director Peter Lee said businesses in many parts of California should have a choice of four or more plans.\u003c/p>\n\u003cp>Lee said rates for the plans, starting in 2014, will be comparable with current rates or \"in many cases\" lower than they are now. \"With the SHOP program,\" Lee told reporters in a conference call, \"we're offering ... a combination of choice and standard benefits for small businesses to offer (health insurance) on par with what large employers do, but without paying additional fees. This is a game leveler.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">\u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Learn more: KQED's Obamacare Guide\u003c/a>\u003c/aside>\n\u003cp>Lee noted that small businesses -- defined as fewer than 50 employees -- are not required to provide health insurance under the Affordable Care Act. But businesses that wish to provide insurance may be eligible for subsidies to purchase it. That subsidy is\u003ca href=\"http://www.coveredca.com/PDFs/English/Covered_California_Small_Business_Tax_Credit_fact_sheet_English.pdf\" target=\"_blank\"> available now\u003c/a>. It's currently 35 percent and goes up to 50 percent of the premium on Jan. 1. Small business owners who want to take advantage must purchase health insurance through the SHOP marketplace.\u003c!--more-->\u003c/p>\n\u003cp>Larry Levitt, senior vice president at the Kaiser Family Foundation and an expert on the health insurance marketplace, said he wasn't surprised that the rates are fairly comparable to today. That's because many market reforms already have been instituted, such as guaranteed issue, where insurers are required to take all applicants, regardless of health status.\u003c/p>\n\u003cp>Still, Levitt was surprised by the variation in premiums for employees of different ages in different regions of California. \"Premiums can vary by, easily, 20 percent across insurers,\" he noted. But, SHOP \"will offer more choice to workers and small business, and hopefully put more price pressure on insurers as well,\" he said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>John Arensmeyer, founder of Small Business Majority, said the major advantage of SHOP is that it will give small businesses access to more plans. Under SHOP, the employer will pick a level of coverage and employees can pick any plan at that level. \"That's something you can't get today and you can't get on the outside market,\" Arensmeyer said. \"That's something that big business employees get where there's a whole range of products. ... Employees will be able to have choice and employers won't have to worry about which employees are going to choose which products.\u003c/p>\n\u003cp>The six carriers offered on SHOP are:\u003c/p>\n\u003cul>\n\u003cli>Blue Shield of California\u003c/li>\n\u003cli>Chinese Community Health Plan\u003c/li>\n\u003cli>Health Net\u003c/li>\n\u003cli>Kaiser Permanente\u003c/li>\n\u003cli>Sharp Health Plan\u003c/li>\n\u003cli>Western Health Advantage\u003c/li>\n\u003c/ul>\n\u003cp>Small business owners may enroll in health insurance on the SHOP marketplace starting Oct. 1. Coverage will take effect Jan. 1.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Polly Stryker contributed to this report.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "No Wonk: How Obamacare Subsidies Work for Consumers",
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"content": "\u003cp>By Julie Appleby, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/July/24/interview-with-cathy-livingston-on-how-to-apply-for-tax-credit-subsidies-for-premiums.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-13827\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/subsidies-key-300.jpg\" alt=\"subsidies key 300\" width=\"300\" height=\"199\">Tax credits to help low- and moderate-income Americans buy health insurance will become available in January under the health law, when for the first time, most people will be required to have coverage or pay a fine.\u003c/p>\n\u003cp>The process could be complicated for some consumers, but information about how the system will work may help.\u003c/p>\n\u003cp>Cathy Livingston, a lawyer in Washington, D.C., who specializes in tax issues involving the federal health law, spoke recently with KHN about how to find out if you’re eligible for a premium subsidy and how the process will work. Before joining the law firm, Livingston worked in the Office of Chief Counsel for the IRS.\u003c/p>\n\u003cp>The credits are available to people who don't get what is considered affordable, comprehensive coverage through their jobs, and whose household income is less than 400 percent of the \u003ca href=\"http://aspe.hhs.gov/poverty/13poverty.cfm\" target=\"_blank\">federal poverty level\u003c/a>, which this year is about $46,000 for an individual, or about $78,000 for a family of three. (Families USA has \u003ca href=\"http://www.familiesusa.org/resources/tools-for-advocates/guides/federal-poverty-guidelines.html\" target=\"_blank\">a great chart \u003c/a>so you can match up your household size and income to see if you are under 400 percent of poverty.)\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Most of the 7 million people projected to shop for coverage in new online health insurance marketplaces, also called exchanges, will be \u003ca href=\"http://www.cbo.gov/sites/default/files/cbofiles/attachments/44190_EffectsAffordableCareActHealthInsuranceCoverage_2.pdf\" target=\"_blank\">eligible for the subsidies\u003c/a>, expected to average $5,290 per enrollee.\u003c/p>\n\u003cp>People who don’t have insurance coverage could face fines, which are $95 per adult and $47.50 per child the first year, or 1 percent of family income, whichever is greater. The fines will rise in later years.\u003c/p>\n\u003cp>Here is an excerpt, edited for length and clarity, of Livingston’s conversation with KHN staff writer Julie Appleby.\u003c/p>\n\u003cp>\u003cstrong>Q: The law bases eligibility on household income. What does that include?\u003c!--more-->\u003c/strong>\u003c/p>\n\u003cp>A: It is income, not assets. The value of a house, stocks or bank accounts is not taken into consideration. Household income starts with adjusted gross income -- a number people can find on their tax returns.\u003c/p>\n\u003cp>\u003cstrong>Q: Who determines eligibility?\u003c/strong>\u003c/p>\n\u003cp>A: The exchange. It will have information from an applicant's last filed tax return. So, for example, if a person filed taxes on time in 2012, the exchange this fall would have income information from that year. There will also be other sources of information, such as state wage databases to which employers already report every quarter. The application also asks people to project their income for 2014.\u003c/p>\n\u003cp>\u003cstrong>Q: What happens once a person is deemed eligible for a subsidy?\u003c/strong>\u003c/p>\n\u003cp>A: The exchange will tell applicants the maximum credit they are eligible for. Consumers can decide whether they want to take the maximum or some lesser amount. Those who think their income might increase beyond what they projected, might consider taking less so they won’t have to pay the government back when the year ends. Once an eligible applicant determines how much he or she wants, the exchange will arrange for the amount to be paid every month directly to the insurance company offering the plan the applicant selects. For example, if the monthly premium is $600 and the individual is eligible for $400 [in a subsidy] and opts for that credit, every month the federal government will send $400 to the insurer. The consumer would be responsible for sending the remaining $200.\u003c/p>\n\u003cp>\u003cstrong>Q. How is the maximum premium subsidy amount determined?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">Check out KQED's guide for Californians \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained\u003c/a>\u003c/aside>\n\u003cp>A: There is a complex formula that includes household income, as well as the cost of a benchmark insurance plan, which the law has identified as the second lowest priced silver plan – one of four levels of plans -- offered on that exchange.\u003c/p>\n\u003cp>The law requires consumers to contribute a specific percentage of income to the premium. It’s a sliding scale based on the federal poverty level. For example, if your household income is at 150 percent of the FPL, you are required to contribute 4 percent of income toward the premium. If your income is at 300 percent of poverty, then you’re required to contribute 9.5 percent. The subsidy then makes up the difference between that amount and the cost of the benchmark plan.\u003c/p>\n\u003cp>\u003cstrong>Q. Do people have to buy the silver plan?\u003c/strong>\u003c/p>\n\u003cp>A: No, an individual can choose any plan they like. They might choose a bronze plan with a lower premium or a higher cost gold or platinum plan. The credit is computed against the silver plan. If they choose a bronze plan with a lower premium, it’s possible the advance payment will cover the entire premium. But the credit cannot exceed the actual premium.\u003c/p>\n\u003cp>\u003cstrong>Q. Can I decide not to take the credit as an advance payment?\u003c/strong>\u003c/p>\n\u003cp>A. Yes but you would need to make sure you have the cash to pay the premiums. If you get past 90 days and the premium is not paid in full, the regulations direct the insurer to terminate coverage.\u003c/p>\n\u003cp>\u003cstrong>Q. Do consumers have to file information about the insurance subsidies on their tax returns?\u003c/strong>\u003c/p>\n\u003cp>A. People getting subsidies in 2014 will report them on tax returns they file in April 2015.\u003c/p>\n\u003cp>\u003cstrong>Q. What kind of information will be reported to the IRS?\u003c/strong>\u003c/p>\n\u003cp>A: The exchanges will report the level of coverage chosen by an individual, total premium and the amount of premium credit made to the insurance company.\u003c/p>\n\u003cp>\u003cstrong>Q. Is a worker who gets job-based insurance eligible for a premium subsidy?\u003c/strong>\u003c/p>\n\u003cp>A. Only if the employer coverage is either not affordable or doesn’t provide minimum value. Those definitions mean the employee’s share of the premium for a policy that covers just the individual (not a family policy) cannot exceed 9.5 percent of household income. And the plan has to cover at least 60 percent of expected medical costs.\u003c/p>\n\u003cp>\u003cstrong>Q. Does the administration's decision to delay by a year the requirement that employers offer coverage or pay a fine affect the subsidies?\u003c/strong>\u003c/p>\n\u003cp>A. It does not affect rules on eligibility. But it may mean that more people are eligible. Employers no longer have the incentive to offer policies or make plans affordable because they are no longer at risk of a penalty.\u003c/p>\n\u003cp>\u003cstrong>Q. What happens if I get advance payment, my income then goes up, and I no longer qualify for that amount?\u003c/strong>\u003c/p>\n\u003cp>A: You will need to reconcile what was paid with the amount you were actually entitled to receive. If you get more than you were entitled to, you will owe it back in the form of additional federal taxes. There are some caps on the amount a person has to pay back, based on their income. If, for example, you are at 300 percent of the FPL, the maximum amount you would have to pay back is $2,500. If you are under 200 percent, the maximum amount is $600. If you receive advance payments, but at the end of the year, your income is over 400 percent of the poverty level, there is no cap on the amount you owe.\u003c/p>\n\u003cp>\u003cstrong>Q. What's the biggest challenge for consumers and the exchanges with these subsidies?\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>A: The learning curve. Over time, Americans have gotten very used to things like 401(k) accounts, IRAs, penalties for early withdrawal and the kinds of documents they need to keep. But it takes a while because there are a variety of different rules and they are complicated. Keeping records will be important – both for consumers and the new marketplaces – because consumers whose income changes during the year may find they are either owed more in tax credits, or have to pay some back.\u003c/p>\n\n",
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"excerpt": "Tax credits to help low- and moderate-income Americans buy health insurance will become available in January under the health law, when for the first time, most people will be required to have coverage or pay a fine.\r\n\r\nThe process could be complicated for some consumers, but information about how the system will work may help.\r\n\r\nCathy Livingston, a lawyer in Washington, D.C., who specializes in tax issues involving the federal health law, spoke recently with KHN about how to find out if you’re eligible for a premium subsidy and how the process will work. Before joining the law firm, Livingston worked in the Office of Chief Counsel for the IRS.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>By Julie Appleby, \u003ca href=\"http://www.kaiserhealthnews.org/Stories/2013/July/24/interview-with-cathy-livingston-on-how-to-apply-for-tax-credit-subsidies-for-premiums.aspx\" target=\"_blank\">Kaiser Health News\u003c/a>\u003c/p>\n\u003cp>\u003cimg class=\"aligncenter size-full wp-image-13827\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/07/subsidies-key-300.jpg\" alt=\"subsidies key 300\" width=\"300\" height=\"199\">Tax credits to help low- and moderate-income Americans buy health insurance will become available in January under the health law, when for the first time, most people will be required to have coverage or pay a fine.\u003c/p>\n\u003cp>The process could be complicated for some consumers, but information about how the system will work may help.\u003c/p>\n\u003cp>Cathy Livingston, a lawyer in Washington, D.C., who specializes in tax issues involving the federal health law, spoke recently with KHN about how to find out if you’re eligible for a premium subsidy and how the process will work. Before joining the law firm, Livingston worked in the Office of Chief Counsel for the IRS.\u003c/p>\n\u003cp>The credits are available to people who don't get what is considered affordable, comprehensive coverage through their jobs, and whose household income is less than 400 percent of the \u003ca href=\"http://aspe.hhs.gov/poverty/13poverty.cfm\" target=\"_blank\">federal poverty level\u003c/a>, which this year is about $46,000 for an individual, or about $78,000 for a family of three. (Families USA has \u003ca href=\"http://www.familiesusa.org/resources/tools-for-advocates/guides/federal-poverty-guidelines.html\" target=\"_blank\">a great chart \u003c/a>so you can match up your household size and income to see if you are under 400 percent of poverty.)\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Most of the 7 million people projected to shop for coverage in new online health insurance marketplaces, also called exchanges, will be \u003ca href=\"http://www.cbo.gov/sites/default/files/cbofiles/attachments/44190_EffectsAffordableCareActHealthInsuranceCoverage_2.pdf\" target=\"_blank\">eligible for the subsidies\u003c/a>, expected to average $5,290 per enrollee.\u003c/p>\n\u003cp>People who don’t have insurance coverage could face fines, which are $95 per adult and $47.50 per child the first year, or 1 percent of family income, whichever is greater. The fines will rise in later years.\u003c/p>\n\u003cp>Here is an excerpt, edited for length and clarity, of Livingston’s conversation with KHN staff writer Julie Appleby.\u003c/p>\n\u003cp>\u003cstrong>Q: The law bases eligibility on household income. What does that include?\u003c!--more-->\u003c/strong>\u003c/p>\n\u003cp>A: It is income, not assets. The value of a house, stocks or bank accounts is not taken into consideration. Household income starts with adjusted gross income -- a number people can find on their tax returns.\u003c/p>\n\u003cp>\u003cstrong>Q: Who determines eligibility?\u003c/strong>\u003c/p>\n\u003cp>A: The exchange. It will have information from an applicant's last filed tax return. So, for example, if a person filed taxes on time in 2012, the exchange this fall would have income information from that year. There will also be other sources of information, such as state wage databases to which employers already report every quarter. The application also asks people to project their income for 2014.\u003c/p>\n\u003cp>\u003cstrong>Q: What happens once a person is deemed eligible for a subsidy?\u003c/strong>\u003c/p>\n\u003cp>A: The exchange will tell applicants the maximum credit they are eligible for. Consumers can decide whether they want to take the maximum or some lesser amount. Those who think their income might increase beyond what they projected, might consider taking less so they won’t have to pay the government back when the year ends. Once an eligible applicant determines how much he or she wants, the exchange will arrange for the amount to be paid every month directly to the insurance company offering the plan the applicant selects. For example, if the monthly premium is $600 and the individual is eligible for $400 [in a subsidy] and opts for that credit, every month the federal government will send $400 to the insurer. The consumer would be responsible for sending the remaining $200.\u003c/p>\n\u003cp>\u003cstrong>Q. How is the maximum premium subsidy amount determined?\u003c/strong>\u003c/p>\n\u003caside class=\"pullquote alignright\">Check out KQED's guide for Californians \u003ca href=\"http://www.kqed.org/news/health/obamacare/obamacare-guide.jsp\" target=\"_blank\">Obamacare Explained\u003c/a>\u003c/aside>\n\u003cp>A: There is a complex formula that includes household income, as well as the cost of a benchmark insurance plan, which the law has identified as the second lowest priced silver plan – one of four levels of plans -- offered on that exchange.\u003c/p>\n\u003cp>The law requires consumers to contribute a specific percentage of income to the premium. It’s a sliding scale based on the federal poverty level. For example, if your household income is at 150 percent of the FPL, you are required to contribute 4 percent of income toward the premium. If your income is at 300 percent of poverty, then you’re required to contribute 9.5 percent. The subsidy then makes up the difference between that amount and the cost of the benchmark plan.\u003c/p>\n\u003cp>\u003cstrong>Q. Do people have to buy the silver plan?\u003c/strong>\u003c/p>\n\u003cp>A: No, an individual can choose any plan they like. They might choose a bronze plan with a lower premium or a higher cost gold or platinum plan. The credit is computed against the silver plan. If they choose a bronze plan with a lower premium, it’s possible the advance payment will cover the entire premium. But the credit cannot exceed the actual premium.\u003c/p>\n\u003cp>\u003cstrong>Q. Can I decide not to take the credit as an advance payment?\u003c/strong>\u003c/p>\n\u003cp>A. Yes but you would need to make sure you have the cash to pay the premiums. If you get past 90 days and the premium is not paid in full, the regulations direct the insurer to terminate coverage.\u003c/p>\n\u003cp>\u003cstrong>Q. Do consumers have to file information about the insurance subsidies on their tax returns?\u003c/strong>\u003c/p>\n\u003cp>A. People getting subsidies in 2014 will report them on tax returns they file in April 2015.\u003c/p>\n\u003cp>\u003cstrong>Q. What kind of information will be reported to the IRS?\u003c/strong>\u003c/p>\n\u003cp>A: The exchanges will report the level of coverage chosen by an individual, total premium and the amount of premium credit made to the insurance company.\u003c/p>\n\u003cp>\u003cstrong>Q. Is a worker who gets job-based insurance eligible for a premium subsidy?\u003c/strong>\u003c/p>\n\u003cp>A. Only if the employer coverage is either not affordable or doesn’t provide minimum value. Those definitions mean the employee’s share of the premium for a policy that covers just the individual (not a family policy) cannot exceed 9.5 percent of household income. And the plan has to cover at least 60 percent of expected medical costs.\u003c/p>\n\u003cp>\u003cstrong>Q. Does the administration's decision to delay by a year the requirement that employers offer coverage or pay a fine affect the subsidies?\u003c/strong>\u003c/p>\n\u003cp>A. It does not affect rules on eligibility. But it may mean that more people are eligible. Employers no longer have the incentive to offer policies or make plans affordable because they are no longer at risk of a penalty.\u003c/p>\n\u003cp>\u003cstrong>Q. What happens if I get advance payment, my income then goes up, and I no longer qualify for that amount?\u003c/strong>\u003c/p>\n\u003cp>A: You will need to reconcile what was paid with the amount you were actually entitled to receive. If you get more than you were entitled to, you will owe it back in the form of additional federal taxes. There are some caps on the amount a person has to pay back, based on their income. If, for example, you are at 300 percent of the FPL, the maximum amount you would have to pay back is $2,500. If you are under 200 percent, the maximum amount is $600. If you receive advance payments, but at the end of the year, your income is over 400 percent of the poverty level, there is no cap on the amount you owe.\u003c/p>\n\u003cp>\u003cstrong>Q. What's the biggest challenge for consumers and the exchanges with these subsidies?\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"soldout": {
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