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ObamaCare enrollment assistance available from local organizations

Health, Wellness & You
Thursday, October 17, 2013

Individuals across the entire county are now able to sign up for new health insurance options made available by the Patient Protection and Affordable Care Act, or ObamaCare. Coverage begins as early as January 1, 2014. The new Health Insurance Marketplace offers different types of health plans to meet a variety of budgets and coverage needs for persons seeking health insurance without the benefit of an employer sponsored plan. This is especially important to persons and families affected by changes in the 2014 State of Wisconsin BadgerCare Plus eligibility allowances. Enrollees who no longer qualify for this program are encouraged to apply for private health insurance through the Health Insurance Marketplace.

The Patient Protection and Affordable Care Act has four primary goals. They are:

 • Provide access to health coverage for millions of Americans, including those with pre-existing conditions who have in the past been denied health insurance;
• Increase competition among insurers and therefore, make health insurance more affordable, with greater common benefits such as preventive care and adding younger, healthy people into the mix to spread the risk and costs associated with those risks among a larger pool of subscribers;
• Provide consumers with greater control over which insurance plan they select, rather than being dependent upon whichever plan their employer selects for them; 
• Encouraging regular visits with primary care doctors and nurse practitioners and putting great emphasis on preventive services to make nationwide changes that result in healthier lifestyles for all.

The Health Insurance Marketplace will make the first three goals a reality, while 100 percent coverage for preventive care by insurance companies is gradually becoming the rule as the healthcare reform law becomes effective. Dozens of preventive services are now covered fully by insurance plans, requiring no office visit co-pay. Even more fully-covered preventive services will be required with the new plans available in the Health Insurance Marketplace.

Individuals without health insurance will need to purchase insurance from the Marketplace. Nationwide, nearly 16 million uninsured Americans will be able to enroll in the newly offered health insurance plans, with Health Insurance Marketplaces opening in all 50 states and the District of Columbia.

The Congressional Budget Office has estimated that about 14 million more Americans will be insured in year one, primarily through the exchanges or the state Medicaid expansions, According to the Kaiser Family Foundation. The ease of the enrollment experience, the plans and coverages offered in the exchanges in their states, and the health-care delivery systems where they live will all have varying degrees of impact upon the overall success of the health reform legislation.

Persons and families interested in signing up for health insurance plans in the new marketplace must enroll by December 15 and make payment on the first premium to ensure coverage beginning January 1. Accounts can be established on the website or by calling 1-800-318-2596 (TTY: 1-855-889-4325).

Persons interested in enrolling have encountered significant problems with the website, although many of the issues with the website are resolving. Users are now able to create accounts for themselves and begin the process of enrolling through the insurance marketplace, according to people aiding the sign-up effort. But further into the process, error messages and other difficulties may be apparent, making it difficult for health insurers and nonprofit groups who want to help millions of uninsured Americans sign up for benefits as promised under the health reform law. Some agencies are now recommending that persons interested in coverage simply wait a few weeks until the website’s functionality is improved.

The website saw 14.6 million unique visits in its first 10 days, a larger-than-expected public response that raised hopes the health reform law would meet with strong enough demand in its first year.

Experts say the administration has until mid-November to iron out the problems or risk jeopardizing its goal of signing up 7 million people in the first year of the health insurance marketplaces. The number includes 2.7 million healthy young adults whose participation will help offset the higher cost of insuring sicker and older beneficiaries.

Applicants are asked to provide some basic information and then establish a secure user name and password. Enrollees will provide personal information regarding size of family, income, household size, and more. Enrollees will then receive information regarding the various health insurance plans available to them. Income levels provided help to determine whether or not the enrollee qualifies for the significant federal subsidies that are available.

Consumers seeking to enroll in the Health Insurance Marketplace program should be able to do so without assistance. A variety of local resources exist to assist new applicants and others to better understand the health insurance options available through the Health Insurance Marketplace where Certified Application Counselors (CACs) have been trained to offer enrollment assistance. These individuals can assist consumers in the application and enrollment process available at They cannot make recommendations regarding which coverage should be selected. For more information, please contact these agencies and healthcare providers:

Fort HealthCare Business Services
920 563-4443

UW Health Partners- Watertown Regional Medical Center
Patient Financial Services
920 262-4396

Southern Consortium, Medicaid and BadgerCare Plus
1 888-794-5780 (toll free)
1 800-362-3002 Option #7 (Español)