ACA is on the way

The Enterprise — Anne Hayden

Planning mode: Kathy Burbank, left, the executive director of the Guilderland Chamber of Commerce, and Victoria Michael, the coordinator of the Small Business Assistance Program, discuss how they will handle the influx of questions they expect to get about the Affordable Care Act; the chamber received a grant to assist people in navigating the new system.

In less than five months, every American — unemployed, self-employed, or working for a business — must be enrolled in a health-insurance program, in accordance with the Affordable Care Act. The Guilderland Chamber of Commerce is set up as a hub for people who need help understanding the act and how it affects them.

“Basically, you are now in charge of your own health,” said Guilderland Chamber of Commerce Executive Director Kathy Burbank, of what the legislation is trying to accomplish. “It’s supposed to make people more aware of their health and how much it costs.”

The goal of the ACA, signed into law by President Barack Obama in 2010, is to make preventive care more affordable, or even free. It eliminates lifetime benefit caps and denial of insurance due to pre-existing conditions, increases Medicaid eligibility, and offers tax credits for small businesses. By putting more people into the health-insurance pool, the hope is that costs will go down.

Small businesses, with fewer than 50 employees, are not required to offer health insurance, but, if they do offer it, they get tax relief. 

All individuals must be enrolled in a health insurance program by Jan. 1., 2014, or risk being penalized $95 on taxes in 2015.

Businesses with more than 50 workers will not be required to offer insurance in 2014, but will be required to offer it by 2015. Nationally, only 10 percent of businesses with 50 to 199 employees do not currently offer insurance.

The ACA also mandates a new exchange rate, meaning more cents per dollar must go directly toward an insured person’s health care, rather than toward the insurance company’s salaries or other administrative costs.

“New York State has already mandated its own exchange rate, so we are ahead of the game,” said Burbank. “The rate is 82 cents per dollar.”

Individuals or small businesses in need of an insurance plan will be able to “shop” for one that meets their needs at one of two online marketplaces. One is specifically set up for small businesses, the other for individuals — unemployed people, sole proprietors, and retirees under the age of 65.

“You can go to the marketplace, shop around, enter what kind of coverage you are looking for, and see what’s offered,” said Burbank. “It basically gives people all the tools needed to choose for themselves.”

Open enrollment in the marketplaces begins on Oct. 1, 2013.

There are different tiers for the plans, Burbank explained, labeled bronze, silver, gold, and platinum. Bronze, she said, is a “bare bones” plan, but still offers free preventive care, and platinum is the “premium” plan. All plans, no matter what tier they’re in, offer mental-health coverage.

The Guilderland Chamber of Commerce was awarded a grant, as part of the Small Business Assistance Program, to help people understand the act, and navigate the marketplaces.

The chamber has always offered small-business plans to members and acted as the administrator of those plans, and Burbank said that service will still be available, but, if small-business owners prefer to enroll in a new program, the chamber will guide them through the process.

The chamber has designated Victoria Michael as the coordinator for the assistance program, and, in addition to answering questions for people who call or come in to the chamber headquarters, she is doing active outreach, and visiting communities to give presentations on the ACA.

She recently visited the Berne Town Hall and talked with Supervisor Kevin Crosier, and said she realized how many questions people have, and how little they know about the ACA.

“I’ll be honest,” Crosier told The Enterprise. “I think people aren’t paying attention to the date.”

The town itself will not be affected, he said, because Berne employs fewer than 50 workers, but town residents will need help figuring out the system.

“I hope that working with the chamber we can do some outreach, and publicize the information on our website and in our fall newsletter,” Crosier said. “It would be really helpful to residents to talk to someone who knows all about it.”

Michael said she was concerned when she discovered that many residents in the Hilltowns do not have access to the Internet, making it hard for them to access the online marketplaces, so she has decided to set up workshops, at locations with access to wireless Internet, for Hilltowns residents to attend.

Crosier said the workshops should give residents the push they need to find an insurance program and register before the deadline.

“I think it could be kind of like tax season,” said Crosier. “Everyone waits until the last minute.”

The Cornell Cooperative Extension of Rensselaer County has also been selected as a navigator for the Small Business Assistance Program.

Kirk Shoen, director of the program, said the Cornell Cooperative Extension will focus some of its outreach on farmers, though it will also cater to small businesses and individuals.

“There aren’t any organizations that really target farmers,” said Shoen. “They are typically less-insured and in the lower-income category, so they are an under-served group.”

Many farmers, he said, are not insured, and don’t offer insurance to part-time or seasonal employees.

“Some that I have talked to have told me that the Affordable Care Act won’t affect them,” said Shoen. “There are so many misconceptions out there.”

Both Michael and Shoen said they would be scheduling programs throughout the county, at which they will give presentations and answer questions. Michael said she was in discussions about having open hours at the Guilderland, Bethlehem, and Colonie chambers of commerce, and at the libraries in those towns on weekends.

In the meantime, said Burbank, anyone, Chamber of Commerce member or not, can call or stop in with questions.

“We can help anybody,” Burbank said. “And, if we can’t, we’ll find someone who can.”

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