Pamela Roshell, regional director for the U.S. Department of Health and Human Services, spoke at a forum at Phoebe Northwest on Tuesday to give an overview and answer questions regarding the Affordable Care Act. Open enrollment for the market place is expected to be launched on Tuesday. (Jennifer Parks)
ALBANY — This week, an official from the federal level was in Southwest Georgia to help clarify the impacts of health care reform as the next phase — the marketplace — is set to open Tuesday.
Leaders from business, industry, area governments, not-for-profit organizations, education and health care met with U.S. Department of Health and Human Services Region IV Director Pamela Roshell in Albany on Tuesday for a conversation on affordable health care.
The forum, presented by state Sen. Freddie Powell Sims, D-Dawson, was held to address questions and concerns about the Affordable Care Act, as well as provide up-to-the-moment information on the legislation.
“This discussion is long overdue for many of us in Southwest Georgia, especially the working poor … so we brought the expert to us,” Sims said at the opening of the program.
In Dougherty County, Roshell said, there are 26,000 individuals who are uninsured, which is the population she said is most strongly encouraged to research their options when it comes to the health care plans being offered. with a population estimated at just more than 94,500 people, that means that about 27.5 percent of Dougherty County’s residents are without health insurance.
The Georgia state government chose to not participate in setting up a marketplace exchange, which means it is being set up by the federal government.
“Even if you think you are not eligible or were rejected before, we really want you to apply to see which plans fit your financial circumstances,” Roshell said.
There will be a choice of plans and levels of coverage — with the highest levels being best suited for those who plan to use their health coverage most frequently, Roshell said. All the plans are expected to include what are considered to be essential health benefits such as ambulatory patient services, emergency care, hospitalization, maternity and newborn care, mental health and substance use disorders, prescriptions, rehabilitation, laboratory services, preventive wellness and chronic disease and pediatric services.
The coverage being offered, Roshell said, is private health insurance for which each plan will have its own network. Open enrollment can be accessed by applying online or through a written application between Tuesday and March 31, 2014. After that point, the next opportunity to enroll in benefits will be in October 2014 unless the individual has a qualifying event, she said.
She also said there is a customer service line set up so those seeking coverage can get personalized help to make their choices. That number is 1 (800) 318-2596.
Those who will be helping uninsured or under-insured individuals in their communities, including agents are both familiar and new to individuals, will get extensive training on how to help people better navigate the market place, Roshell said. The plans will be released online at www.healthcare.gov at 8 a.m. Tuesday.
“All the plans signed agreements over the last week,” Roshell said. “We are on track to launch Oct. 1.”
Coverage begins on Jan. 1 for those who sign up by Dec. 15. For those who sign up later, the start date of their coverage will depend on when they enroll, Roshell said.
As regional director, Roshell is responsible for meeting the needs of communities and individuals served through HHS programs and policies within the eight states of Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina and Tennessee. Health and Human Services is handling the implementation of marketplaces in all of those states, with the exception of Kentucky.
Those seeking more information on the market place or how to enroll are encouraged to call the customer service line or visit www.healthcare.gov. There has also been a line set up for small business owners to ask questions on how the market place will impact them, which is 1 (800) 706-7893.