Wintony McCullough, outreach and enrollment manager for Albany Area Primary Health Care, presented an overview of the new Affordable Care Act for members of the Dougherty County Rotary Club. The Affordable Care Act was signed in law by President Obama in March of 2010. (Staff photo)
ALBANY — Representatives of Albany Area Primary Health Care were on hand at the Dougherty County Rotary Club Tuesday to provide an overview of the new Affordable Health Care Act.
Clifton Bush, chief operating officer, and Wintony McCullough, outreach and enrollment manager of AAPHC, delivered a detained illustration of the act, which was signed into law on March 23, 2010 by President Barack Obama. Eligible uninsured individuals and families have until the end of this month to enroll in the plan, McCullough said, or face a financial penalty.
Bush said that AAPHC, which provides health care services to more than 30,000 patients and nearly 130,000 visits per year to qualified members of Dougherty and surrounding counties, serves a regional marketplace for ACA enrollees.
The Health Insurance Marketplace is designed to help individuals and small employers obtain private-market health coverage, McCullough said, in part by facilitating an “apples to apples” comparison on plans. Unfortunately, insurance providers are not competitive in Southwest Georgia, McCullough said.
“Blue Cross/Blue Shield is the only provider here, so far,” McCullough said, “so that makes the insurance more expensive.”
The marketplace also serves to provide “transparency” in plans and providers, navigation and assistance to those seeking insurance, and provide tools and information.
According to McCullough, four separate plans are available for eligible individuals and families, to best suit needs and budgets: At the top of the heap is the Platinum plan, McCullough said, which would pay 90 percent of the insured’s medical costs. Below that come the Gold at 80 percent, Silver at 70 percent and finally the Bronze plan, which will pay 60 percent of health care costs. All insurance plans sold under the exchange must include essential health benefits as designated by ACA, McCollough said.
To be eligible for an ACA plan, individuals and families may not have access to Medicare or Medicaid coverage, McCollough said, or have access to plans offered by their employers, unless the plan exceeds 9.5 percent of the household income or fails to meet 60 percent of actuarial value.
McCollough said the penalty for missing the March 31 enrollment deadline will be as high as $285 in 2014, rising to $975 in 2015 and $2,085 in 2016.
McCollough said AAPH has enrolled 126 individuals in an ACA plan so far.