Published on October 04, 2013

Genesis Leads Efforts To Enroll Uninsured

Marketplace opens

Uninsured people use a number of reasons to explain why they don’t have health insurance.

“I never get sick,” is a popular, but risky explanation.

“My employer doesn’t offer health insurance,’’ is another more reasonable explanation.

“I can’t afford it,’’ is an understandable explanation.

Both the reasonable and unreasonable explanations of why someone is gambling on staying healthy are about to have less credibility. Millions of uninsured and underinsured Americans now have the best opportunity since 1965 when Medicare became law to enroll in a health insurance plan that is right for their health and financial needs.

And, as of 2015, virtually everyone in the U.S. will have access to a health insurance plan. If you are eligible and decline any plan, you will be taxed each year at tax time at a cost scheduled to increase from $95 (or 1 percent of family income, whichever is greater) for tax year 2014 to $695 (or 2.5 percent of family income, whichever is greater) by 2016.

The federal government, under provisions of the Affordable Care Act, is making it relatively easy for the uninsured and underinsured to find a plan.

Enrollment began Tuesday, Oct. 1

One of the ways the federal government is providing assistance is through health insurance navigators. Across the country, grants have been awarded to community and health organizations to implement outreach programs to assist individuals, families and small businesses in their search for a health insurance plan.

Beginning this week, Genesis Health System is a visible leader in enrolling Quad Citians in a health insurance plan to match their needs. Genesis will collaborate with other community and health organizations to sign up thousands of individuals and families.

Genesis VNA & Hospice has been awarded grants totaling $265,713 in both Iowa and Illinois from the U.S. Department of Health and Human Services. Genesis VNA is using the funding to hire three health insurance navigator positions; staff a call center; inform the public about the program; and, provide translation services for eligible residents.

“We applied for the grants because it was the right thing to do for the communities served by Genesis Health System,’’ said Ken Croken, Genesis vice president of corporate communications. “We hope thousands of residents of the Quad Cities will take advantage of this opportunity if they have never had health insurance, or possibly lost it when they lost a job.”

Croken added, “Over the coming months, our health insurance navigators will go wherever we can gather folks together who are interested in having health insurance. Our navigators will be in libraries, community centers, churches, homeless shelters, day care centers … really, anywhere there is an identifiable need.’’

The Genesis health insurance navigators may host 200 or more signup events before Jan. 1.

Thousands in QC will enroll

Michele Cullen, community health manager for Genesis VNA, manages the Genesis health insurance navigators program. She said there are thousands of uninsured individuals in the counties served by Genesis who could potentially begin 2014 with health insurance.

“In just the five counties the navigators will focus on, there are nearly 50,000 uninsured people. We know we won’t reach every one of them, but we would like to help enroll about 11,000 individuals,’’ Cullen said. “We’ll be hosting sign-up events wherever they are needed in Scott, Clinton and Jackson counties in Iowa and Rock Island and Mercer counties in Illinois.’’

One of the most important reasons to enroll in a health insurance plan is for management of chronic diseases.

“Often someone with chronic obstructive pulmonary disease or diabetes won’t seek help until they are so sick they need hospitalization,’’ Cullen said. “The opportunity exists for uninsured people with a chronic disease to enroll in an insurance plan, begin a relationship with a primary care doctor or specialist, and manage and treat the disease before a trip to the hospital is necessary.

“Just by adding thousands of people to health insurance plans, we can reduce emergency admissions to the hospital, reducing some of the cost burden on the individuals and health care providers.’’

There will be insurance options at different price points and coverage for enrollees through the health insurance marketplace in Iowa and Illinois. For example, a platinum plan provides the highest level of coverage with the least outof- pocket expense, but also with the highest premium cost. There also is gold, silver and bronze plans with declining coverage, but also declining costs.

Austin Bird, associate government relations specialist for Genesis, said financial assistance from the federal government will be available to uninsured and underinsured people who qualify based on income and family size.

“There is a scale based on income and family size. If you’re making less than 400 percent of federal poverty level ($94,000 a year for a family of four), you will likely qualify for subsidy from the federal government to purchase insurance. Virtually everyone will be required to have insurance or will pay a fine for not having insurance at tax time,” Bird said.

“One of the roles of the navigators will be to explain what the options are for each individual.’’

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