Linda Sheppard, director of Health Policy for the Kansas Insurance Department, dispelled an urban legend about the Affordable Care Act when she spoke to Iola Rotarians Thursday.
Opponents have railed legislation to enact health insurance contained more than 1,000 pages. The total bill does, Sheppard said, but it has 10 components and only one has to do with health insurance.
However, she predicted that with ACA “just beginning, it will take a decade to fully implement.”
The bill became law March 23, 2010. Enrollment in health insurance began last fall and initial policies took effect Jan. 1. The objective was to provide insurance coverage for people who were unable to purchase it privately because of pre-existing conditions or because they simply couldn’t afford it.
With the new law, insurance companies no longer can base their rates on health status. Instead they use one’s age and geography to determine costs. Tax credits are for those making between 100 percent to 400 percent of the federal poverty level. That means if a qualifying person’s monthly premium is $400 and the tax credit is $200, the individual pays $200 and the federal government the other $200.
For those too poor to qualify for ACA coverage, the alternative was meant to be Medicaid. In Kansas, that shoe didn’t fall.
Kansas refused an infusion of federal money that would have covered 100 percent of Medicaid costs for three years and 90 percent beyond that. The rationale of Gov. Sam Brownback and legislators was that they couldn’t be sure that federal money would be forthcoming in the years ahead.
Medicaid eligibility under ACA would have been from 33 percent of federal poverty level to the 100 percent ACA insurance threshold.
Sheppard said about half the states turned down the Medicaid money, which left Kansas taxes supporting Medicaid coverage elsewhere.
Those caught in the gap either go without medical care or wait until their circumstances worsen to the point they seek treatment at a hospital’s emergency room. Hospitals can’t refuse treatment, which leaves them with unpaid bills.
“The rollout of ACA was a disaster,” when its website failed to function or did so in haphazard fashion, Sheppard said. “It’s gotten much better.”
The most recent numbers she had available — due an update — are that 29,000 Kansans have signed up for ACA health insurance coverage, Sheppard said. An estimated 365,000 Kansans didn’t have health insurance when enrollment started.
“We had a lot of activity in March,” as the enrollment was winding down, “and I think the new numbers will be quite a bit higher,” she said.
The next open enrollment period is Nov. 15 to Feb. 15, 2015.
She pointed out that Medicare and Tri-Care, for military retirees, were not affected by ACA.
SHEPPARD, in an explanation of the state insurance department, said every insurance company had to be reviewed before it was licensed in Kansas.
