What You Need to Know About the Healthcare Exchange - KATV - Breaking News, Weather and Razorback Sports

What You Need to Know About the Healthcare Exchange

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Nearly 500,000 Arkansans are estimated to benefit from the Healthcare Exchange that is forming now. But how many of us even know what that is, or how it's supposed to work? 

According to the state of Arkansas, 25% of Arkansans between the ages of 19 and 64, don't have health insurance, but if they could get it, they would.

"We know that when they're offered health insurance from their employer, they buy it, because they value it, but so many of these people work for smaller employers who cannot afford the health insurance premium either. So neither the employer, or the employee have a mechanism to be able to pay for it," said Dr. Joe Thompson, Arkansas Surgeon General.

 But changes are coming with the new healthcare law, and Americans may not be prepared. A recent poll finds 56% of the uninsured say they have too little information to know how the new health care law will impact them.

And here at home, about 500,000 Arkansans will be able to buy insurance on the Healthcare Exchange beginning next year.

Roughly half of those, because of the new state law driving new Mediciaid recipients to the exchange, where they would use federal money to pay premiums. This would include individuals making up to $15,415 a year, and families making up to $31,809. The other half will be eligible to receive federal subsidies to pay premiums. This includes individuals making up to $44,680 a year, and families up to $92,200. If this describes you - here's what you need to know.

The Exchange will be set up online. It's being likened to websites like Expedia, where you go to find travel deals, except you'll go to find a deal on health insurance.

"The way the Exchange is set up, is plans are going to be able to put their product with same basic benefit, now we have everybody getting the same benefit package, but they're going to show a bronze, silver, gold, platinum level, which is basically determined by how much you want to pay out of pocket," explains Dr. Thompson.

 In other words, if you want to pay a higher premium, but pay less out of pocket when you go to the doctor - you can go for platinum. If you want a lower premium, but with a higher co-pay go for bronze. And you'll get the coverage regardless of prexisting conditions. That's good news for 39-year-old Stephanie Jackson, who's been working, and living without health insurance since late last year, when she lost her coverage after making a career change.

"working 40 hours plus a week in retail doesn't allow for that. So I can either choose rent, car payment, health insurance, or food," she said.

Stephanie shopped around, but says when insurance companies found out she was on prescription medication for ADHD, her premium nearly doubled to more than $300 a month. She says that's about $100 more than she can afford.

"It's scary when you don't know what you would do if you had an emergency or do I go to the hospital? What are they going to do? Are they going to charge me? Cause I don't have any money. Or are they going to let me bill it out or do I just suck it up, stay at home and tough it out.>

The theory behind the Exchange, is, insurance companies compete for your business, so premiums should be affordable. Four insurance companies have expressed interest in participating in the Exchange so far, and Thompson expects more to come on board this summer. But, he says it's too early to predict how affordable the premiums will be.

"That's the big question. I think that's one of the issues that we're waiting in June when the plans come in, submit what they want to offer on the exchange. We think the private option buy in, stabilizes that number because it puts a quarter million people in and will make plans be more competitive in their bid to get people's business," he said.

"I'm just really excited it could really be beneficial to us little folks on the food chain right now," said Jackson.

Enrollment in the Exchange starts October 1st. Coverage starts January 1st, 2014. The state will be hiring navigators to help guide new enrollees through the process.

 

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