Donna Cail remembers being “a nervous wreck” last month when she went to Medical Associates Plus @Belle Terrace to get health insurance for her disabled sister, Justina, who was losing her Medicaid coverage. But within minutes, her sister had coverage from Humana that kicked in last week and suddenly the prospect of her going without much-needed medical care vanished.
“I am just experiencing the weight coming off of our shoulders,” said Cail, who, along with her husband and her mother, looks after Justina.
Cail is one of more than 14,000 who have enrolled in the Augusta area under the Affordable Care Act as of Jan. 16, and one of 420,000 in Georgia, according to data from the U.S. Department of Health and Human Services. But many more are expected to scramble to get enrolled ahead of a Feb. 15 deadline to sign up. To raise awareness, the Enroll America bus campaign will make a stop at the clinic tonight.
Those who do not get coverage potentially face a financial penalty. The “fee” for not having health coverage in 2015 is 2 percent of in come or $325 per person in your household, whichever is higher, according to the federal Health Insurance Marketplace Web site, Healthcare.gov. Georgia is one of 37 states who chose not to create their own marketplace Web site and use the federal Web site for
For people like Cail, who has health insurance, it was more about making sure her sister, who suffers from multiple health problems like congestive heart failure and kidney failure, had coverage until she qualifies for Medicare through the Social Security disability process, which is almost two more years from now.
“We needed something in that gap,” Cail said. “We were in a desperate state.”
But even though her husband urged her to get signed up through the computer, Cail said she was hesitant because “I didn’t know who would be on the other end taking her information.” She worried about identity theft.
“She wouldn’t end up with any insurance or her identity,” Cail said. But then she found Medical Associates Plus and got in-person help.
“I am so happy it is here,” she said, sitting in the clinic off Golden Camp Road.
Many of those showing up this year at Medical Associates Plus, perhaps 75 percent to 80 percent, are new applicants, navigator Terri Gant said. Those who had coverage last year could automatically renew their coverage and others might feel they can handle re-enrolling on their own, she said.
“I am kind of proud of what we did last year because this year people feel more empowered to actually call the Marketplace” and handle things on their own, Gant said.
The vast majority of those enrolling in Georgia – 90 percent – are getting subsidies to help them pay for their insurance, said Gant, who has had only a handful of people who did not qualify. That is one of the biggest misconceptions people have going into enrollment, said Jason Studley, CEO of Trinity Hospital of Augusta, which has been doing both an in-person weekly session and daily phone counseling to help people enroll.
“A lot of them think they do not qualify for a subsidy, (but) in fact a lot of people actually do qualify,” he said. “The subsidies are actually pretty significant and do make it affordable.”
Some people are gauging whether to pay the penalty versus what they would pay in premiums, but getting the coverage and all of the benefits from that makes more sense, Studley said.
Last year, Augusta had three navigators and some insurance agents who were trying to provide all of the hands-on help versus many more agents participating this year, Gant said.
“There’s more hands on deck,” she said.
And they will probably be needed, particularly over the next two weeks, Studley said.
“We’re adding additional staffing to our phone lines as well as with our counselors, providing additional resources for them,” he said. “Because we are anticipating that there is going to be a flood at the very end. Probably the entire week of the 15th.”
Staff Writer Sandy Hodson contributed to this report