Many insured in S.Carolina must buy new health plans

 

COLUMBIA — Nearly a month into the health care rollout, many South Car­o­lin­ians with health insurance are learning they must buy a new policy.

Despite President Oba­ma’s promise that those who like their health plans will be able to keep them, residents across the country are being notified they must switch to a more comprehensive, and often more expensive, policy that complies with the federal law.

Policies sold or altered after the health care law passed in 2010 must meet its requirements. That means many people who buy their own insurance will need to choose a new plan for 2014.

State law requires insurers to give policyholders a 90-day notice of discontinued plans. How many letters are going out in South Carolina, and what they say, is unknown.

Aetna Inc., which bought out Coventry Health Care earlier this year, is notifying about 3,600 policyholders in the state that their plans won’t exist next year, so they’ll need to choose a new one when theirs is set to renew, spokesman Walt Cherniak said.

Officials with Blue Cross Blue Shield of South Carolina, the state’s largest insurer, declined to answer any questions last week on the issue. According to the company’s Web site, its short-term health plans and Personal Blue plans, including high-deductible options, won’t be available after Dec. 15.

About 160,000 Blue Cross Blue Shield customers in North Carolina are receiving notices. Florida Blue is discontinuing 300,000 policies.

The new options, though coming at a much higher cost, do have broader benefits.

The federal law requires individual and small group plans to cover 10 benefit categories it deems essential. Those include maternity care, mental health and substance abuse services, children’s dental and vision care, therapy for injuries and chronic conditions, and preventive services such as health screenings, diet counseling and immunizations.

Other parts of the law affecting individual policies’ cost include required changes in how rates are calculated.

“Policies will cover more of your medical bills, which is good news, but when you buy more protection, it costs more. For some people, it will be a shock,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation.

However, she noted, federal subsidies might help offset increases. They’re available to families earning between 138 percent and 400 percent of the federal poverty rate – with the maximum income allowed for the credit translating to $45,960 for a single adult, $62,040 for a two-person family and $94,200 for a family of four.

However, the subsidies are available only for plans purchased through the online marketplace.

Both Blue Cross Blue Shield and Coventry are selling plans in South Carolina over the exchange, which went live Oct. 1. But the federally run Web site has been plagued by problems. People must enroll by Dec. 15 for coverage that begins Jan. 1. People have until March 31 to avoid paying a penalty.

As of last week, none of the Cooperative Ministry’s two dozen certified navigators had been able to assist anyone through the online process. The Columbia-based nonprofit was among three groups in South Carolina receiving a combined $2 million to educate the uninsured and help them enroll in health plans.

With the Web site not working, navigators are telling people what they’ll need to enroll and helping them fill out paper applications. So far, they’ve not heard from anyone who has gotten a packet back in the mail, Cooperative Ministry program director Wanda Pearson said.

“We expect enrollment activity to pick up when the system gets better,” she said.

DECO Recovery Manage­ment, which received the largest outreach grant, did not respond to questions.

The Obama administration is still refusing to release any numbers on how many people have successfully enrolled through the marketplace, which the federal government is running in the 36 states that chose not to run their own, including South Carolina.

Meanwhile, the state Medi­­caid agency doled out detailed numbers in touting the success of its new online application, which also launched Oct. 1.

South Carolina’s Re­pub­lican leadership refused to expand Medicaid eligibility to adults making up to 138 percent of poverty – an option for states under the U.S. Supreme Court ruling that upheld the federal law.

Still, the state Department of Health and Human Services expects roughly 200,000 people who were already eligible to enroll in the government health insurance program for the poor and disabled as they learn of the option, enroll to avoid fines, lose insurance through their jobs or can no longer afford it.

By Wednesday, nearly 3,100 Medicaid applications had been submitted online, accounting for one of every seven filled out over the 23 days. In that time period, nearly 12,400 people had visited the Medicaid Web site, and more than 6,600 people had created accounts, said agency spokeswoman Colleen Mullis.

The 21,325 total applications received represented an increase of several thousand more than the daily average before Oct. 1, according to the agency.

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