Many of the 50 individuals who showed up for a community forum to find out about the Maryland Health Connection on a September evening in suburban Washington appeared to share a need for what the health insurance exchange could offer them.
But they wanted to understand how the exchange would work and how and where to start enrollment.
One healthy-looking audience member said she was recently divorced and when she sought her own health insurance, she was rejected because of a pre-existing condition, one for which she said, "I only take one pill per month for." A family of two working parents with two children in tow said they were hoping they could use the exchange ato find an affordable, subsidized policy with more comprehensive coverage than their current employer-sponsored plan.
While many states and groups have been dragging their feet on the Affordable Care Act, Maryland early on embraced health reform and the exchanges and has conducted dozens of outreach events around the state like the one in Bethesda, MD.
As of Oct. 1, individuals are able to set up an online account and login for return visits for enrollment information on the Maryland Health Connection portal, to shop and compare among the various tiered metal plans, and to determine if they are eligible for financial assistance through tax credit subsidies to reduce the cost of monthly insurance premiums.
In 2014, the state will have 45 plans from four carriers – CareFirst, Kaiser Permanente, UnitedHealthcare and Evergreen.
The plans may have different formulas for some cost-sharing, but they must offer at least the standard 10 essential health benefits, something missing from many current plans, said Dourakine Rosarion, special assistant to the director, Montgomery County Department of Health and Human Services, who led the forum and whose office sponsored the gathering along with the Montgomery County Regional Service Centers.
"This is what makes the plans great," she said. "These are not flimsy plans."
A single, streamlined application will determine eligibility for Medicaid or private insurance and walk the applicant through the process with prompts and questions. "It will ask for salary, pulls in last year's tax filing and asks for some verification of income, which is scanned into the system," Rosarion explained. The applicant can always log back into the system and update information.
Consumer assistance will also be available through a call center or in-person throughout the state in local health departments, social services and a network of consumer assistance organizations known as "Connector entities." Maryland's call center has a 150-person staff answering questions and available in multiple languages, she said. The in-person application process is estimated to take one hour.
The county HHS office also will post a calendar showing when and where in-person navigators will be offering assistance in areas where consumers will be, including area chain grocery stores, drug stores and churches.
The last question of the evening came from an individual who surprisingly asked, "So you mean Obamacare isn't government insurance?" Many in the audience chuckled and whispered among themselves.
But it demonstrated that even in a majority Democratic state, which has pumped out a lot of public information about the ACA and insurance available on the Maryland exchange, more education and outreach will be a lengthy process to undo misinformation and confusion.