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March 12, 2014

Thousands of Area Residents May Lose Health Insurance

Effective April 1, 2014, new income limits go into effect for Wisconsin’s BadgerCare Plus health insurance for low-income residents. Adults with family income over the federal poverty level will no longer qualify for this plan. If their employer does not offer health insurance they must enroll in the federal Health Insurance Marketplace at HealthCare.gov in order to continue coverage.

March 31 BadgerCare Plus Transition deadline

The countdown to March 31 — when thousands of area residents could lose their health insurance — is on.

Effective April 1, 2014, new income limits go into effect for Wisconsin’s BadgerCare Plus health insurance for low-income residents. Adults with family income over the federal poverty level will no longer qualify for this plan. If their employer does not offer health insurance they must enroll in the federal Health Insurance Marketplace at www.HealthCare.gov  in order to continue coverage.

Residents affected by this change received a letter from the State of Wisconsin in December, but only about 10 percent have sought assistance with the enrollment process at an area enrollment site.

“Our records indicate approximately 5,000 residents in our three county area received the letter, however, only about 500 individuals have sought assistance,” said John Rathman, Deputy Director for Outagamie County Health and Human Services.

Children and pregnant women will still qualify when family income is under 300 percent of the poverty level. However, for some families, parents will be enrolled in a different healthcare plan than their children. This can be confusing, especially when many of those affected have language barriers or may have cognitive or mental disabilities.

“On average, the enrollment process takes between 45 and 90 minutes per family, depending upon the complexity of the case,” said Patricia Sarvela, Development Director for Partnership Community Health Center, which operates a downtown Appleton enrollment site. “For many, this is their first experience having a choice between multiple health insurance plans and it takes time for them to make the right decision.”

The good news is that help is available and Fox Valley organizations have joined together to get the word out. Area non-profit organizations and healthcare providers such as Community Foundation for the Fox Valley Region, United Way Fox Cities, Affinity Health System, ThedaCare, Partnership Community Health, Goodwill, FISC and LEAVEN are collaborating with the three area counties (Outagamie, Winnebago and Calumet) to focus on two important goals. 

Terrie Pohjola is leading the collaboration. “The first goal is to encourage folks to enroll at healthcare.gov,” she said. “We have developed an extensive outreach campaign to inform Fox Valley residents of the need to enroll in the healthcare marketplace and where they can receive assistance with the process.” 

The United Way Fox Cities 2-1-1 call center is prepared to answer questions and direct callers to an enrollment site.

Susan Richards, call center manager, said, “The 2-1-1 phone lines operate 24/7. Our call center specialists are able to offer a number of options for assistance to each caller depending upon their circumstances.”

“The second goal is to create an educational process for those who are new to the healthcare marketplace so they learn how to use their new insurance and plan for their medical expenses,” said Pohjola. The idea behind the educational process is to be more proactive.  

Mary Parsons, Executive Director of LEAVEN, said, “Our agency has identified medical debt as one of the reasons clients seek out financial assistance. Many of the new healthcare plans carry sizable deductibles and these families have never had to plan for that sort of expense.”  LEAVEN is an area non-profit agency that provides temporary financial assistance with basic needs when people are in crisis with nowhere else to turn for help. 

The vision of the collaborative group is for all individuals in the Fox Cities area to have healthcare they can afford and understand with no time gap in their coverage. For more information on the enrollment process, call 2-1-1 or contact the enrollment site at 920-882-6420, 500 W Franklin St, Appleton. Or go directly to www.Healthcare.gov to enroll.