Seminar addresses health reform questions

Oct. 11, 2013 @ 07:25 AM

While the Affordable Care Act is the sticking point behind the shutdown of the federal government, some in Lenoir were looking for technical answers Thursday on just what that health reform law would mean for them and their families.

At a “Lunch and Learn” event hosted by Life Store Insurance at the Exela Pharma Sciences building in Lenoir Thursday, a presentation by Wade Brown of Blue Cross Blue Shield of North Carolina mapped out details on changes to health insurance.

One of the main changes made by the law is that benefits offered under insurance plans that BCBS offers “got a lot richer,” Brown said. Maternity coverage will be added to every plan, and rehabilitation and habilitation coverage will be added as well, which Brown called “a major additional benefit.”

Co-pays, deductions and coinsurance now are all included in the maximum out-of-pocket payment limits. On the worst plan offered by BCBSNC, Brown said, a person would not have to pay more than $6,350 out of his own pocket for his treatment.

The change that has gotten the most negative attention is the personal mandate, the requirement that each person have insurance or else pay a penalty. In 2014, if an individual is not offered government or employer insurance, makes at least double the amount of the poverty level, and chooses not to buy insurance, the penalty is $95 or 1 percent of adjusted gross income, whichever is greater, Brown said. In 2015, the penalty moves to $325 or 2 percent; in 2016, it’s $695 or 2.5 percent.

Brown explained that if you like the insurance you have, and the plan was in effect as of March 23, 2010, the plan will be grandfathered through the new system and will not change.

An issue that a number of the two dozen or so people attending were concerned about is that if a person already has health insurance but that plan is not grandfathered under the ACA, it will go away, and if the person fails to choose a new plan, the insurance company will have to pick a "reasonably similar" plan for the customer. Brown assured them that “you’re not going to get insurance you don’t want.”

Brown said he suggests each person go to an insurance agent or someone else qualified to navigate and explain the choices because otherwise a person making up to triple the poverty level could potentially make a $4,000 to $5,000 mistake.

Brown said there are about 1 million people in North Carolina who could qualify for subsidized insurance through the ACA.

Nationally, the cost of health care has been eating up an ever growing share of the at the economy, and now nearly 18 percent of the U.S. gross domestic product is devoted solely to health care. At 20 percent, Brown said, “we will go broke.”

Thursday’s seminar was the fifth that Life Store has hosted, following events in Ashe, Wilkes and Watauga counties, and two more are already scheduled. Jody Brown, president of Life Store, said the seminars began because the company wanted to educate people about health care reform, saying that under the ACA health insurance will be “totally different from health insurance as we’ve known it before.”