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Officials with Volunteers in Medicine, the free clinic on Jackson Street that cares for uninsured and indigent patients, expect fewer than one-third of their 1,200 patients will be able sign up for subsidized coverage on the federal health insurance exchange in Indiana.
Perhaps 70 percent still will fall through the cracks for a variety of reasons — because they’re undocumented immigrants or they earn too much money to qualify for Indiana’s limited Medicaid rolls and too little to afford a new policy on the federal exchange that went live Oct. 1, the health advocates say.
Despite such bleak statistics, though, Volunteers in Medicine executive director Mary Ferdon said her agency still plans to lead efforts to educate the uninsured and low-income populations of Bartholomew County about what’s available through federal health reform — the Affordable Care Act.
This month, Volunteers in Medicine has started recruiting volunteers who will serve as navigators to educate people on how federal health reform works and what the new, often-subsidized insurance policies cost.
Still, not all very poor people will be able to afford coverage — at any cost — on the new insurance market.
Here’s how it breaks down, health advocates say:
People with incomes between 100 percent and 400 percent of the federal poverty level will qualify for tax subsidies that will reduce the cost of their new policies.
In Indiana, that equates to a family of four earning between $23,550 and $94,200 per year.
But that still leaves a vulnerable population trapped in a wide gap between Medicaid eligibility (in Indiana, anyone who makes more than 25 percent of the federal poverty level can’t enroll in Medicaid) and the 100 percent poverty level where subsidies for federal insurance begin to kick in, said Julie Abedian, president of the Columbus Regional Health Foundation.
Abedian said she’s hoping for the best, adding that the nonprofit arm of Columbus Regional Hospital that she runs will help pay the cost of certification and training for volunteer navigators.
“For us, it seems like a very natural extension to provide more people with access to health care,” Abedian said of the Affordable Care Act’s reforms. “We want to have as many people as possible enrolled to promote a healthier community in Columbus.”
In Bartholomew County, two insurers — Anthem Blue Cross Blue Shield and MDWise — are participating in the federal exchange, offering a variety of insurance coverages designed to cover anywhere from 60 percent to 90 percent of medical claims. Premiums, co-pays and deductibles also will vary.
Ferdon’s goal is to have navigators who have mastered a nearly 200-page federal manual outlining the rules of the new insurance market ready to meet with consumers by mid-November.
Volunteers in Medicine hopes to arrange a one-day training session later this month.
Volunteers in Medicine coordinator Lyle Leitholt said he has tried to be upfront with potential navigators about the difficulty of their task.
The navigators are allowed under federal and state rules to guide consumers, but they can’t recommend a particular coverage or encourage people to buy.
The volunteers also will have to take a state test to get licensed in Indiana before they can conduct one-on-one sessions with consumers. The certification exam costs $88.
That expense is among those that the Columbus Regional Hospital Foundation plans to absorb. Ferdon said the total cost could be as much as $200 per person up to 20 navigators.
Ferdon said educating the public about the complex insurance rules could be a daunting task, especially with low-income residents who have never had health insurance before and for whom terms such as “deductible,” “co-pay,” or “premium” may seem like a foreign language.
“For a lot of people, this is a whole new concept,” Ferdon said, “and it will take some time to find out who is eligible and at what cost.”
Six to eight navigators will be headquartered at Volunteers in Medicine’s clinic in the 800 block of Jackson Street. Another dozen or so navigators will be placed in other community locations — the Bartholomew County Public Library, for example — to educate other community members, Ferdon said.
Other locations are likely to be established in the next few weeks, with Leitholt and Ferdon saying the setup will be similar to community income tax help stations that pop up every spring.
Federal health exchanges online have gotten off to a rocky start with the federal website that provides information state by state suffering numerous outages and long waiting times for access.
Ferdon said the good news is that consumers have several months to sign up for federal policies, which won’t actually take effect in terms of insurance coverage until Jan. 1.
“We plan to start providing navigators in the middle of November; and once people sign up for a policy, we will help them find a doctor,” Ferdon said.
But Volunteers in Medicine won’t be knocked out of business by the federal health reforms, the VIM director said.
“We still expect to have a load of 800 to 850 patients who won’t be eligible for the policies,” she said.
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