Monday, December 23, 2013

Las Cruses Sun: "Thousands apply for New Mexico Medicaid"



More to be eligible for program Jan. 1
By Brook Stockberger
bstockberger@lcsun-news.com


LAS CRUCES >> About 43,000 New Mexicans have applied for Medicaid since Oct. 1 and as many as 20,000 of those will be eligible to start the program as of Jan. 1.
The Medicaid program in New Mexico will soon be known as Centennial Care and it will expand to take on more people as the Affordable Care Act -- better known as ObamaCare -- kicks in with the start of the new year. Already 550,000 New Mexicans -- about 1 in 4 -- are covered by Medicaid and, as coverage is expanded, the state projects that number to grow through the rest of the decade.
"We've revised the numbers up, and by 2020 as many as 205,000 more people (could be on Medicaid)," said Matt Kennicott, communications director with the state's Human Services Department.
Las Crucen Michael Marrufo said he applied online on Nov. 14 but does not yet know if he will be accepted.
"They shot me an email saying, 'You will receive a final decision from the New Mexico Department of Human Services,' So now I am waiting," he said.
Las Crucen Dave Meade said that he does not currently have health insurance and, with the expansion of Medicaid to include more people, he decided to try and enroll. He applied online last month and is also waiting to hear back.
"If they count our housing costs, which are quite high, I should qualify no problem," Meade said. "If they don't count for housing costs, maybe I won't qualify."

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He said that he has also enrolled for health coverage on the Affordable Care Act's federal website just in case he is not accepted on Medicaid.
Who is eligible?
As of the start of 2014, states that choose to expand Medicaid -- like New Mexico -- can set eligibility levels to 138 percent of the Federal Poverty Line, or about $32,500 for a family of four.
There are other criteria as well. The website yes.state.nm.us offers what it calls a "quick, easy and private way" for people to determine if they are eligible. In addition, people can contact the Income Support Division offices in Las Cruces at 655 Utah Ave., and at 2121 Summit Ct. The phone numbers are 575-524-6500 and 575-524-6568, respectively.
How to apply
Potential enrollees can also use the website yes.state.nm.us to apply or they can also visit the local offices.
"We got outreach to help sign people up at (other) locations as well," Kennicott said.
Both Memorial Medical Center and MountainView Regional Medical Center have pitched in.
"MountainView is helping people get signed up," said MountainView spokesman Kelly Duke, who pointed out that 20 people attended a seminar at the hospital on Friday.
Mandy Leatherwood with Memorial Medical Center said that MMC has six staff members trained as healthcare guides.
"They can help people with signing up for the New Mexico Health Insurance Exchange and the Medicaid expansion," she said.
Problems
Some people have expressed frustration with the sign-up process and even with the state.
Meade said he does not expect to hear back on his eligibility anytime soon based on a phone call he made to the state.
"I tried to get through and it took me a couple of days," he said. "Based on what they told me, it seemed like they hadn't even looked at my application yet. My impression was that it would be sometime in January or February."
Marrufo said the application process was a chore.
"The log-in was a pain," he said. "It took several tries and finally I got an email response from the health insurance marketplace telling me that they knew I was having problems with the site and to try logging in again and complete the registration (so) I did."
Kimmarie Hartley applied on Oct. 6 and received a letter that she was not accepted on Nov. 4. She said that she was denied because she does not have any minor children, but she believes, under the expanded program, that should not matter. She will be covered by Medicare in March, so she has decided not to appeal the process. But her daughter, who also applied, was sent a denial letter too for the same reason. The problem? She has a minor child.
Hartley said her daughter has filed an appeal and was told she'll have to wait a month before she learns more.
Kennicott said people can file appeals with an ISD office.
Brook Stockberger may be reached at 575-541-5457.

Sebelius Announces Three Affordable Care Act Deadline Extensions



Sebelius Announces Three Affordable Care Act Deadline Extensions
Friday, December 13, 2013
On Thursday, HHS Secretary Kathleen Sebelius on Thursday announced that her department is implementing a trio of Affordable Care Act deadline extensions intended to ease the transition to coverage in the law's new insurance marketplaces in 2014, Modern Healthcare reports (Demko, Modern Healthcare, 12/12).

Sebelius said that changes were prompted by the various technical issues that plagued the online marketplaces --particularly the federal health insurance exchange -- when they were launched in October, which caused problems and delays for consumers when they tried to enroll in health plans. As a result, she said many consumers will need more time
to select and pay for the new coverage (Pear, New York Times, 12/12).

Sebelius said HHS has: Officially asked insurers to honor the new Dec. 23 deadline for coverage that begins on Jan. 1 (Kliff, "Wonkblog,"
Washington Post, 12/12); Urged insurers to give consumers more time -- until Dec. 31 -- to make their payments for coverage that begins Jan. 1
and asked them to accept late or partial payments for coverage (New York Times; 12/12); and Extended by one month -- through the end of January 2014 -- the federal Pre-Existing Condition Insurance Plan, which
has been providing coverage to about 100,000 U.S. residents with severe health conditions who were unable to purchase private coverage prior to the ACA (Galewitz, Kaiser Health News, 12/12).

An HHS fact sheet said the department "will consider moving [the Dec. 23] deadline to a later date should exceptional circumstances pose barrier to consumers enrolling on or before" that date (Young, CQ Roll Call, 12/12).
In addition, Sebelius announced that:

HHS has asked insurers to provide "retroactive coverage for people who sign up after Jan. 1," meaning that if a consumer signs up for coverage on Jan. 5, his or her coverage still would be effective on Jan. 1; and
Some consumers who experienced unique problems with signing up for coverage in the federal or state exchanges would be eligible for a "special enrollment period," which will provide them with extra time to complete their enrollment (New York Times, 12/12).
Officials in the Obama administration said that they are encouraging insurers to make additional voluntary accommodations for new enrollees, such as:
Continuing coverage for patients' preferred physicians, even if they are out-of-network under their new coverage plan (Modern Healthcare, 12/12); and12/13/13 Sebelius Announces Three Affordable Care Act Deadline Extensions - California Healthline

Providing temporary coverage for prescription drugs beyond Jan. 1, even if the drugs are not on the plans' list of approved
medications (New York Times, 12/12).

Reactions
In a statement, America's Health Insurance Plans CEO and President Karen Ignagni criticized the new changes, saying that "continued changes to the rules and guidance could exacerbate the challenges associated with helping consumers through the enrollment process." She added, "Health plans will continue to do everything they can to protect consumers from potential coverage disruptions caused by the ongoing technical problems with HealthCare.gov" (CQ Roll Call, 12/12).
Some Republican leaders in Congress also criticized HHS' move. Rory Cooper, a spokesperson for House Majority Leader
Eric Cantor (R-Va.), said, "It's clear that the administration knows Obamacare's problems are only going to get worse, and
patients will be the ones who suffer

Eight Northern Indian Pueblos Council Inc. " Creating a culture of Coverage"

Get Covered this Holiday Season!

WOULD YOU LIKE INFORMATION REGARDING YOUR COVERAGE OPTIONS UNDER THE AFFORDABLE CARE ACT (OBAMACARE)?

You may be eligible for no or low-cost, high quality health insurance coverage.  

If you are a single adult and your income is less than $15,856 a year, you may be eligible for no-cost coverage.  If your income is less than $34,470, you can receive financial assistance to purchase a low cost health plan and may not have to pay any out of pocket expenses (i.e, co-pays, deductibles).

The Eight Northern Indian Pueblos Council, Inc. (ENIPC) is offering confidential, unbiased assistance to help Pueblo members navigate through all of the options available to Native Americans in this process.  

Please note that with Obamacare, if you already have coverage offered by your employer that is "affordable" (amounting to 9.5 % or less of your total household income), you are not eligible to shop in the Exchange Insurance Marketplace.  For those who are eligible, to obtain coverage starting January 1, 2014, the deadline to enroll is December 23, 2013, although Native Americans benefit from an ongoing monthly open enrollment period.  Native Americans are also exempt from requiring insurance coverage, without incurring any penalties. if they decide to opt-out.

A Certified Health Guide/Navigator will be on-site at the Nambe Pueblo Tribal Administration Building every Monday from 1 p.m. to 5 p.m., to assist you with information and application enrollment assistance, both with the Marketplace Insurance Exchange (healthcare.gov) and Medicaid applications.  For preliminary assistance and/or to set up a free in-person appointment, 
call our toll-free line at 1-855-241-8137, or just drop by!  

Protect yourself and your family from unforeseen medical expenses and get the care that you need.