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Area residents seek answers on new health care program

DAILY LEADER / JUSTIN VICORY / Camille Simms attempts to clear up some of the confusion people have over the Affordable Care Act Wednesday at a workshop held at Bethel AME Church in Brookhaven.

DAILY LEADER / JUSTIN VICORY / Camille Simms attempts to clear up some of the confusion people have over the Affordable Care Act Wednesday at a workshop held at Bethel AME Church in Brookhaven.

In the first week of open enrollment earlier this month, there were more than seven million attempts to access the federal government’s website concerning the Affordable Care Act.

While the website is certain to provide area residents some clarity regarding where they fit into the new system, there’s still inaccurate information swirling around, which helped to lead area residents to the Bethel AME church Wednesday night to seek out answers for themselves at a local workshop on the program.

Camille Simms, a health and life insurance agent with Moore’s Financial Group and a Humana representative, spoke to a room full of Brookhaven residents, hoping to clear up some of the massive confusion related to the Affordable Care Act, which also is known as Obamacare.

“There’s a lot of misinformation out there. I would like to help,” Simms said.

By a show of hands, a majority of people at Wednesday night’s meeting indicated that they do not have health insurance and were interested to find out where they fit in. Despite working full-time, Mary Fells, for instance, doesn’t have health insurance because her workplace doesn’t offer it.

Simms was able to offer three plans to those in attendance Wednesday night. The gold plan is based upon an 80/20 formula; the silver plan, 70/30 and the bronze plan, 60/40.

Each plan’s particular premium depends upon the formula. Someone that has the gold plan will be expected to pay more in premiums, but less at the hospital. With the 80/20 plan for instance, the insured person would be expected to pay 20 percent of the premium, while the insurance company would pick up the other 80 percent, and so on for the silver and bronze plans.

The insured person would pay the highest premium up front for a gold plan, however, followed by the silver and bronze plans, respectively.

“In my opinion, based upon the median salary of the area, I recommend the silver plan to most people. However, it all depends on one’s specific circumstances,” said Simms.

Some of the benefits of the new law according to Simms, will be the fact that the law mandates the following “essential health benefits”:

• Ambulatory patient services

• Emergency services

• Maternity and newborn care

• Pediatric services including dental and vision care

• Rehabilitative/facilitative services and devices

• Mental health/Substance use disorders

• Preventative/wellness services

• Hospitalization

• Lab services

Beretta Character, retired from the post office, currently has Blue Cross/ Blue Shield. Despite having what is considered one of the better plans, Character was at the meeting to compare insurance rates.

She said her main interest at the meeting concerned her husband, who is currently uninsured, and how much it might cost to include him. Character said she would review the information provided at the meeting and make a decision in the near future.

Specific prices are primarily based upon income and a detailed accounting of how much an individual or family will be expected to pay is currently unavailable.

The new Affordable Care Act website, www.healthcare.gov, which rolled out Oct. 1, was quickly swamped by the large numbers trying to log in, and many people who have attempted to access the site have been unable to enroll.

“We have everything ready to go, including how much one can expect to pay for health insurance with Humana. However, we have to wait on the healthcare.gov website … before we can post this information,” Simms said.

As soon as the government website is back online, Humana will post specific rates. In the meantime, Simms was able to answer some questions area residents had.

Simms did provide those attending with an example of what they might expect once Humana goes online. An individual who makes $30,000 a year wouldn’t pay anything in premiums, after receiving tax subsidies and credits under the new law, according to Simms.

While the Affordable Care Act moves into implementation, Mississippi lawmakers decided earlier in the year not to expand Medicaid, which would have potentially provided hundreds of thousands of currently uninsured individuals access to affordable health care.

Additionally, a lack of competition among health insurance providers in Mississippi doesn’t help lower premiums, according to Mississippi Insurance Commissioner Michael Chaney, who spoke at a recent local conference.

Wednesday night’s presentation by Simms helped to alleviate some of area residents’ concerns though.

“The meeting helped me out a great deal. I’m serious about getting health care. I just haven’t been able to afford it so far,” said Mary Fells.

By 2014, U.S. citizens that are not currently insured will be required to have health insurance. Open enrollment under the Affordable Healthcare Act began Oct. 1.