Overdrive before the overhaul

COEUR d'ALENE - Ready or not, here comes Idaho's version of ObamaCare.

The enrollment period for the new state-based health insurance online "marketplace" (formerly called an exchange) starts Tuesday and runs through March 31 for uninsured residents or those who qualify due to low income. Coverage will go into effect Jan. 1.

The state has determined that more than 14,000 uninsured residents in Kootenai County alone will qualify for a tax credit and therefore benefit from health care reform.

Peggy Therriault, of Worley, was among dozens of local residents who attended one of several free seminars hosted this week by the Idaho Association of Health Underwriters. The sessions were aimed at those trying to get a handle on what the new health care system will mean to them.

Even armed with handouts and a better understanding of the program, Therriault said it's all still murky.

"I was hoping it wouldn't be so confusing," she said, adding that she recently received a notice from her current insurance provider stating her policy doesn't meet the government's mandated coverage guidelines and that she'll need to get a new policy.

"I'll get a hold of my (insurance agent). There is no way people will be able to ever figure it out on their own."

Therriault was relieved to discover she has a lot of company when it comes to not having a grasp of the new system.

And she's ahead of many people by simply realizing access to and enrollment for the marketplace starts Tuesday.

A national survey by the nonprofit Kaiser Family Foundation revealed 42 percent of the public doesn't realize the Patient Protection and Affordable Care Act, commonly known as ObamaCare, was signed into law in 2010. They believe it's going to become a law next year.

Unsettled business

Americans will pay an average premium of $328 monthly for a mid-tier health insurance plan under ObamaCare, and most will qualify for government subsidies to lower that price, federal officials say. The prices of the new plans are the topic of a political debate over whether they will be affordable enough to attract millions of uninsured Americans.

Idaho Association of Health Underwriters members say that people don't need to rush into health insurance brokers' offices on Tuesday - or even soon thereafter - because of the debate in Washington, D.C., and kinks that need to be worked out. Multiple IAHU members said they wouldn't be surprised if the deadline to enroll gets bumped as a result.

"I'm thinking around Halloween would be a great time to sign up," said Brad Miles, president of the local IAHU chapter. "I think it's more prudent to wait."

Mark Woodworth of Helbling Benefits Consulting added: "Many glitches are expected; give them time to work it out. I trust the people in Idaho, but unfortunately they're dependent on the people in Washington, D.C."

Dave Munger, legislative chairman of the IAHU, said other states, such as Oregon and Washington, that were among the first to get funding to set up their marketplaces, are weeks behind schedule.

Still, it's time for individuals to educate themselves about whether they even qualify to enroll in the marketplace, IAHU members say.

Educating the public, Munger said, is a huge undertaking, "There are a lot of people interested in it and not many of us."

Many residents covered under their employer's insurance won't qualify for tax subsidies and credits under Obamacare. Seniors covered by Medicare won't be affected, Miles said.

Insurance requirement

As of Jan. 1, all individuals will be required to have "qualified" health insurance - or they'll face a fine from the Internal Revenue Service - and the marketplace will be another means to obtain such coverage. In 2014, if you're uninsured for three months, the penalty will be $95 per adult and $47.50 per child (up to $285 per family).

The marketplace will offer eligible individuals multiple plans from multiple companies. Those who already have a health insurance plan and want to look for different coverage can shop on the Your Health Idaho site. Additionally, small businesses with up to 50 employees can use Your Health Idaho to select a plan for all of their employees.

Miles said a common question he has been asked is who is going to pay for the advantages the marketplace offers those who qualify. He said it's a question he can't answer specifically, because that's part of the debate in Washington. Generally, he said, taxes are the answer, which concerns some individuals.

Miles said the marketplace won't be perfect and will even be unfair in some ways because two people making the same amount of money may have to pay different premiums, depending on several circumstances.

"But it's the law and we'll let people know how it affects them and what they can do about it," he said. "That's why Congress is spending so much time stewing over this. It's still trying to fix the unfair pieces before they come into play in January."

Miles said that with the looming start of the enrollment period, interest in the marketplace is gaining momentum. One of the seminars at the Coeur d'Alene Library attracted a standing-room-only crowd of more than 100 despite limited advertising.

"As the word gets out, more people are wanting to know if they qualify for help," he said. "Now is the time to figure out your best insurance for the best price."