While major improvements to the flagship website of healthcare reform have been made, parts of the reform law remain a work in progress, a representative of the Alaska Native Tribal Health Consortium said.
The troubled healthcare.gov website has started to show signs of improved functionality, said Monique Martin, the consortium’s representative. Martin visited Wrangell Tuesday to discuss problems and remaining issues with the site. She spent most of the day Tuesday consulting with local healthcare consumers worried about the laws effects, and delivered a presentation on the subject in the Stikine Middle School Commons. The group noticed a significant uptick in the site’s functions in the beginning of December.
A general theme or typical question was difficult to discern, Martin said.
“It gets really specific really quickly,” she said. “People are worried about their personal circumstances, their health issues, their income.”
The website is the gateway to health exchanges established by states, or in the case of Alaska, the federal government. The exchanges are designed to allow people to easily compare and select insurance plans available in their area. During the site’s rollout in October, severe problems developed with the technological infrastructure. A few bugs related to functionality remain, Martin said.
“When people get to the point where they’re ready to buy a plan, there are links in the site designed to help them find out more information about the plan,” she said. “Those links are still broken.”
“That’s a huge issue,” she added. “For a lot of people, it’s who’s my doctor in Seattle? If I want to choose Virginia Mason Hospital, can I?”
The biggest issues remaining are subsidies and exemptions, Martin said. Everyone in the U.S. is required to show proof of insurance meeting minimum standards by Dec. 23, or pay a fine. Those with limited income may qualify for a federal subsidy to purchase insurance on the exchanges, Martin said. A family of four making up to $117,760 qualifies for at least some basic assistance, Martin said.
“They’re gonna qualify for a subsidy,” she said. “It can be significant.”
Martin recommends the website of the Kaiser Family Foundation – http://www.kff.org – which provides a subsidy calculator.
Another issue is an exemption for members of American Indian and Native Alaskan nation groups. While the law provides them with an exemption, the exemption must be filed through the mail. The forms required to request that exemption aren’t yet available, so telling Alaskan Natives what they’ll need is currently impossible, Martin said.
“They might need to show a tribal enrollment card,” she said. “We really don’t know.”
Uninsured residents face tax penalties of up to 1 percent of income, or $95 per adult and $47.50 for each child in the family, whichever is more, Martin said.
Another exemption exists for residents of states like Alaska – which has elected not to expand its Medicaid program – who earn incomes too high to enroll in Medicaid and too low to afford the plans on the exchange.
“There’s a donut hole, of people squeezed between the sides,” Martin said.
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