WHEELING - The deadline to sign up for health care coverage through the Health Insurance Marketplace passed at the start of April, with some local residents finding the plans too expensive and opting instead to pay penalties for not having health insurance, according to Wheeling Health Right Executive Director Kathie Brown.
Coverage under the Affordable Care Act has been beneficial for those with incomes under 138 percent of the federal income levels, but can be costly for those earning more who then seek insurance in the Health Insurance Marketplace, Brown said.
"For those people who qualify for tax credits, it's awesome," she said. "Now when they need surgery (or other medical care) they can get it. There is not as much reimbursement as there is for regular insurance, but there is payment. Those over 138 percent, though, who don't qualify for tax credits are finding high deductibles and high co-pays. ... They couldn't make the decision to choose coverage through the Marketplace. They didn't think they could afford it because they have no tax credits, and some deductibles are as much as $6,500. Some made the decision to take the penalty, and wait until next year to see if plans are cheaper."
According to information at the HealthCare.gov website, fines for those who fail to obtain health insurance will be calculated in one of two ways: The fine will be equal either to 1 percent of the uninsured family's yearly household income, or $95 per person in the household up to a maximum of $285.
The uninsured person will be asked to pay this fine on their 2014 tax return filed in 2015.
Brown said while Wheeling Health Right assisted many patients in navigating the Healthcare.gov website, the agency signed up no one for coverage through the Health Insurance Marketplace or took their first month's payment on-site. She suspects many went on to complete the process at home, or signed up through other providers.
Wheeling Health Right, though, did sign up many of its clients for expanded Medicaid coverage, she said. The agency has about 20,000 patients, and about 45 percent qualified for coverage under Medicaid.
"Some people qualified for original Medicaid who should already have had it, but didn't," Brown said. "We are seeing a lot of new people. They came in to see what they could get, and couldn't get."
There wasn't much of a rush locally from those needing to acquire coverage by the April 1 deadline, according to Brown.
"We had five people call on Friday who wanted to get into the system so they could get an extension," she said. "But none of them ended up coming in."