MASON CITY | Whether through public workshops, consumer mailings or staff training, North Iowa hospitals and human service agencies are preparing now to help customers better understand the Affordable Care Act, the enrollment period for which begins Oct. 1.
Under the Affordable Care Act, everyone is required to have health insurance in 2014 or face a penalty. Income-based subsidies are available to make it more affordable.
Most people who receive their health insurance through an employer, or those age 65 and older who are on Medicare, will not have to make any changes.
“There are people being trained that will help (consumers) go through what insurance policies are available and which ones will help them,” said Ron Osterholm, director of the Cerro Gordo County Department of Public Health. “They will help them go through the paperwork.”
The Certified Application Counselors (CAC) are being trained through the federal Centers for Medicare and Medicaid Services.
Osterholm anticipates having three or four Health Department employees trained as CACs.
“We deal with a wide population and a variety of people, from very low income to middle income," Osterholm said. "We serve a lot of people that really don’t have a medical home.”
At Mercy Medical Center-North Iowa, “you name it, we’re doing it,” said Steve Davis, director of marketing and planning.
"We have a communications campaign to alert people to the availability of insurance exchange options -- what they are, how they function, how they would benefit people. We and a number of community agencies are here to help."
Mercy's communications campaign includes mailings, public events, advertising and information on the Mercy-North Iowa website, www.mercynorthiowa.com. A subsidy calculator, to compute insurance subsidies based on income and other factors, is included on the website.
Hospital staff members are also available to give presentations about the Affordable Care Act to community groups, Davis said.
At a Health Insurance Marketplace Townhall Public Meeting on Sept. 28 at Mercy-North Iowa, officials from the Iowa Insurance Commission presented information about the Iowa Health Insurance Marketplace, financial assistance that is available, enrollment assistance and other pertinent information.
Vance Jackson, chief executive officer of Hancock County Health System, and Laura Zwiefel, chief nursing officer, said a series of educational events about the Affordable Care Act are being planned in Hancock County.
"We're trying to get it organized and ready," Jackson said.
Hospital representatives will speak to civic groups, at social events, put information on the hospital website, Facebook and "any place people might go," he said.
If all else fails, "people can always call us," Jackson said. "We have staff being trained to answer questions and understand how the new law impacts them."
Hancock County Community Health will provide information about the ACA at wellness screenings, blood drives and immunization clinics, Zwiefel said.
The advent of the Affordable Care Act is prompting Hancock County Health System to change the way it functions, Jackson said.
"This puts a much higher focus onto primary care and preventative services."
Patients, including people with chronic diseases, who do not currently have a medical home, will be encouraged to find it at Hancock County Community Health, where they can be helped to avoid higher-cost medical services by taking advantage of health screenings and preventative health care measures.
Health coaches can help form personal connections with patients to help them navigate the health care system.
The hospital will also work with local employers to help them keep their work force healthy and maintain company-sponsored health insurance, Jackson said.
Barb Kellogg, associate director of planning and development at North Iowa Community Action Organization, said the agency has applied to be a Certified Application Counselor organization.
“We won’t be enrolling people, but will be providing information," she said. "We’re going to help people understand what kind of choices they have on the health care marketplace exchange and helping them to understand the differences in the plans being offered.”
In North Iowa, two plans are available: CoOportunity Health, with which Mercy-North Iowa is affiliated; and Coventry Health Care of Iowa.
The agency is working with Mercy-North Iowa and the Cerro Gordo County Department of Public Health “to ensure we have an appropriate local response to individual and family needs for information and access to health care,” Kellogg said.
Community Action has also sent information to its employees about insurance options they will have, Kellogg said.
Greg Polzi, chief financial officer of Iowa Specialty Hospital in Clarion, said the hospital is a Certified Application Counselor Organization.
"We'll have no less than 10 individuals trained as counselors on staff."
The CACs will provide information about the full range of qualified health plan options and insurance affordability programs for which consumers may be eligible, Polzi said.
The counselors will also assist patients with applications for insurance coverage and facilitate enrollment in qualified health plans and insurance affordability programs.
"We can't steer them in one direction or the other but can provide them with information so they can make the best decision that pertains to their situation."
ISU Extension and Outreach is also offering help about the Affordable Care Act through its Smart Choice program.
"Currently, ISU Extension and Outreach-Cerro Gordo County is working on scheduling Smart Choice programs for late November and the first few weeks in December of this year," said John Sjolinder, executive director. "The sessions will be free to the public and two hours long."
The first series of programs will deal with purchasing health insurance. Other Smart Choice programs will focus on areas of concern such as Smart Use and Smart Choice for farm families, Sjolinder said.
Some programs will be held at the Extension office in Mason City. Others are being planned at area libraries. As programs are scheduled, the dates and times will be posted on the Extension website and other venues, including the media.
"We're trying to help people that haven't had to work with health insurance, or haven't been able to work with health insurance, determine what they need to do."
Two other agencies directly impacted by the ACA are Prairie Ridge Addiction Treatment Services and the Mental Health Center of North Iowa. They have a vested interest in ensuring consumers hook up with health insurance coverage.
"This Affordable Care Act is changing our world," said Jay Hansen, executive director of Prairie Ridge. "It requires a huge change in the way we do business."
Behavioral health care services were previously outside the health care system and depended upon government grants and contracts for funding, Hansen said. Now their funding will hinge on clients having health insurance coverage, which in some cases may be Medicaid.
Staff is being trained to help clients do their financial assessments to determine which insurance option best meets their needs. Those eligible to go the insurance exchange will be helped to navigate the exchange, if needed.
"I think in the end this (Affordable Care Act) will be better for patients," Hansen said. "Our clients will have better health care."
Andy Eastwood, executive director of the Mental Health Center of North Iowa, said the agency is participating in training offered through Mercy-North Iowa and talking with regional county services to request assistance in helping clients sign up for an insurance plan in the insurance exchange prior to Jan. 1.
"This is definitely going to take a concerted effort among everyone to make sure we don't have anyone not covered by health insurance and finding that they have huge medical bills and no way to pay them when they could have been covered."
It is also important for people in frail health, which includes disabling mental health conditions, to know they have a choice of being covered under Medicaid rather than insurance from the marketplace, Eastwood said.
Gail Arjes, administrator of the Floyd County Department of Public Health, may have spoken for many when she said the Health Department will have informational materials available for consumers. Employees will also be able to refer consumers to additional information if needed, Arjes said.
"Right now, it's a matter of educating ourselves on it, too."