It’s true that Obamacare requires almost everyone to get health coverage. That’s the individual mandate, and it starts January 1. Lots of people have heard about that.
But many of them don’t know that the law will help them get that coverage through so-called insurance marketplaces. Mimi Garcia is director of Enroll Texas, a nonprofit, non-partisan campaign to help Texans learn how to get coverage.
“We’re starting this summer because over 78 percent of all uninsured have no idea about these marketplaces.”
The marketplaces offer subsidies to help pay for the insurance plans, depending on your income.
Even a family of four with an income as high as $94,000 a year will be eligible for a subsidy.
To apply, people will go to an online website, choose from a menu of health plans, and sign up. That starts October 1.
But it could be a hard sell. Steven Vargas is a community health worker with the Association for the Advancement of Mexican Americans, in Houston’s East End.
“Now there’s going to be premiums and co-pays that go along with that too, and (we) know that that’s going to be a deterrent for some folks, thinking ‘I’ve never had to fork out any money before, I don’t intend to fork out any money.’ But we have to also make them aware that the cost is going to be subsidized, depending on your income.”
There are also complications to explain.
Strangely enough, the poorest of the poor are not eligible for any subsidy. That’s because the poorest adults were supposed to get their insurance through Medicaid, but Texas officials decided not to offer that option, at least for now.
And undocumented immigrants are also not allowed to use the marketplaces. Both groups will have to continue to rely on emergency rooms and safety-net clinics.
Vargas says explaining all this could be tough.
“You may have a family where the grandmother may not be a legal citizen, but everybody else is, so that kind of breeds some of that mistrust. ‘What are they going to do with my uncle? What are you going to do with my mother?’ Something like that. That’s where some of that mistrust lies, and a little hesitancy to engage.”
Hispanics make up 17 percent of the U.S. population, but 32 percent of the country's uninsured.
Advocates say getting that population insured will help them stay healthier, but also reduce pressure on emergency rooms and charity clinics.
Enroll Texas estimates 3.5 million Texans are eligible for a subsidy if they buy a plan through the on-line marketplace.
Again, director Mimi Garcia:
“If you’re uninsured in Texas you will not be able to escape the message about the marketplaces. Going shopping they’ll be an info table at your local grocery store, and you turn on the radio and there’ll be an ad about it, and we’ll have billboards and we’re planning a paid media campaign as well.”
This on-line calculator can help you see how much of a subsidy your family may qualify for.
You can find more information on how to get coverage at HealthCare.gov or CuidadoDeSalud.gov. You can also call (800) 318-2596. Hearing impaired callers using TTY/TDD technology can dial 1-855-889-4325 for assistance.