‘Obamacare’ brings change to Social Services

Published 11:19 am Monday, September 16, 2013

WINTON – You’ve probably seen the flyers, the billboards, signs, and the commercials.

The Affordable Care Act, or “Obamacare”, is coming, with a goal to increase insurance coverage and reduce the cost of health care for all Americans.

But sometimes the interpretation of the new law and how it will be applied to can be confusing.

Last week, members of Family Service/Medicaid with the Hertford County Department of Social Services made a presentation before the Board of Commissioners, in the words of supervisor Rachel Askew, “to help when the public comes to you asking questions”.

The Affordable Care Act also includes provisions that would impact medical assistance eligibility and those who come into their local department of Social Services.

With emerging technology, individuals and small businesses will be able to use the web-based marketplace to compare plan benefits and shop for health insurance.

North Carolina has chosen to utilize a Federally Facilitated Marketplace (FFM) system in lieu of creating a state-run exchange. This FFM will screen for Medicaid (if applicable) and allow for some individuals on Medicaid to apply for tax credits on insurance premiums.

Assisting those seeking to purchase health insurance in the marketplace in North Carolina will be NCFAST, which stands for North Carolina Families Accessing Services Thru Technology. As its name implies, the new technology will allow DSS workers to assist clients quicker.

Those individuals potentially eligible for Medicaid will be directed to NCFAST with applications being taken beginning on October 1 of this year, with benefit coverage beginning on January 1, 2014.

“We’re told it will just be a one-page application when they come in to apply for this coverage,” said DSS’s Connie Wilson.

“We’ll gather some different information for the FFM other than what’s needed on a traditional Medicaid application,” she added.

Certified Application counselors will be available to assist applicants, but not as salespersons for health insurance policies.

“We can only assist them for where they need to be about a policy,” said DSS’s Debbie Myers.

Furthermore, the cost of the policy for those who qualify will not be transferred directly to Social Services.

Since North Carolina chose not to expand Medicaid, two situations will apply according to Wilson.

“You may qualify for the lower cost of health insurance at the FFM based on your household size or income,” she stated. “Or you may not qualify for the tax credit or the cost-sharing reductions and you will have to pay full price for your health insurance.”

CountyManager Loria Williams wanted more clarification on eligible participation.

“If they’re currently receiving assistance, then they will stay under the assistance until they are no longer eligible,” explained Askew. “The Affordable Care Act is additional.”

“Heretofore it’s been in food and nutrition,” queried Williams. “Now it’s moved into Medicaid and trying to determine eligibility for future eligible persons or even those that we’re currently serving?”

“Some of this application process is now going to be electronic,” Williams said. “But we’re going to have to talk to, communicate, technologically speaking, with the marketplace.”

“That telephone signature is a big piece that’s still out there and we just don’t know how that’s going to happen right now,” Williams continued.

The DSS officials said one of the larger effects they anticipated is an increase in applications for Medicaid or for ACA.

“North Carolina’s anticipating that there’s between 500 and 700 thousand citizens just in our state that may apply because they’re going to see so much media coverage about the Affordable Care Act and they may be eligible under that where they wouldn’t necessarily be eligible under Medicaid,” said Askew.

Williams says the county made a huge commitment a year ago in upgrades to prepare for the coming changes.

“Hardware is pretty much our (Hertford County’s) responsibility and we did a huge purchase of computers in DSS to make certain we had assistance to run this new technology,” Williams said.

“We’ve had quite a bit of expenditures as it relates to NCFAST, and not just us; but there will always be that on the hardware side,” she added.

Commissioner Johnnie Ray Farmer asked if DSS was receiving technical support from state Health and Human Services.

“Dr. Wos (NC HHS Secretary) told us they had doubled their support staff and there should be no reason for any Social Services department to be lacking in support,” Farmer said.

Wilson reiterated that with the approaching deadline the countyDSS was working to make its adjustments.

“This is a much greater expansion and the consequences of technology and defects are of graver consequence than they were with Food & Nutrition. We need to prepare for high as well as low,” Wilson said.

“We’re in it now so hopefully this will happen,” she said. “Nothing’s going away, it’s just all new has been added. We don’t know how many are going to be affected. All points of interest are going to come thru Social Services; the application will go thru NCFAST.”

“Everyone’s not clear on just what is Obamacare,” said Askew. “So there are going to be plenty of questions.”

“The Affordable Care Act is not free insurance,” she added. “There is a cost to it.”

Applicants who do not qualify for Medicaid and NC Health Choice may still be eligible for the insurance, but it may be at full price; though that price will be less expensive than in the general health insurance marketplace.

“The best way we can help families is with the best information because things are changing,” concluded Wilson. “We want to keep the lines of communication open.”