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Navigators explain plans as ACA deadline looms

Federal Navigator Heather Trascapoulos (left) answers Karen Epps' questions during an Affordable Care Act town hall meeting at the Moss Free Clinic in Ferdericksburg on Tuesday, March 25, 2014.

Federal Navigator Heather Trascapoulos (left) answers Karen Epps’ questions during an Affordable Care Act town hall meeting at the Moss Free Clinic in Fredericksburg on Tuesday, March 25, 2014.

UPDATE – Enrollment deadline extended: (AP) WASHINGTON – The Obama administration has decided to give extra time to Americans who say that they are unable to enroll in health-care plans through the federal insurance marketplace by the March 31 deadline.

Federal officials confirmed Tuesday evening that all consumers who have begun to apply for coverage on, but who do not finish by Monday, will have until about mid-April to ask for an extension.

Under the new rules, people will be able to qualify for an extension by checking a blue box on to indicate that they tried to enroll before the deadline. This method will rely on an honor system; the government will not try to determine whether the person is telling the truth.

The rules, which will apply to the federal exchanges operating in three dozen states, will essentially create a large loophole even as White House officials have repeatedly said that the March 31 deadline was firm. The extra time will not technically alter the deadline but will create a broad new category of people eligible for what’s known as a special enrollment period.

The change, which the administration is scheduled to announce Wednesday, is supported by consumer advocates who want as many people as possible to gain insurance under the 2010 Affordable Care Act. But it’s likely to be criticized by Republicans who oppose the law and have denounced the way the administration is implementing it.

Administration officials said the accommodation is an attempt to prepare for a possible surge of people trying to sign up in the final days before the deadline. Such a flood could leave some people unable to get through the system.

A police officer knocked on Linda Webb’s door on New Year’s Eve, upending the Florida resident’s world and sending her into a health insurance nightmare so complicated she couldn’t see a way out.

So Tuesday night, Webb sought help at Mary Washington Healthcare’s town hall meeting on the Affordable Care Act. There, she met a health care navigator who helped Webb sort out her options.

On Dec. 31, Webb’s son, Chris Myers, had a stroke, which left him unable to talk or move. His mother immediately flew to Virginia, where she has spent every day at his bedside.

A perky woman with an easy laugh, Webb tried to hope for the best—that her son will recover and resume a normal life. Tuesday, she started to panic. Unable to work, her son will lose his job-based insurance March 31. Webb has Myers’ last two paychecks and could use them for extended coverage through COBRA. But she hopes to move him to Florida, where her five other children could help care for him.

Myers hasn’t been declared disabled yet, so he doesn’t qualify for Medicaid, and without an income, he wouldn’t qualify for a subsidy under the Affordable Care Act.

“I’m between a rock and a hard place,” she told Lorena Paredes, a federally trained navigator who works for Advanced Patient Advocacy. Tuesday night, Paredes talked Webb through her options, and Webb decided to sign up for COBRA after learning she could enroll her son in the marketplace in Florida if she moves him there.

Many of the people who came to Tuesday night’s meeting had less complicated reasons for attending. Stafford resident Susan Insisiengmay wanted to find out just how affordable the coverage could be.

She stopped working six years ago after giving birth to twins. Paying day care for the babies and an older sibling cost more than her mortgage payments, she said.

But when Insisiengmay lost her job, she also lost her insurance. She’s been getting health care through the Fredericksburg Christian Health Center, and suspected that getting insurance in the marketplace would cost more than the fine for not having insurance.

Tuesday night, she learned she was right. But Insisiengmay also learned that she could be helped if Virginia expands Medicaid, which would make the state-funded insurance available for low-income adults. Now, Medicaid is only available for people who are younger than 21, pregnant, disabled or older than 65.

And in the marketplace, people who make between 100 percent and 400 percent of the poverty line qualify for subsidies, so an individual making $11,400 or less wouldn’t qualify.

More than 50 people attended the town hall meeting Tuesday night, listening to a brief presentation on the details of the health care reform. Then, they could get one-on-one help from navigators or sign up to get a call from a navigator in the next day or so.

For those hoping to enroll in marketplace insurance plans, time is running out. Open enrollment ends March 31.

Amy Flowers Umble: 540/735-1973


The open enrollment period for getting insurance through the marketplace ends March 31. To find out about available plans and their costs, contact a federally trained navigator:

Heather Trascapoulos, who works out of Mary Washington Hospital: 540/741-2541. Or stop by her office, in Patient Access, adjacent to Mary Washington Hospital’s atrium.

Bill Botts, who works for ENROLL Virginia: 540/374-5023, or 500 Lafayette Boulevard, Suite 140 in Fredericksburg.


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