Health care reform under the provisions of the Patient Protection and Affordable Care Act ("Obamacare" or ACA) continues to move forward, at greater speed in some states and at slower speed in others. We are fortunate that Oregon is one of the states that embraced the ACA process from the beginning.
We have some important changes in process and some important dates coming up. If you don't know why Oct. 1 and Jan. 1 of 2014 are important, you'd better read on.
Medicaid (known in Oregon as the Oregon Health Plan or OHP) access will be expanding in Oregon under the new rules from the ACA. Starting on Jan. 1, coverage will be available to people who earn up to 138 percent of the federal poverty line (about $15,800 a year for a single person or $32,500 for a family of four). Starting on Oct. 1, you will be able to get information and to sign up. This expansion gets rid of age and gender qualifiers and gets rid of the "lottery" for coverage. The program is largely supported by federal tax dollars.
A new, state government-sponsored company will be able to tell you about your eligibility for the Oregon Health Plan and help you sign up if you are eligible. Cover Oregon is the name of the company, and it will be running the "health insurance exchange" we have been waiting for.
People who are eligible for the Oregon Health Plan will receive help enrolling in that plan. People who are not eligible will receive assistance in choosing a health plan that will work well for them among the offerings of the 16 companies that are participating in the exchange.
Many people will receive financial assistance in purchasing insurance which is based on family size and income and phases out with higher incomes up to as high as 400 percent of the federal poverty line (almost $95,000 a year for a family of four). People who obtain health insurance coverage through Cover Oregon will receive assistance in comparing policies' coverage, whether they are eligible to receive financial assistance or not. All of the policies offered through Cover Oregon must meet the criteria designed to ensure quality coverage established by Cover Oregon.
Lots of people in southwestern Oregon are essentially locked out of the health care system by lack of insurance and by their inability to afford either insurance coverage or the care itself. These changes will help many of those people (estimates run as high as over 500,000 Oregonians) to gain coverage and gain access to the medical services they need.
Opening pathways to coverage for more people is important to all of us. When more people have appropriate financial access to care, the cost of insurance goes down for everyone — because right now, those of us with insurance are paying for the care provided to those who cannot pay for it themselves. Even more important, evidence suggests that when coverage is broader, the quality of care goes up and everyone gets better care.
There are good effects in our society as well. Healthier people are more productive in the workplace, making our communities more attractive as places to bring a business and look for employees. Economic prosperity tends disproportionately to flow to healthy populations.
Healthy children learn more quickly. People who learn more quickly are better able to adapt to new jobs and new roles in business, another reason why improving health care is likely to improve the overall strength of our community.
Oregon Action is proud to offer an educational session. If you are still unclear about what to do or where to go, come to the Medford Library at 6:30 p.m. Monday, Sept. 9. We will have lots of information for you.
Roger Howe is a retired family physician.