For some Americans, there is a deadline just as daunting as filing income taxes by April 15. They have until April 30 to acquire health insurance in 2015 if they do not want to pay penalties for not having it on next year’s taxes.
Although the deadline for the second open enrollment period in the federal Health Insurance Marketplace was Feb. 15, officials in the U.S. Department of Health and Human Services extended the deadline for six weeks starting March 15.
“A McKinsey report that came out last week showed that 41 percent of the uninsured were unaware of the fine, which means that there will be a lot of people in Delaware County and throughout the state who will be able to benefit from this tax filing special enrollment period,” said Julia Cusick, spokesperson for Enroll America, a nonprofit coalition aimed at getting Americans enrolled in and retaining health care coverage.
The Health Insurance Marketplace is a product of the U.S. Patient Protection and Affordable Care Act of 2010, designed to offer health insurance plans at competitive prices for uninsured or underinsured Americans. According to the health care reform law, Americans without health insurance who refuse to buy it must have health coverage exemptions or pay penalties.
“It’s clear that there’s still a lot of confusion about how the fine works, so ensuring that consumers have an opportunity to find coverage once they see how it affects them during tax time is important,” said Cusick.
The penalty for not having health insurance in 2014 was 1 percent of an individual’s yearly household income or $95 per adult and $47.50 per child under 18, whichever is higher. The maximum penalty per family is $285.
“Department of Treasury estimates that 3 to 6 million people nationally will be paying the fine,” said Cusick.
The penalty for not having health care coverage in 2015 will be 2 percent of an individual’s annual household income or $325 per adult and $162.50 per child, whichever is higher. The maximum penalty per household is $975. Individuals without health insurance can avoid the 2015 penalty by acquiring health insurance during the extended enrollment period that ends April 30.
“This special enrollment period is great news for consumers and it was something that Enroll America and other members of the enrollment coalition encouraged HHS to consider, since the tax filing moment is an important time to engage consumers and help them understand the coverage options available,” said Cusick.
Crozer-Keystone Health System has nearly 60 certified application counselors who have assisted marketplace applicants during the second open enrollment period at its five hospitals. They include Crozer-Chester Medical Center in Upland, Delaware County Memorial Hospital in Upper Darby, Taylor Hospital in Ridley Park, Community Hospital in Chester and Springfield Hospital.
“Our staff members across the health system have fielded more than 50 calls from people in the community during this extension period,” said Grant Gegwich, vice president of public relations and marketing for Crozer-Keystone Health System.
The Health Insurance Marketplace in Pennsylvania is facilitated through the federal government because former Republican Gov. Tom Corbett, an opponent of the Affordable Care Act, opted against it being implemented by the commonwealth. During his election campaign, Democratic Gov. Tom Wolf indicated he would eventually implement a state-run exchange.
Wolf is also dismantling Corbett’s Healthy PA plan and accepting federal Medicaid Expansion funds to provide health insurance for an estimated 300,000 working Pennsylvanians who earn too much for traditional Medical Assistance, but not enough to purchase insurance through the marketplace. Wolf has assured those already enrolled in Healthy PA that they will be transitioned to the simpler, less-restrictive Medicaid Expansion program.
“Our counselors report that they are getting more inquiries from patients about Healthy PA because they can’t afford the Health Insurance Marketplace. Some patients are also confused about the difference between Medical Assistance and Healthy PA,” said Gegwich.
Cusick noted that many consumers in search of health insurance don’t realize that financial help is available, so the extended open enrollment period will give them an additional chance to explore their options rather than making them wait another year to get covered.
“Here in Pennsylvania 81 percent of people who signed up for coverage through the Health Insurance Marketplace got financial assistance,” said Cusick.
On Tuesday, U.S. Department of Health and Human Services Secretary Sylvia M. Burwell announced that about 16.4 billion uninsured people have gained health care coverage since the passage of the 2010 Affordable Care Act, the largest reduction of the uninsured in 40 years. In Delaware County alone, the number of Health Insurance Marketplace enrollees as of mid-January had exceeded 25,000, nearly 6,000 more than last year.
Assistance in navigating the Health Insurance Marketplace during the extended open enrollment period is still available at Crozer-Keystone Health System’s five hospitals and through ChesPenn Health Services at its Chester, Upper Darby and Coatesville, Chester County offices.
Date: March 18, 2015