Having insurance doesn't only give a person access to medical care; it also provides financial assurance in case of emergencies, as well as peace of mind. However, many Summit County residents and Coloradans generally are either underinsured or without insurance altogether. While sometimes this is by choice, often it's a matter of cost.That may soon change, however.In October, the Connect for Health Colorado plan will go into effect. The program, also referred to as the Health Benefit Exchange or simply "the exchange," is a system for connecting people with affordable insurance plans on the private market.Unlike the publicly funded Medicaid and Child Health Plan Plus (CHP+) programs, the exchange is not a single insurance plan, but a collection of plans from insurance companies on the private market. The plans are designed to be affordable for low- to moderate-income individuals, families and small businesses. This may also include families in which some members qualify for Medicaid or CHP+ and other members do not. Over the last three years, for example, the Summit County-based Family & Intercultural Resource Center, or FIRC, has enrolled more than 400 children in CHP+, but limits to the program mean that there are many who cannot benefit. It only covers children and pregnant women, not any other parents. And some families' incomes are just high enough to make them ineligible for the program."There are a lot of parents out there whose kids qualify for Medicaid or CHP+ but the parents don't qualify," said Robert Murphy, FIRC community support manager. "The exchange will be an opportunity to find coverage for themselves."The exchange program isn't restricted only to low-income individuals and families. The range of eligibility is meant to be broad, and anyone is allowed to take a look at what plans are available."I think the most important thing would be for people to understand that the exchange is intended for a very broad audience," Murphy said. Even those who don't qualify for Medicaid and CHP+ may find that the plans offered by the exchange offer some appealing and affordable options.While some people are reluctant or refuse to take part in government-sponsored programs, that shouldn't be a problem with the exchange, Murphy explained, because it is not that kind of program. "Government certainly has a role in this but not as the actual provider of insurance," he said. "It's a partnership and the insurance is being provided by the insurers."
In Summit County, FIRC and Social Services plan to work together to assist residents with the process of navigating the exchange, including understanding what it is, finding out about eligibility, choosing a plan and getting signed up. To do this, FIRC is hoping to receive a grant through the Family Resource Center Association. The FRCA is applying to the state government on behalf of FIRC and other family resource centers around the state. The grant, if approved, will provide FIRC the funds necessary to hire at least two new staff members to act as guides to the health exchange process. Those with potential to benefit from the program include not only families and individuals but small businesses and the self-employed."Many employers are able to offer insurance that is good coverage and a lot of times affordable for maybe the employee, but once you try to add a spouse, family, children, things like that, it becomes much more unaffordable, and it's very difficult for the business, as much as they would like to be able to keep costs down, to provide any decent coverage while still keeping the amount of premium that an employee has to pay down," Murphy said. Through the exchange, more small businesses will be able to find an insurance plan with better coverage at an affordable rate.
The exchange, similar versions of which are being planned out in states across the nation, comes from the Obama administration's Affordable Health Care Act. The exchange program is just one aspect of many. The insurance mandate is another aspect. Going into effect in 2014, the mandate will require that most U.S. citizens and legal residents purchase insurance or pay a tax penalty. While there will be exceptions, it will certainly be something that is a consideration for many citizens, Murphy said. The hope is that the exchange can provide an affordable insurance option for people and help them avoid any tax penalties from the mandate."I know a lot of people are going to want to avoid having to pay a penalty," Murphy said. "And even more importantly, a lot of people are going to want to have an opportunity to be better insured, so we want to make ourselves available to help as many people get signed up for a good plan as we can."FIRC hopes to start building up its outreach this summer and then push to get people enrolled in plans from October onward.