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Another ACA Open Enrollment Period Coming To An End

Aileen LeBlanc

**UPDATE**  

The latest data published by the U.S. Department of Health and Human Services indicates 96,226 Kansans have signed up for health care coverage through HealthCare.gov

This story originally aired during Morning Edition on Thursday, February 12, 2015

This Sunday marks the deadline to enroll in the Affordable Care Act (ACA) for 2015. Last year, over 57,000 Kansans chose a coverage plan through the HealthCare.gov website.

As KMUW’s Sean Sandefur reports, another open enrollment period is about to close.

After the bungled launch of HealthCare.gov, roughly 10 million Americans have since signed up for health insurance through federal and state online marketplaces. Nearly 86,000 of those have been in Kansas.

Debra Guerra, who suffers from multiple sclerosis, is one of them.

“I was suffering from extreme fatigue," Guerra says. "I felt like my body was encased in concrete. Now I know that's one of the number one symptoms of MS.”

Credit Sean Sandefur
Debra Guerra suffers from multiple sclerosis. She signed up for health care through HealtCare.gov during the second ACA open enrollment period

Guerra lives in a colorful, mid-century home in northwest Wichita. She was diagnosed with MS in April of last year. She says she unknowingly lived with symptoms for years.

She was also uninsured for a period of seven years.

Currently unemployed, Guerra’s symptoms have made it increasingly difficult for her to work. However, her official diagnosis of MS last year made her eligible for disability payments. With that added income, she could finally afford health insurance premiums.

"I went to (Healthcare.gov), I selected the insurance provider that I wanted, I filled out all of the information and I was accepted," she says. "That was that."

It hasn't always been this simple for Guerra. Without insurance, she paid full price for doctor’s appointments and trips to the hospital. She says she was barely getting by.

“I would live on beans, I would live on peanut butter," Guerra says. "I had to cut corners wherever I could.”

Guerra says she received health care through her employer for most of her life, never thinking she might one day be without it, having to choose between groceries and health care.

That day came when she quit her job in Indianapolis to be with her ailing parents in Wichita.

Her own health began to deteriorate and she looked at private insurance. Premiums were $500 and deductibles were as high as $6,000. All where far too expensive.

Now, her payments are manageable.

“With the ACA, I chose the higher premium and I pay $370 a month," she says. "But, my deductible is only $1,600.”

Guerra also receives help with copays. Before, it would cost her $150 out of pocket for a single trip to her neurologist. Now, it’s about $25. That goes for other preventative care, too. She says trips to the chiropractor, her general physician, or an acupuncturist are all affordable.

Guerra says none of this would’ve been possible it weren’t for Project Access, a program facilitated by the Central Plains Health Care Partnership, located just past Kellogg on South Hillside. 

Monica Flask is the director of programs there.

Credit Sean Sandefur
Monica Flask is the director of programs at the Central Plains Health Care Partnership

"We serve people who are residents of Sedgwick County, who are uninsured and who have an immediate medical need,” Flask says.

A big part of her job during open enrollment periods is helping her clients sign up for health insurance. She says many people still don’t know about deadlines or the expensive penalties for going without coverage. These fees are already in place for 2014, but will increase for 2015 and 2016.

“The fees are significant. It's about $325 a person this year," she says. "Or it can be up to 2 percent of your income. So, it's really quite a big chunk that can come out of your tax refund.”

Flask is only able to help those already enrolled in Project Access. But, the uninsured can receive help throughout Sedgwick County from marketplace navigators. Their assistance isn't required, but they can help explain different coverage levels and help with navigating the HealthCare.gov website.

Credit whitehouse.gov

She says awareness and access to information on the Affordable Care Aact is a big hurdle for some people. But an even bigger barrier that keeps many low-income Kansans from receiving insurance is Kansas' decision to opt out of Medicaid expansion.

“About 62 percent of our patients are actually below 100 percent of the federal poverty level," Flask says. "To give you can example: that would mean a person working full-time would be making about $5.65 an hour. These folks can't afford insurance through the Affordable Care Act because we haven't expanded Medicaid in Kansas.”

There are hundreds of thousands of Kansans who make too much money to qualify for state aid, but not enough to receive subsidies from the Affordable Care Act. Monica Flask says this problem will continue until Medicaid expansion comes to Kansas.

Which, could already be in the works.

Clark Shultz is the director of government affairs at the Kansas Department of Insurance. He’s also a former state senator.

Credit whitehouse,gov

“The Vision 2020 Committee held meetings to come up with a bill, and they have done that and introduced it,” Shultz says.

The bill was introduced earlier this week in the Kansas statehouse. It would extend Medicaid coverage in Kansas to all households living below 138 percent of the federal poverty line. The bill’s sponsor, Rep. Tom Sloan of Lawrence, says it would provide health insurance to over 169,000 Kansans.

Many Republicans warn the state can't afford it.

Shultz did say that this open enrollment period saw roughly 30,000 additional people sign up than last year. He attributed this to more awareness and the fear of potential penalties.

To contact KMUW News or to send in a news tip, reach us atnews@kmuw.org.  

Follow Sean Sandefur on Twitter, @SeanSandefur