What you need to know about Kentucky's health care reform plan

mmeehan1@herald-leader.comJuly 27, 2013 

An animated video produced by the state promotes signing up for health insurance under the new health care reform act as being "as easy as going online to book airline tickets or book a hotel."

That remains to be seen. But the video is part of an $11 million information campaign aimed at telling Kentuckians how to enroll for health care through what's being called an online "exchange" at Kynect.ky.gov.

The messages about the online service will become more frequently seen — on billboards, newspaper, radio and television ads and online — in the coming months.

The audience the state's campaign is trying to reach is vast. An estimated 640,000 Kentuckians, or nearly 15 percent of the state's population, are currently uninsured. That number includes 300,000 Kentuckians who don't have insurance and will for the first time be eligible for Medicaid.

Everyone, with very few exceptions, is required to have health insurance by March 31, 2014, or pay a penalty.

Enrollment begins Oct. 1, but recent interviews with local and state health officials, health care advocacy groups and representatives of Lexington's major hospitals indicate there are still many questions unanswered.

For example, a legion of health care "navigators," who will help people determine whether they are eligible for care and help them enroll, has not been identified. Gwenda Bond, a spokeswoman for the Cabinet for Health and Family Services, said that bids for that contract are currently being reviewed.

It's also unclear what kind of medical help those signing up for insurance for the first time might need precisely because they haven't been in the health care system. Dr. Rice Leach, Lexington's commissioner of health, has been working to get Fayette County's medical community together to share information and to answer questions such as what kind of care might be needed. Leach, known for his often blunt assessment of any given situation, said the change is going to be difficult.

"It is likely going to be very confusing and very annoying and very distressing," he said.

Here are some tangible things in the works and some answers to big questions.

What's Kynect?

The center of activity will be the state's website, Kynect.ky.gov, which carries the tagline "Kentucky's Healthcare Connection." You can't sign up for insurance until Oct. 1, but the website has a list of frequently asked questions, a short explanatory video and fact sheets including general information about the scope and cost of coverage. Starting Oct. 1, people will be able to sign up for coverage through the website.

Who can you call?

The state has hired 100 people to work at a call center to answer questions about how to obtain insurance and insurance options. It is scheduled to begin operation on Aug. 15. The number will be 1-855-459-6328 and operators will be on hand from 8 a.m. to 7 p.m. Eastern time, Monday through Friday. Saturday hours will begin Oct. 1 with open enrollment.

If you call before Aug. 15 you will get a recording telling you to call back or visit Kynect.ky.gov.

Plan options

Kentucky's health care plans are divided into four categories — bronze, silver, gold and platinum. Individual health insurance companies will design plans to match the state requirements for each category.

A platinum plan has a higher premium but lower out-of-pocket costs. A bronze plan has a lower premium and higher out-of-pocket cost.

Specific coverage details will be available when open enrollment begins on Oct. 1.

What do you need to do?

You can sign up for health insurance beginning Oct. 1. Enrollment runs through March 31, 2014. The earliest coverage can take effect is Jan. 1, 2014.

Is enrolling early better?

Applications will be processed as they are received. People who are eligible for health insurance will be able to qualify as long as they enroll in a plan before the March 31, 2014 deadline. Access to all of the plans will be available throughout the entire enrollment period. In other words, if you want the platinum plan or any other specific plan it will be available whether you sign up on Oct. 1 or March 31, 2014. Signing up as early as possible won't necessarily get you coverage any quicker. All insurance won't be effective until at least Jan. 1, 2014.

What if I can't afford it?

Kynect.ky.gov will be connected to federal databases — including IRS databases — to determine if someone qualifies for assistance based primarily on income.

People qualifying for Medicaid won't have to pay a premium. Others may be eligible for some payment assistance or tax credits.

What if I don't qualifyfor assistance?

You can still buy health insurance on the site or go directly to an insurance company. You will pay the full premium.

Is there help using Kynect?

Yes. Here are some options.

■ Public libraries: The state is training library staffs to help people without home internet access to use library computers to access the website.

■ Department for Community Based Services: People can go to the local offices, which now administer social services such as Medicaid and food stamps.

■ Call-center workers can answer questions for people who are on Kynect.

■ The "navigators" will help people individually. The details of that plan haven't been released.

What if I don't sign up?

Those who don't sign up for health insurance of some kind will have to pay a fee. In 2014 it will be 1 percent of a person's annual income or $95, whichever is higher. The fee increases every year. In 2016 it is will be 2.5 percent of a person's income or $695 per person, whichever is higher. The fee will be collected by the Internal Revenue Service. There is also a penalty for not providing coverage for children.

Sources: Kentucky Cabinet for Health and Human Services; Kynect.ky.gov; Healthcare.gov; IRS.gov; Foundation For a Healthy Kentucky; KaiserHealthNews.org, Carrie Banahan, the executive director of the Health Benefit Exchange.

Mary Meehan: (859) 231-3261. Twitter: @bgmoms. Blog: BluegrassMoms.com. Reporter Beth Musgrave contributed to this report.

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