Forum looks at health care law
VIENNA – Hundreds of people will be available to help West Virginia residents when the Affordable Care Act enrollment begins Oct. 1 and the health care program becomes effective Jan. 1, an official said Monday in Vienna.
About 30 area residents heard from a representative of the West Virginians for Affordable Health Care group Monday night at the Vienna Public Library.
Lisa Diehl, North Central regional coordinator for WVAHC, spoke to the Wood County League of Women Voters and other members of the public.
Diehl discussed provisions in effect, including young adults under 26 still being on their parents’ health insurance policy to training the community on the health care reform act.
“There’s going to be a lot of help out there for people who are going to need it,” she said. “We’ve been working very hard and we think we’ll have trained about 700 to 800 community assistors around the state by the time all of our trainings are over with.”
Diehl was a carpenter who completed her apprenticeship in 1983; she is the co-founder of West Virginia Women Work, a small nonprofit that trains and places women in the skilled trades. She helped start the Good News Mountaineer Garage, a program based in Charleston where cars are donated to qualified applicants.
“There are four goals on the affordable care act,” Diehl said. “There is a big emphasis on prevention.”
The original law demanded every state expand Medicaid; however, the law now leaves it up to individual governors of states, Diehl said. West Virginia elected to expand the state’s Medicaid coverage.
The state expects 91,500 more people to seek coverage once the changes take effect in 2014.
About 350,000 state residents received Medicaid benefits last year.
West Virginians can enroll in the new program starting Oct. 1 and start to receive the new benefits Jan. 1, 2014.
“Most recently Medicaid covers and will continue to cover disabled, nursing home care and low-income residents,” Diehl said. “It’s also designed to get parents some relief when they couldn’t find coverage for their kids.”
Anyone under the age of 26 can remain on their parents’ insurance plan, she said.
Diehl said the act takes more control over preventive measures in the health care system. The plan includes 62 types of preventive services without co-pays or deductibles, including mammograms for women, she said.
Another change in the health care reform is called the 80/20 rule. The Affordable Care Act holds health insurance companies accountable to consumers and ensures American families receive value for their premium dollars.
Because of health care reform, insurance companies must disclose how much they spend on health care and how much they spend on administrative costs such as salaries and marketing.
If an insurance company spends less than 80 percent of a customer’s premium on medical care and efforts to improve the quality of care, it must rebate the portion of the premium that was exceeded.
Diehl said residents of West Virginia received about $4.4 million back after insurance companies failed to follow the 80/20 rule last year.