Groups help with ACA applications

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The new Affordable Care Act and Medicaid expansion will kick in on Jan. 1, and most people will be required to have health insurance.

Low-income citizens without health insurance will receive low-cost to no-cost medical coverage, and a one-stop shopping insurance exchange is being created to help the uninsured find the most cost-effective coverage.

The state received $43 million in federal money to set up the New Mexico Exchange and provide community outreach to help the uninsured get coverage by the March 30, 2014, deadline. Exchange enrollment begins Oct. 1.

If you get health insurance through your job, your coverage will remain the same.

According to the New Mexico Center on Law and Poverty, there are 425,000 uninsured New Mexicans; 9,500 of them live in Valencia County.

Most uninsured residents will qualify for the new expanded Medicaid.

Undocumented immigrants, who are not eligible, can qualify for emergency medical services such as childbirth. Children of immigrants who have applied for citizenship might qualify for coverage during the five-year citizenship process, but adults will have to wait.

Valencia County has more than 3,000 uninsured children. Those from low-income homes of citizens and documented immigrants most likely already qualify for Medicaid, said Linda Montaño, a patient eligibility specialist with First Choice Community Healthcare.

Many low-income seniors, pregnant women and some citizens with disabilities are also eligible for Medicaid and, when Medicaid is expanded, more services will be available.

They can apply at First Choice Community Healthcare in Los Lunas with Montaño, and Patricia Gregor in Belen, or they can visit Edwina Moya, program manager at Youth Development Inc. in Los Lunas for assistance.

"We're going to make it super simple, and we'll be out in the community going to events to help people apply," said Michelle Melendez, First Choice training and community outreach director.

An information booth will be set up at the Americana Music Festival in Belen on Aug. 17.

Several informational town hall meetings are also planned for the upcoming months, said Montaño.

Low-income households with an annual salary ranging from $16,000 for one individual to $32,500 for a family of four will be eligible to receive health-care coverage at low to no cost, and most families will be eligible for financial assistance to help pay for their coverage.

The federal government is giving most people who buy coverage through the exchange financial assistance to make health insurance more affordable.

Tax credits can help pay for premiums, caps on co-pays and sliding fee scales can also help to keep costs down.

Those with higher incomes who don't qualify for financial assistance will be eligible to shop for coverage from private providers on the exchange, where competition is expected to keep the prices reasonable, said Melendez.

A household of four earning less than $2,709 a month will receive free coverage. If monthly income ranges from $2,709 to 7,850, coverage on the exchange is available.

There are different income rules for senior citizens, children, pregnant women, people with disabilities and Native Americans.

Those who don't get insured could face a penalty. For example, an uninsured individual could be fined $95, or 1 percent of his or her 2014 income. The next year, the penalty jumps to $325, or 2 percent of income. In 2016, it jumps to $695 or 2.5 percent.

Some people are exempt from the penalty, including Native Americans, undocumented immigrants, people in prison or with religious reasons not to buy insurance, people with incomes below the tax threshold and people who can demonstrate any other hardship.

Small businesses with fewer than 25 employees with salaries under $50,000 can get tax credits to help buy insurance for their employees.

Residents covered by State Coverage Insurance (SCI) will notice the transition as their coverage is rolled into health care reform.

For assistance and more information, call Linda Montaño in Los Lunas at 865-4618, Patricia Gregor in Belen at 861-1013, YDI's Edwina Moya at 352-3473 and Spanish-speaking outreach specialist, Cecilia Vazquez at 352-3475. You can also visit the First Choice Community Healthcare website at www.fcch.com, or www.ydinm.org/index.php/valencia.


-- Email the author at dfox@news-bulletin.com.