LEWISTON — Potential enrollees gathered for an informational presentation about the  Affordable Care Act at the Lewiston Public Library on Tuesday evening.

State Sen. Margaret Craven delivered opening statements to a group of about six, explaining her role on the ACA Oversight Committee. She told the group that she was excited for the self-employed to now have this resource.

Jake Grindle, Health Marketplace navigator and program specialist for Western Maine Community Action, took to the lectern to offer a presentation on what he stressed was now “the law of the land.”

Grindle said the ACA, also known as Obamacare, is taking a two-pronged approach to health care: It expands social programs such as Medicaid and it expands private programs, allowing sliding-scale access to individuals and small businesses based on income.

Grindle said it enacts insurance reforms at the federal level with the Patients Bill of Rights and by holding insurance companies accountable.

Starting in 2014, Grindle said the ACA will demand a “minimum credible coverage requirement” of all people. He said in 2015, there likely will be a place for proof of insurance on tax forms.

Medicaid will expand its eligibility in 2014 to 133 percent of the federal poverty threshold.

Grindle described the health-care marketplace as a way to compare and review choices in a consumer-friendly manner and said most of those eligible will receive cost breaks.

According to Grindle, the sliding scale will provide insurance subsidies for 100 percent to 400 percent of the federal poverty level.

Although enrollment kicked off Oct. 1, Grindle said there is no rush. People can enroll as late as March 31 for coverage that begins Jan. 1, 2014.

Within the marketplace, Grindle said people can choose providers based on bronze, silver and gold ratings, depending on coverage and deductibles.

According to the rating system, bronze would provide the most basic care while gold would be a more top-of-the-line option. A platinum option also exists, but Grindle said none is offered in Maine.

Grindle showed a small video of a hypothetical enrollment process. The group watched as William Doe, a fictional single man from Arizona, applied using his computer. William answered some simple questions with his tax information. He was asked about his income and whether he smoked before being shown his options.

The video didn’t take the alternative route by which Doe refused to participate in the ACA. In the alternative line, William would have incurred a fine of $95 or 1 percent of his annual income, whichever was greater.

The fine would increase each year for noncompliance but would not result in jail time.

If Doe were offered insurance by his employer, according to Grindle, he would not be exempt from participating in the ACA.

Employers must offer “affordable” health insurance that does not exceed 9.5 percent of the employee’s income. If the cost of insurance exceeds 9.5 percent, they may participate in ACA.

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In Maine, enrollment in the Affordable Care Act is being handled through the website healthcare.gov. Prospective enrollees can apply via the site or call 1-800-318-2596 to speak to a representative.


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