PARIS — An Affordable Care Act information session in the Paris Fire Station Tuesday evening offered a run-through of the new law, but left some still scratching their heads. 

“The biggest take-away for me is that this may confuse issues rather than make them more straightforward,” Bill Bryant said after the session. “Obviously there are more questions by everyone, the experts and the consumers, than there are answers at this point, it would appear.”

About 25 people attended the public session offered by the Maine Bureau of Insurance. During his hourlong presentation, Bureau Superintendent Eric Cioppa urged people at least four times to seek additional help from insurance companies or trained ACA “navigators” for help with what the law offers and requires.

“Whoever you go to, you need to consult with someone, because this stuff is complicated,” Cioppa said. “You really need to get out there and get as much information as you can.”

Key provisions of the ACA come into effect in 2014, principally the federal and state health care “exchanges” where the uninsured can buy government-subsidized health plans, Cioppa told the group. 

Consumers can browse and purchase plans from Internet sites that went online earlier this month. 

Two insurance carriers, Anthem and Maine Community Health Options, are competing in the federally-run Marketplace for individuals, Cioppa said.

Cioppa discussed the different levels offered on the exchanges. Under the ACA, no plan on the exchange can have more than $6,350 in out-of-pocket expenses, he noted. 

Subsidies were calculated as part of enrollment on the exchange, and started at 400 percent of the federal poverty level, or $45,960, Cioppa said.

Michael Newsom of W.J. Wheeler Insurance in South Paris said people could also apply for exchange plans by telephone or through the mail if they didn’t want to go through the “frustration” of the Internet site.

Cioppa outlined the open enrollment period, Oct. 1, 2013, through March 31, 2014, and the “individual mandate” that penalizes uninsured, with exceptions for poverty and other factors, if they do not purchase insurance. 

The state was waiting to see how many young people would buy insurance and how many would simply pay fines, Cioppa said. Without buy-in from “young invincibles” Maine’s system could face serious issues, he noted. 

Other topics included the minutia of the employer mandate to provide insurance to employees, “narrow” vs. “broad” health care networks offered, and some of the complications presented by using a plan purchased in Maine for nonemergency care out-of-state.

Following the presentation, Cioppa said his office scheduled around 25 information sessions around the state. So far, he said, attendance averaged about 25 to 30 people.

State Rep. Roger Jackson, R-Oxford, said his constituents have expressed confusion with the ACA, and he also found some aspects confusing. 

Despite its complexity, Jackson predicted the ACA was “here to stay.” The law’s success, however, depends on its implementation, he said.

For his part, Bill Bryant wasn’t too comforted by the presentation. At age 64, he’s getting ready to go on Medicare and has plenty of questions about that program. He said he was recently laid off from work and now gets health care through the COBRA system, which sent his premiums from $450 a month to $1,870 a month. 

With a 22-year-old daughter suffering from chronic illness, his family also can’t afford not to have insurance, he said. Even after listening to Cioppa’s presentation and speaking to a bureau representative, he still wasn’t sure what the ACA held in store for him.

“I think I’d need to sit down with somebody I trusted, who had a good background from a tax and an insurance perspective and plug in my variables,” he said.

People may contact the bureau for more information at 1-800-300-5000, or 207-624-8475, or online at www.maine.gov/insurance.

pmcguire@sunjournal.com

Affordable Care Act 101

We break down the ACA, what it does and what it requires you to do.

• Just the FAQs ma’am: Frequently asked questions and helpful answers
• An ACA Timeline: How health care coverage has evolved.
• Where to get assistance and more info: There are more sources of information and help understanding how the Affordable Care Act affects you.

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