MEXICO — The River Valley Healthy Communities Coalition held its monthly networking meeting Wednesday afternoon at the new Med-Care building, where residents heard a presentation on the Affordable Care Act.

Jake Grindle, the health marketplace navigator and program specialist for Western Maine Community Action, fielded questions about the act and how it will affect people in the region. He started with the idea of individual mandate as it pertains to the Affordable Care Act.

“The idea of individual mandate is that almost everyone, starting in 2014, will have to have some kind of health coverage or they’ll have a penalty on their taxes,” Grindle said. “This has been what’s scaring people, but the truth is, there are a number of exemptions to the individual mandate.

“The important one I like to mention to folks is that if the things in the Affordable Care Act don’t result in you receiving a policy that they consider affordable, you’re exempt from having to pay that penalty,” Grindle said. “They have to do their end of the bargain before you have to do yours.”

Grindle added that there are other factors that will grant exemptions, including religious objection to health care, incarceration, not being legally present in the country or membership in a federally recognized Native American tribe.

One of the features of the health insurance marketplace, Grindle said, was the presence of health navigators.

“We’re here to distribute fair, accurate and impartial information to people,” he said. “We help people sign up for these plans and help them understand what their insurance options are. I’m never going to try to steer somebody toward a particular plan. I can answer factual questions about them.

“I won’t even use the word ‘better,’” Grindle said. “I won’t say that one is necessarily better than the other, but I’ll say, ‘Here are your options, and you can decide yourself.’”

Another feature of the Affordable Care Act, Grindle said, is that by 2015, it will be a requirement for businesses with more than 50 employees to offer coverage to their full-time employees.

“If they didn’t comply, they would have to pay a penalty,” he said. “When I look at the business makeup of Maine, I see that many of our businesses are small and won’t have to meet this requirement, and of the businesses with 50 or more employees, 97 percent are already offering coverage. It’ll be a relatively small sliver that will have to decide whether to make changes, but it’ll be a big change, nonetheless.”

Grindle said businesses with fewer than 25 employees can receive tax credits of up to half of what they put in to the premiums to cover employees.

“The idea is to encourage businesses to help their employees,” Grindle said.

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Affordable Care Act 101

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


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