Thousands to be caught in the CoverTN health care squeeze

Thousands to be caught in the CoverTN health care squeeze

November 24th, 2013 by Kate Harrison Belz in Local Regional News

AT A GLANCE

Changes to Cover Tennessee plans:

CoverTN -- A limited-benefit insurance plan where the premium cost is split among the employee, the employer and the state. The plan's annual benefit limit of $25,000 means CoverTN will not meet Affordable Care Act-related requirements that go into effect Jan. 1 and coverage will end Dec. 31 unless federal and state officials determine otherwise.

AccessTN -- The state's high-risk pool offers coverage to 2,600 people who are uninsurable because of pre-existing conditions. Members pay monthly premiums for this comprehensive coverage. The program was slated to end Dec. 31, but TennCare announced Thursday that because of the problems with HealthCare.gov it would extend coverage until April 30.

CoverRX -- A pharmacy assistance program for people who need medication and have incomes below 250 percent of the poverty level. This program ends Dec. 31.

CoverKids -- The Tennessee Children's Health Insurance Program (CHIP) is funded by the state and federal governments. A small number of families whose incomes are above 250 percent of the federal poverty level have been notified their coverage will end Dec. 31.

Source: TennCare

UPCOMING ENROLLMENT EVENTS

Local navigators have scheduled events to help educate people about open enrollment in the new health insurance marketplace throughout December.

Northgate Library: 278 Northgate Mall, Dec. 3, 11-3 p.m.

Collegedale Library: 9318 Apison Pike, Dec. 3, 5- 7 p.m.

Collegedale Library: 9318 Apison Pike, Dec. 4, 11-3 p.m.

Eastgate Library: 5705 Marlin Road, Dec. 5, 11-3 p.m.

Mount Canaan Baptist Church: 2800 N. Chamberlain Ave., Dec. 7, 10-2 p.m.

Thousands of Tennesseans were able to breathe sighs of relief last week when the state announced that their canceled health insurance policies would stay in force for another year.

But there hasn't been that kind of respite for Nancy Colvin.

Colvin, who works at a privately owned assisted living facility, is among 15,400 Tennesseans who get health insurance through the state's "stopgap" program CoverTN, which is still scheduled to hit the chopping block Dec. 31.

"It's very scary knowing it will end," said Colvin, who has medical problems and says replacement plans she has researched are too expensive. "I'm extremely anxious about this change and finding new coverage."

Adding to the pressure, another key deadline looms just four weeks from now for people who want subsidized plans from the new health insurance marketplace HealthCare.gov. They must be signed up with a new plan if they want their coverage to start Jan. 1.

"For those people there is a particular kind of urgency," said Rae Young Bond, director of the Medical Foundation of Chattanooga, which oversees one of the region's navigator offices helping people enroll.

People on CoverTN make up approximately 10 to 15 percent of the client base seeking assistance with another navigator group with Erlanger Health System, said Katherlyn Geter, director of that program.

The reforms under the Affordable Care Act were meant to rid the market of bare-bones plans like CoverTN's, which include an annual cap on expenses, and move people into more robust plans with the option for federal subsidies through HealthCare.gov.

But for many, that hasn't been an option because of the chronic problems with the site. For Colvin, shopping on the site has been "excruciating."

Few people seem to be faring much better.

Two months into the insurance marketplace launch, Erlanger Health System's navigator program has not been able to enroll a single person through HealthCare.gov, Geter said. The Chattanooga Medical Foundation's program finally enrolled its first last week.

"I was in Nashville in a meeting and I just got this text that said, 'We made it through!'" said Bond. "It was a big deal."

In Tennessee, just 992 people were able to select a plan through the federal website in October.

Federal officials have pledged to fix the faulty website by the end of this week.

Local navigators say that while they see improvements, they are nervous about the level of problems they still encounter on the site as the first round of deadlines looms.

"The major concern is if the system isn't fully operational by the end of November, what's next?" Geter said. "It is just not a lot of time."

On Friday the federal government announced that the deadline to sign up for coverage starting Jan. 1. would be pushed back a week, from Dec. 15 to Dec. 21.

That came after the Obama administration announced it would allow people to keep plans that don't meet Affordable Care Act standards for an additional year. Tennessee officials agreed to go along with the extension, but TennCare's director said last week it would not apply to a state-run program like CoverTN.

But on Friday, TennCare spokeswoman Kelly Gunderson said the chance for a CoverTN extension is still alive.

"We're still awaiting the official policy from [the U.S. Department of Health and Human Services] to see what the options are," she said. "It may be that we can continue coverage and it may be we can't, because we don't know what's in the policy. So that's why it's still up in the air."

East Ridge residents Michele and Doug Roberts, who are on CoverTN, say they are hoping for an extension.

The limbo has affected their family planning, since an extension of the maternity portion of the insurance will be allowed for those who can prove a pregnancy before Dec. 31.

"We actually contemplated having a baby a year earlier than we had planned," said Roberts, who has been on CoverTN for five years.

But after the president's announcement, they are rethinking the decision.

Gunderson said the office did not know when it would receive a copy of the extension policy from the HHS, and said the office would have to organize an extremely tight turnaround to arrange a postponement if it were approved.

"We'd have to draw up a contract with BlueCross," she said. "They've already moved some of their people working on this program, so I don't know where this would put us."

Contact staff writer Kate Harrison at kharrison@timesfreepress.com or 423-757-6673.