Marylanders who have been uninsured for at least six months and are ineligible for Medicare or Medicaid may qualify for health benefits under the federal Patient Protection and Affordable Care Act (PPACA), health care officials said.

Though all of the measures inside the PPACA won’t go into full effect until 2014, some of the benefits for people with certain medical conditions have been available since President Obama signed the bill into law in March of 2010.

With preventative care available to working Marylanders now, University of Baltimore School of Law Professor Jose F. Anderson says state and national medical costs are sure to fall as dependence on emergency room services lessen.

“Hospital emergency rooms are expensive and we need to adapt to providing the type of healthcare, both preventative and emergency, that are more suitable for those persons who know they don’t have coverage and don’t visit a doctor regularly,” said Anderson in a previous interview with the AFRO.

“Many proponents of this law say it’s the first step in trying to getting healthcare costs under control for those who use emergency rooms as the sole source of health care across the country.”

In 2010, the PPACA extended health care benefits to young adults by allowing them to stay remain covered by their parent’s health care coverage until age 26.

That same year tax credits to offset healthcare costs were also made available to 4 million small businesses, and individuals with pre-existing conditions and no insurance for at least six months were also given an opportunity for coverage.

Since the act was signed, there has also been $5 billion in federal funds set aside to give aid to those who retire early between the ages of 55 and 65, their spouses, and dependents.

The PPACA has also established a $15 billion fund to help smoking cessation classes and other preventative care programs that help bring down disease treatment costs nationwide.

Like many Marylanders, Mary Hunt had heard of the change in health care law, but was unaware that programs were available to immediately begin helping those in need of health insurance.

Hunt hadn’t had insurance in well over decade when a crucial eye surgery in December 2011 nearly ruined her financially.

“I’m a working person,” said Hunt, a resident of Baltimore County in her 40s. “I’ve been working two jobs–sometimes three jobs–but the jobs that I worked didn’t offer insurance.”

“I didn’t qualify for any assistance,” said Hunt, whose daughter then suggested a program offered by the state. “I enrolled in the Maryland Health Insurance Plan in February and since then I’ve been able to go to the hospital when ever needed.”

In order to enroll in a Maryland Health Insurance Plan (MHIP), individuals must be legal Maryland residents without insurance for at least six months. They also must either be unable to afford insurance offered an employer because of a medical condition, have a qualifying condition, or have been denied coverage because of an existing condition.

Medical care for all pregnant women is offered under the MHIP as one of the more than 50 qualifying conditions including certain cancers, congestive heart failure, diabetes, HIV, and stroke.

Hunt said that her experiences under the new law exceeded expectations, citing instances where her doctors at Johns Hopkins University cut short vacations to assist her in treatment and recovery.

“I’m not asking for a handout, but I feel that if you’re a hardworking person and trying to invest in other people to make them good citizens, it seems like you should be able to get affordable insurance,” said Hunt, who works as a music consultant and voice instructor at Empowerment Academy.

Hunt said she has a $1,500 cap on co-pay fees annually. The fees vary by age and income, depending on which of the three plans an individual chooses.

“I had been without insurance for about seven years,” said John Mosby, 31, also an MHIP member.

“I’m able to go to the doctor much more frequently. It’s $161 a month and I’d say it’s pretty affordable,” said Mosby.

An employee at Maryland Port Administration for the past eight years, Mosby was unable to afford the health insurance offered by his job. The lowest premium was still $400 dollars a month.

As a result of becoming a part of the MHIP, Mosby was able to have a hormonal imbalance diagnosed for which he now receives care at the hospital of his choice, Greater Baltimore Medical Center (GBMC).

More than a dozen states filed a joint lawsuit in March 2010 to stop the PPACA from taking effect, including Florida, Louisiana, South Carolina, Texas, Utah, and Virginia.

In a Jun. 28 ruling, the Supreme Court upheld the provisions of PPACA, including the controversial insurance mandate.

By 2014 all individuals and businesses with more than 50 employees are required by federal law to have health insurance plans or face stiff penalties that will gradually increase over time.

The fines will increase yearly for individuals until 2016, when the amount owed for not having insurance will become nearly $700 annually, or 2.5 percent of the person’s income.

 

Alexis Taylor

AFRO Staff Writer