NACOGDOCHES, TX (KTRE) - Hundreds of Deep East Texans who otherwise would not have been able to afford health insurance have it today due to coverage through the Affordable Care Act.
Some of those insured could expect some increases, but not all. It all depends on your income.
Since Day One of insurance offered through the Affordable Care Act outreach enrollment specialist Willie Watts has been encouraging the poorest of East Texas Community Health Center's clients to obtain coverage. He's talked to over 700. Only about 150 were enrolled. The penalty for not enrolling didn't seem to be their concern.
"That penalty is lot less than the insurance," Watts said.
Watts said most of the ones turning down ACA coverage are younger, healthier individuals. Older, sicker clients are the typical ACA policy holder.
The result for insurance companies is ...
"They're paying out more in benefits than what they're receiving in pay," Watts said.
Next year, Aetna and United Health Care will no longer provide ACA coverage in Texas. Blue Cross Blue Shield, the primary carrier for Deep East Texas, will continue service but with a 58-percent rate increase. Watts says government subsidies will offset the rate increases for the very poor.
"A lot of that increase will be reduced," Watts said. You might see a small increase."
The story is different for policy holders who pay out of pocket, but even they can shop around for the best available price.
Watts said he is concerned they'll decide to drop coverage, but need it later. He knows. He's seen it happen.
"Several months later he come back to me and wanted to enroll," Watts said. "He had a $60,000 hospital bill."
And nothing could be done.
The enrollment period for ACA coverage isn't until November, but advisors say use that time to your advantage.
Shop around if you pay out of pocket, and if you obtain subsidies, remember to update your plan and don't forget exemptions on tax returns.
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