FREEPORT — The health insurance marketplace provision of the Affordable Care Act went into effect nationally on Tuesday, and a lot of people probably have no clue what that means.
That was the reason for an information session hosted Monday night by state Rep. Sara Gideon, D-Freeport, at the Freeport Community Center.
While Congress squabbled over the act better known as Obamacare, leading to the first government shutdown since 1995, Gideon calmly laid out the potential impacts of the health insurance marketplace.
She was joined by Rep. Anne Graham, D-North Yarmouth; Christie Hager, the regional director for the U.S. Department of Health and Human Services; Janice Daku of Western Maine Community Action, and Chris Hastedt of Maine Equal Justice Partners. Sen. Stan Gerzofsky, D-Brunswick, was also in attendance.
The health insurance marketplace is an exchange designed to help individuals, families and small businesses shop for private health insurance. All plans are required to cover a comprehensive set of benefits, including physician visits, preventive care, hospital stays and prescriptions. Discrimination based on pre-existing conditions is not permitted. The marketplace enables buyers to compare rates between providers.
“It’s apples to apples,” Daku said. “It’s going to be using the same terms. You’ll be able to make an informed decision.”
In Maine, the marketplace is limited to two insurers: Anthem and Maine Community Health Options, a non-profit, co-op insurance plan.
“I feel like Maine is very limited in terms of insurance companies that represent the population,” said Victoria Dunner, a resident of Durham who attended Monday’s info session. “I was just wondering if there would be an opportunity for other insurance companies to come in. Are we still stuck with Anthem? It looks like we’re going to be.
“I still have a lot of unanswered questions, but overall, I’d say it was a start. I guess we have to do a little more exploring on our own with the websites and the places they told us about to get more information. Maybe get a navigator to help us out.”
Navigators are individuals and organizations that have volunteered to help people understand the Affordable Care Act and navigate the health insurance marketplace. Mainers can schedule an appointment with a navigator, and sign up for coverage, by visiting Enroll207.com.
“The navigators are here so you don’t have to be an actuary,” Graham said. “You don’t have to be an insurance agent.”
Scammers have begun calling people and posing as navigators, offering insurance advice for a price, Daku said. Registered navigators do not charge a fee.
The audience of about 60 people looked, by turns, confused, intrigued and bored. Several audience members said they already had full health-care coverage and attended just to learn more about the law.
Nearly every discussion of Obamacare has been overshadowed by the vitriol of its opponents. Most of the attendees at Tuesday’s info session appeared to be neither detractors nor ardent supporters. They were curious, and perhaps cautiously optimistic, about the law’s possibilities.
“I think we often find that people who are in opposition to something can be very, very loud, especially with the health-care law,” Gideon said. “I don’t think everybody in this room is a fan of the Affordable Care Act, per se, but they recognize that this is the law and it’s going to affect them.
“At the end of the day, when you put all these people in a room together, there are probably many different ideas about what the right approach to health care is,” she said. “But one thing everybody probably agrees on is that every man, woman and child should have access to a family doctor, and that no one should be denied access to health care because they can’t afford it. And that’s really why we’re here.”
April Gilmore, a navigator from the Maine Lobstermen’s Association, discusses Obamacare with Charles Dunner of Durham.