Health: Local responses to Obamacare changes

02/23/2014 5:00 AM |

PBMC2

Just as local health care officials speculated, the rollout of the federal health insurance marketplace has made for a lot of moving targets — with the rules changing for both providers, patients and business owners. 

Here is a roundup of what’s been reported so far, including one change business owners may be happy about.

• All three East End hospitals — Eastern Long Island Hospital, Peconic Bay Medical Center and Southampton Hospital — will accept six out of the eight insurance plans offered to residents in Suffolk County through the state’s health care exchange marketplace, according to hospital officials.

The hospitals, which together form the East End Health Alliance, will accept EmblemHealth, Empire Blue Cross, Oscar, United Healthcare and Affinity, as well as Health Republic, a nonprofit alternative health plan, Paul Connor, chair of the alliance confirmed, last week.

Alliance officials are also negotiating with Fidelis Care and North Shore-LIJ CareConnect, two other options offered on the exchange, Mr. Connor said.

Stony Brook University Medical Center, the closest university hospital to area residents, is currently not accepting any of the coverage plans offered through the exchange, according to Newsday, which reported that hospital is currently in negotiations with six of the eight options.

Stony Brook officials did not comment in the Newsday report on which six options they were considering.

• Last Monday, federal officials announced that owners of medium-sized businesses — those with 50 to 99 workers — will now have until 2016 to offer their full-time employees insurance, almost two years longer than originally mandated under the Affordable Care Act.

• According to the New York State of Health website, just over 410,000 state residents have enrolled in the marketplace, while about another 290,000 have completed applications but not yet purchased an actual plan.

Enrollment jumped 53 percent nationwide in January, with enrollment among those between ages 18 and 34 increasing by 65 percent in that time period, according to the U.S. Department of Health and Human Services.

The number of Suffolk County residents utilizing the exchange is still unclear.

“Active coverage began around Jan. 1, so it’s probably too early to tell what kind of penetration these exchange products will make on Long Island,” Mr. Connor said, adding that information might become available shortly after the first quarter’s end.

So far, PBMC officials said EmblemHealth and Health Republic seem to be popular choices among by patients taking part in the exchange.

The local hospitals have not yet encountered issues with patients who have purchased exchange options they do not accept, although Zita Harris, director of patient access for PBMC Health, said some patients have had problems with receiving insurance cards from Health Republic.

“As long as they have an ID number, we can confirm coverage,” Ms. Harris said.

Hospital officials said that before purchasing a plan on the exchange, it’s important to check with one’s primary care provider to make sure it accepts the insurance as well — as the provider is usually a patient’s gateway to the hospital.

Ms. Harris said PBMC patients with insurance exchange questions can call 631-548-6931 Monday through Friday. Contact ELIH at 477-1000.

Got a health question or column idea? Email Carrie Miller at cmiller@timesreview.com. Follow her on twitter @carriemiller01.

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