Six months ago, Ashley Slocki was on her husband’s employer-provided health insurance, and it came with dental, vision and low prescription co-pays.
Slocki, now 27 and divorced, opened her mail one day in July to learn her so-called Cadillac plan was going away. Panicked, she turned to a private insurer, a costly expense she could only afford with her parents’ help. Now, a list of prescription pills that ran $60 under her old plan cost more than three times as much. Slocki is sometimes forced to buy a week’s supply at a time, carving out money for medication, food and rent with not much left over.
Suffering from a heart condition, migraines and depression, all requiring pricey pills, Slocki hopes to turn to Cover Oregon, the state’s new health exchange. It’s the centerpiece of the expanded health care coverage under President Barack Obama‘s Affordable Care Act. Enrollment launches Tuesday.
Anyone can purchase insurance through Cover Oregon, which will serve as a marketplace for health insurance coverage, where people can compare coverage and prices. Some people will qualify for financial assistance — a calculation based on family income and household size.
“Hopefully, I’ll qualify,” Slocki said at FolkTime, the mental health recovery clinic where she works.
Single people earning up to $45,960 per year will qualify, as will a family of four earning up to $94,200.
Slocki learned of the exchange through a coordinator at the National Alliance on Mental Illness Oregon, one of several recipients of Cover Oregon grants aimed at populations that are traditionally difficult to enroll in health insurance programs. NAMI Oregon executive director Chris Bouneff said the group will try to enroll as many people as possible between October and the end of March, when commercial enrollment closes.
“One of the things we know is that it can take extra effort to get them enrolled in health care,” said Oregon Health Authority spokeswoman Patty Wentz.
The health exchange is intended to make it easier for people to buy affordable health insurance by creating a market where insurance companies compete for business. Mental health patients are among the populations who will be looking at the Oregon health exchange starting Tuesday to determine whether they should shop there for health insurance.
Thirty programs across the state received a total of $3.16 million to work with various communities, from the Oregon Latino Health Coalition to Native American Rehabilitation Association of the Northwest. Outreach efforts began about 18 months ago.
A similar program was aimed at small businesses.
When enrollment begins Tuesday, people will only be able to sign up through community groups like Bouneff’s or through licensed insurance agents. Eventually, people will be able to do it on their own at the Cover Oregon website, www.CoverOregon.com, or call center, which can be reached at 1-855-CoverOR (1-855-268-3767).
Dealing with a client population of the mentally ill, at least half of whom are uninsured, is an imposing task, Bouneff said. The group receives thousands of calls for help each year, and each one can draw them into a different spectrum of treatment. Some people need mental health treatment, some need emergency care, some need prescriptions or a caseworker, and some need all of them.
The Cover Oregon program can help by drawing off some of that caseload, Bouneff said, and giving Oregon’s mentally ill and homeless populations another place to turn for primary care and mental health treatment. The grants afforded his organization the chance to do direct outreach to the mentally ill and homeless, and also partner with organizations like FolkTime.
“We’ve done all the legwork,” Bouneff said. “We’ll see what happens Tuesday.”