Even after ACA deadline, health insurance remains available for some, Berkshire advocates say


PITTSFIELD -- Public health officials are worried that the highly publicized deadline to apply for Affordable Care Act coverage has people thinking they can no longer sign up for health insurance.

But even after the April 15 deadline, health insurance options exist for low-income residents and people facing special circumstances.

"There are noticeably fewer people calling us," said Charles "Chip" Joffe-Halpern, executive director of Ecu-Health Care, which links people with health insurance options. "Anecdotally, many people think they can’t apply until the next enrollment period. But that’s not true."

Area health care navigators Ecu-Health in North Adams, Community Health Programs and Advocacy for Access in Great Barrington and Pittsfield, and Hilltown Community Health Centers Inc. in Worthington say inquiries are down this month.

"There are those ... that didn’t sign up [for ACA] because they think they missed the deadline, but there are also those who are so confused and they are frozen in place. And those are our biggest concerns," Bryan Ayars, executive director for Community Health Programs.

Low-income residents earning 300 percent below the poverty level remain eligible for insurance coverage. Individuals earning $34,476 and a family of four earning $70,656 are also eligible. People facing special circumstances -- marriage, birth, adoption, the loss of a job or reduction in the number of working hours -- are also eligible through a 60-day window.

People who have mistakenly enrolled through the Massachusetts Health Connector due to an error or inaction are also eligible.

Despite problems with the insurance enrollment website, Massachusetts enrolled 320,000 people -- surpassing a federal target enrollment of 250,000 people, according to Jason Lefferts, the communication director for the Health Connector.

While the state is still gathering information on whether overall enrollment has increased, there are 175,000 first-time applicants for a subsidy. These applicants have been placed on a temporary health plan through June 30 until it can be determined if they are eligible for coverage.

"We went into the open enrollment period for the Affordable Care Act hoping to provide new opportunities to get people insurance and that was clearly heard because they are clearly trying to access that help," Lefferts said.

The percentage of the state without health care prior to the enrollment period was 3 percent, or about 200,000 people.

In the lead-up to the enrollment deadline, Ayars said CHP was receiving 80 calls a week. CHP staff were submitting paperwork by fax because the website was unreliable.

"The hope is we did not create more uninsured in the chaos of enrollment," Ayars said.

Although most have insurance, residents could still be challenged in accessing health care because of a countywide physician shortage, Ayars said.

In North County, for example, there are only three primary care practices: Adams Internists, Williamstown Medical Associates, and Northern Berkshire Family Medicine.

Williamstown Medical Associates is no longer accepting patients. Northern Berkshire Family Medicine had five physicians, but they are down to one full-time and one part-time physician, according to Ayars.

The county is also older than others, which increases demand for health services.

"We get calls everyday from people looking for a provider," Ayars said.

To reach John Sakata:
or (413) 496-6240.
On Twitter: @jsakata


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