San Marcos resident Steve Bibby broke his 16-year streak without health insurance this January because of the Affordable Care Act.
Bibby was one of the 24.1 percent of San Marcos residents who did not have health insurance between 2010 and 2012, according to an American Community Survey on the United States Census Bureau website. Since the ACA was passed in March 2010, San Marcos residents have been signing up for insurance through the government website with the help of “navigators.”
“I tried (having health insurance) for a while, but (companies) kept raising the rates and jerking you around with pre-existing conditions and stuff, so I just said, ‘To heck with it,’” Bibby said.
The Alamo Area Council of Governments (AACOG) has trained “navigators” to help individuals access and navigate the governments health insurance marketplace website, said Mary Skillman, payroll services lead navigator for the AACOG.
“We help them literally navigate the website, go from screen to screen,” Skillman said.
Individuals are eligible to receive tax credit based on their income that can be applied toward the cost of the health insurance premium on the government website, Skillman said.
“So what a tax credit does is reduce the size of the premium that you pay for your health insurance,” Skillman said.
All insurance plans on the marketplace include the 10 essential health benefits that the ACA requires, Skillman said.
The AACOG lists emergency services, outpatient care, pediatric assistance including vision and dental, laboratory service and prescription drugs as some of the required essential benefits.
The “navigators” are not allowed to direct individuals to pick specific plans and are not licensed to sell insurance, Skillman said.
“We’re serving a 10-county area, and so we have navigators in the northern Travis County area—we have a navigator who goes to Bastrop,” Skillman said. “So we just have different people that kind of focus on different parts of the area.”
Skillman said AACOG navigators are mobile and provide assistance that works with the individuals’ schedules whether clients wish to meet in the evening or during the weekend. She said she uses public libraries as a meeting place when helping individuals to navigate the website.
“I’ve tried to have tables at farmer’s markets or just information sharing,” Skillman said. “Libraries have been good because they are comfortable places people are familiar with, and they seem to have a commitment to getting information out to people, so it works out well.”
Skillman said she has given information presentations about the health insurance marketplace at public libraries in Kyle, Wimberley, Austin, Blanco and San Marcos.
In San Marcos, 16 percent of all family income and 36.2 percent of individuals 18 years or older fell below the poverty level, according to the survey.
Before the act was passed, some insurance providers allowed patients to carry their children insurance until age 25, some made them stop at age 18 and some made them drop dependants if they were not students, said Aimee Mick, payroll services lead navigator for the Alamo Area Council of Governments.
Since the ACA was passed, it has allowed some students to receive health plans at universities as part of enrollment, Skillman said