A significant number of uninsured North Dakotans have yet to meet a March 31 deadline to get health coverage and avoid federal penalties, based on the gap between expected and actual enrollments through the new health insurance marketplace.
"I think there's a great number of people who are still eligible who have not signed up," said Neil Scharpe of Minot, who heads the Navigators program in North Dakota. The program seeks to educate and assist people in signing up.
About 83,000 people, or 13 percent of North Dakota's population, didn't have health insurance in 2010, according to the U.S. Census Bureau. The North Dakota Department of Human Services projects that the Medicaid Expansion program approved by the 2013 Legislature can extend coverage to another 20,000 people. As of March 1, there were 5,080 North Dakotans who had enrolled in Medicaid Expansion. The program has no enrollment deadline.
As of March 9 in North Dakota, 5,681 people had selected a plan through the federal health insurance marketplace. Signups during the first week of March reflected an uptick in activity, Scharpe said.
"The closer we get to the end of March, the more urgent it is, because the door closes until next November, except for those people who have a qualifying event," he said.
North Dakotans can sign up for a health plan at (www.healthcare.gov).
Jessica Stimpson, manager of health care reform analysis for Blue Cross Blue Shield of North Dakota, Fargo, said issues that plagued the marketplace website when it first came online last October have largely been addressed so that people should not be hesitant to use the site. Blue Cross Blue Shield and Sanford Health Plan both offer plans for North Dakotans in the federally-run marketplace.
People who need help navigating the website can contact the Navigators at 858-3596 or 1-800-233-1737.
North Dakotans who sign up by Saturday will have coverage on April 1. Those who delay to a later March date will get coverage May 1.
People need to sign up by March 31 to avoid a financial penalty assessed for failure to have insurance. The penalty is the greater of 1 percent of taxable income or $95 per adult, $47.50 per child or $285 per family. That annual figure, paid with one's income taxes, will be pro-rated based on the number of months a person or family remains uninsured, Stimpson said.
Premium subsidies are available to applicants below 400 percent of the federal poverty level, which is $94,200 for a family of four. There also are lowered out-of-pocket expenses that applicants may be eligible for in the silver tier of plans. Plans are classified as bronze, silver, gold, platinum or catastrophic, based on their coverage levels.
People who are insured but their plans will expire under the Affordable Care Act have until May 1 to select new plans from the marketplace. The reform act was set to cancel plans that didn't meet certain coverage requirements, but the target date for cancellation was extended through this year. Howver, companies had the option to continue with cancellation, and Blue Cross Blue Shield of North Dakota chose to do so after determining that extension wasn't feasible, given the cost and likely impact on premiums.
Stimpson said Blue Cross Blue Shield has been working with its subscribers to help them enroll in new plans, including providing them with information on comparable, affordable plans on the exchange. People whose plans are expiring and who fail to sign up for a new plan before May 1 will be transferred to those comparable options rather than be left with no insurance, she said.
Stimpson had no figures on how many people had already signed up for new policies.
Information from the Department of Health and Human Services showed on March 1 that about 25 percent of enrollees through the healthcare marketplace, for whom data was available, were aged 18 to 34. Another 28 percent were aged 55 to 64. About 84 percent of enrollees were eligible for subsidies.
The most popular plan type was the silver, in which 44 percent of applicants enrolled, followed by the gold plan with 39 percent of enrollees. Only 16 percent chose bronze plans and 1 percent catastrophic plans.
Among people receiving subsidies, 48 percent chose silver plans, 37 percent chose gold plans and 15 percent chose bronze plans.