Special enrollment & the Affordable Care Act

For a large segment of the US general public, open enrollment for health care coverage through the Affordable Care Act (ACA) in 2014 was October 1, 2013 through March 31, 2014. Most who missed that window will have to wait until the next open enrollment period for coverage in 2015, which is November 15, 2014 through February 15, 2015. However, exceptions for certain life events qualify some people for special enrollment, which is year round. Exceptions include those who qualify for or are renewing Washington Apple Health (formerly known as Medicaid in Washington state), marriage, divorce, birth or adoption of a child, foster care, or death of a dependent. There are many other qualifying factors, but all of the explanatory jargon can be confusing at times.

Thankfully, our Family Assistance Program has been hard at work providing trainings and legal advice on the ACA. The purpose of these trainings is to assist people with education on and enrollment in the newly available medical insurance through the Health Benefit Exchange and Apple Health. For example, one of the major changes from the expansion of the Medicaid program affects those making up to 138% of the Federal Poverty Level. Specifically, if a single household earns under $1,274 per month (or $15,290 per year), then they can access Apple Health and apply for it at any time. Folks who make more than that are potentially eligible to purchase a Qualified Health Plan through the Health Benefit Exchange during the next open enrollment.

Solid Ground holds an ongoing commitment to educate and enroll the uninsured in free or affordable health care. From October 1, 2013 to May 29, 2014, 178,659 residents were enrolled for health care coverage in King County. Amazingly, 40,021 of them were previously eligible for Medicaid but not enrolled, 48,344 are receiving coverage through a Qualified Health Plan, and 90,294 newly eligible people signed up for Apple Health. Our President and CEO, Gordon McHenry Jr., couldn’t be more thrilled. “These impressive results were the work of a great partnership involving King County Public Health, our medical providers and many nonprofits, including Solid Ground,” he said in a letter to Solid Ground staff. “Equitable access to quality, free or affordable health care is essential to a community that is healthy and thriving.”

Reminder: Open enrollment for Apple Health is year-round, and applications can be accessed through Washington Healthplanfinder. If you have questions regarding special enrollment or anything else regarding coverage under the ACA, please contact the Family Assistance Program at 206.694.6742.