No fines if you enroll for health insurance by March 31

A few weeks ago, I wrote that the deadline to sign up for health insurance under the Affordable Care Act -- without getting a fine -- was actually Feb. 15, not March 31 as has been advertised.

But the Obama administration this week announced it will delay imposing penalties for six weeks so that people can safely enroll through March 31. 

The healthcare.gov website has malfunctioned since enrollment opened Oct. 1, but the White House said the delay is not linked with those website problems. Rather, officials said it's a clarification of the law's intent.

The law currently requires that by Jan. 1 most people must have health insurance, and allows enrollment through March 31.  It also allows consumers to be without coverage for less than three consecutive months without a fine.

But to have insurance by March 31, consumers would have to choose a policy by Feb. 15 to allow enough time for their enrollment to be processed so coverage would start March 1. Most insurance coverage begins on the first of the month.

With the new administration announcement, consumers can wait until March 31 to enroll and not face fines.

Here's an article from the Kaiser Health News: 

http://www.kaiserhealthnews.org/Stories/2013/October/23/administration-adjusts-deadline-for-health-law-coverage-penalty.aspx

Charlotte physician named Eisenhower Fellow

Dr. David Callaway, director of the Division of Operational and Disaster Medicine at Carolinas Medical Center, is one of eight U.S. citizens who will be studying abroad next year as USA Eisenhower Fellows.

Dr. David Callaway

The announcement came recently from Retired Gen. Colin L. Powell,  chairman of Eisenhower Fellowships.

Callaway is board-certified in emergency medicine and holds a master's degree focused on national security from Harvard's Kennedy School of Government. During his fellowship, Callaway will examine the impact of the Syrian crisis on the healthcare system and the international security policies of Turkey and Jordan. He will also work with local leaders to identify opportunities for health innovation in crisis zones.

He will travel on an intensive four- to five-week individualized professional program. While abroad, he will meet with experts in business, academia, government and nonprofit institutions working in the areas of health technology, health policy, innovation, national security and public 
policy. 

Eisenhower Fellowships is a private, nonprofit, nonpartisan organization seeking to foster 
international understanding and leadership through the exchange of information, ideas, and 
perspectives among leaders throughout the world. 

Established in 1953 as a birthday tribute to President Dwight D. Eisenhower, the organization has sponsored more than 2,000 Fellows from 108 countries. 

For more information,  www.efworld.org.

Enrollment deadline really Feb. 15 for Affordable Care Act

When enrollment in the Affordable Care Act's new online insurance exchanges opened Oct. 1, those in the know assured everyone there was plenty of time.

Although you have to enroll by Dec. 15 to get insurance starting Jan. 1, the law says the uninsured have until March 31 to be covered and avoid paying a fine.

But it turns out that really isn't true.

The Christian Science Monitor broke the news last week that, because of technicalities in the insurance world, the real deadline if Feb. 15.

Although open enrollment runs through the end of March, individuals are  required to be insured all year in 2014, and the IRS will forgive only brief coverage gaps of less than three consecutive months. (Some people will qualify for exemptions to this rule, such as if they have very low incomes.)

So people need to be covered by insurance in March. And to do that, they'll need to enroll by Feb. 15.

According to the Monitor: "Most companies start their policies on the first of the month, and so to be covered on March 31, one has to buy insurance that starts on March 1. To get insurance that starts on March 1, one has to sign up by around Feb. 15."

I called the Kaiser Family Foundation to find out more. Senior fellow Karen Pollitz said it's worth noting that people who enroll later than Feb. 15 might face only a partial penalty because the penalty is assessed for coverage months.  

Take someone whose income would mean they'd draw a $95 fine for not having insurance next year. If they enroll on Feb 16, coverage will take effect April 1. That means that person will have had a three-month coverage gap. Pollitz said the penalty would be 3/12 x $95, or $23.75.

By the way, the federal government's enrollment website, www.healthcare.gov, still isn't working properly. But a new feature popped up last week that allows consumers to window shop for plans without having to create an account. Without an account, you can't see if you're eligible for a subsidy or how much, but you can get an idea of the number of plans and their before-subsidy costs.

Kaiser's state-specific subsidy calculator  can provide estimates..

Consumer Reports also has launched an interactive tool for consumers.

And here's another from WebMD.

Affordable Care Act website still not working for Charlotteans

Charlotte area consumers ready to search for health insurance on the new federal exchange are still not able to do so.

"We've had to cancel any appointments we've had," said Lori Giang, executive director of North Carolina MedAssist, one of three Charlotte agencies that received money to train "navigators" to help consumers.

The federal exchange, also called the marketplace, is at www.healthcare.gov.

Madison Hardee, a lawyer with Legal Services of the Southern Piedmont, said she is keeping appointments but hasn't been able to enroll clients online. She's helping some of them to fill out paper applications or apply through the North Carolina e-PASS website -- nc.epass.gov -- which is used to enroll clients in other medical assistance programs offered by the state, such as food stamps or Medicaid.

The federal exchange website hasn't been working properly since Oct. 1, the first day of enrollment.
But Hardee said she has heard that some consumers have been able to enroll through the toll-free number, 1-800-318-2596.

"We plan to try that with the next appointment," Hardee said.

For enrollment assistance from navigators and certified application counselors:
--North Carolina MedAssist: 704-536-1790, www.medassist.org.
--Legal Services of the Southern Piedmont: 704-376-1600, www.lssp.org.
--C.W. Williams Community Health Center: 704-405-9510, www.cwwilliams.org.

After Oct. 14, you can make appointments for one-on-one enrollment assistance navigators and application counselors by calling 855-733-3711.

Novant Health will have financial assistants available at two workshops for walk-in visitors: 1-5 p.m. Nov. 6 at the BB&T building, 108 Providence Road in Charlotte, and 3-7 p.m. Nov. 14 at the Salisbury Civic Center, 315 S. Martin Luther King Jr. Ave. S., Salisbury.

Blue Cross and Blue Shield of North Carolina will open two Charlotte stores near the end of October. One will be near Northlake mall, at 9325 Center Lake Drive., and the other in Whitehall Commons, near S. Tryon Street and I-485. It will also have a kiosk at Concord Mills.

New 'lean and mean' co-op health plans threaten the 'bigs'

As enrollment in the Affordable Care Act rolls out this week, it's interesting to see how varied the insurance offerings are in different states.

North Carolina has only two insurance options, Blue Cross and Blue Shield of North Carolina and Coventry Health Care of the Carolinas. South Carolina has four: BlueCross BlueShield of South Carolina, BlueChoice, Coventry Health Care of the Carolinas and Consumers' Choice Health Plan. That latter is a newly created nonprofit cooperative, which doesn't exist in our state.

In this article for the Center for Public Integrity, Wendell Potter, a former Cigna executive-turned-whistle blower, suggests this is the "beginning of the end of the health insurance industry as we know it." And he refers to co-op plans like the one in South Carolina.

Here's an excerpt:

"One of the things apparent right off the bat is that some of the best deals will be offered by nonprofit health insurers, including the brand new co-op plans that will be available in about half the states. These plans will be lean and mean. They won’t have the enormous overhead costs of the big for-profit insurance corporations that I used to work for, and they won't have to charge extra for coverage just to satisfy the profit demands of shareholders. They won’t have shareholders.

"If you’re wondering why Aetna, Cigna, Humana and UnitedHealth Group, four of the biggest for-profits, are not planning to participate in many of the marketplaces, it’s because they know they cannot be competitive and still satisfy the profit expectations of their shareholders.

"Before long both Wall Street and Main Street will catch on to the idea that the big for-profits are bloated Goliaths that can and will be taken down by the new Davids of the insurance world. The value proposition held out by the bigs for years — that their armies of underwriters, marketers and 'medical management' specialists are essential — will be blown to smithereens.

"The bigs have to know this, and it explains why we are seeing some of their desperation tactics. Like the letter Aetna is sending to some of its policyholders encouraging them to renew early this year so they can avoid the 'big changes' that are on the way."  

Terrie Hall, anti-smoking advocate, dies

Terrie Hall, a Lexington, N.C., grandmother who appeared in one of the most startling anti-smoking commercials you'll ever see, died Monday, 13 years after being diagnosed with mouth cancer.

Terrie Hall

She was 53, and had appeared in one of eight national "Tips from Former Smokes" TV ads sponsored by the Centers for Disease Control and Prevention as part of a $54 million anti-smoking campaign.

But Hall's ad was by far the most popular. Last year, when I first wrote about her, her video on the CDC website had garnered 749,000 views - more than twice that of the others.

In the Associated Press article about Hall's death, Dr. Tom Frieden, CDC director, called her a "public health hero... She may well have saved more lives than most doctors do."

Last year, she also received the Surgeon General's Medallion, one of the highest honors in public health.

Hall was a lifelong smoker, having started when she was 17.

"I wanted to be like my friends, " she told me last year. "All of them were smoking. That just seemed to be the thing to do. It made me feel grown up."

She was up to two packs a day in 2000, when a sore throat led to diagnosis of mouth cancer. She continued to smoke during radiation therapy.

Her sore throat got worse, and her voice deteriorated. A year later, at age 40, she was diagnosed with throat cancer and had surgery to remove her larynx. She had a permanent stoma, or hole in her throat, and a voice prosthesis that had to  be replaced every few years.

Until she got the "hands-free" device that she demonstrated in the ad, she used to put her thumb over the stoma to close off the air before she could speak. 

In the CDC public service announcement, Hall, a slender, bald woman with a deep, scratchy voice speaks directly at television viewers.

"I'm Terrie and I used to be a smoker.

"I want to give you some tips about getting ready in the morning."

For a moment, the screen shows a photo of lovely, youthful Terrie from 1978, when she was a senior at Forbush High School in East Bend.

Then you watch as the adult Terrie puts in her false teeth, dons a long blond wig and inserts a device into the permanent hole in her neck.

"Now you're ready for your day, " she says.

When I spoke to her on the phone last year, her voice was hard to understand at first. But she said she had no trouble relating to laryngectomy patients in the hospital or to students at high schools and middle schools across the state. 

"Some kids cry. Some kids get scared, " she said. "Some kids feel sorry for me. Some kids say, 'I'm never gonna smoke.' "

People recognized Terrie almost everywhere she went. "You're that lady on TV, " they'd say. 

Some added: "When I saw your commercial, I threw away my cigarettes."

But Terrie didn't want people to feel sorry for her. 

"I thank God every day that I'm here (and) that I can talk and get the message out, " she said last year. 
"I was killing myself smoking ... I just hope I save lives."

Former Charlotte woman refuses to let cancer block career and family goals

It was July 2009, and Morgan Thompson was 26 and living her dream, working for Redbook magazine in New York City, when a surgeon delivered shocking news.

“It’s lymphoma.”

A swollen lymph node, just above her left collarbone, had turned out to be malignant – Hodgkin’s lymphoma.

Thompson

Thompson burst into tears. Then, she turned to her family and friends for support. She was told by doctors that, if she had to get cancer, this was the kind to get because the cure rate is high, 90 percent or better.

But after six months of chemotherapy and a stem cell transplant, her scans still showed the presence of cancer cells. Her disease was more aggressive than most, and four years later, she continues treatment, taking experimental drugs as part of a clinical trial.

Now 30, Thompson will tell her story Friday at a fundraiser for the Belva Wallace Greenage Cancer Foundation. The Charlotte-based group was created in 2010 by Belva Greenage, a two-time cancer survivor, former bank executive and publisher of Today’s Charlotte Woman.

Thompson’s mother, Linda Lockman-Brooks, a Charlotte marketing executive, became friends with Greenage when both worked at Bank of America. Lockman-Brooks admired the way Greenage handled her disease and turned to her for advice and comfort when her daughter was diagnosed.

“One of the first calls I made was to Belva,” Lockman-Brooks said. “She was really my safe place.”

This spring, when Greenage was planning her fifth annual “Coffee & Conversation” program, she invited Thompson to be a speaker. She wanted someone young to talk about “claiming your best life,” Lockman-Brooks said. Coincidentally, Thompson’s new job as associate merchandising director with Seventeen magazine, would be bringing her to Raleigh this week. She accepted the invitation.

Other speakers will be Moira Quinn, also a cancer survivor and senior vice president for communications at Charlotte Center City Partners, and Dr. Russell Greenfield with Greenfield Integrative Healthcare.

“I want my daughter to live the best life she can live,” said Lockman-Brooks, who will be in the audience with her husband Wil Brooks, a State Farm insurance agent.

“These are the cards she’s been dealt, but I’m so pleased that she’s living her best life, and she’s taking care of herself. That’s the best message for me.”

In an interview, Thompson acknowledged there have been times over the years when she felt defeated. But she refused to let cancer define her. A 2004 journalism graduate from UNC-Chapel Hill, she continues to pursue her career goals and also married Ross Thompson on June 4, 2011, while in the midst of chemotherapy.

Cancer “is just a part of my life now,” Thompson said. “I think about it, but my life is so full that I don’t dwell on it.

“This is an awful thing that has happened to me, but I won’t let it keep me from reaching for my dreams.”

For more information:
The Belva Wallace Greenage Cancer Foundation "Coffee & Conversation" event is Friday 7:30 to 10 a.m. at the Charlotte Convention Center. Tickets are $40 at www.belvascancerfoundation.org.
For information about Thompson’s journey, read her blog: http://beatingcancerwhilestayingfabulous.blogspot.com/