Two Oklahoma experts on the Affordable Care Act, Terry Cline and Andrew Rice, answered questions at a public gathering on Sept. 24 at Kamp’s 1910 restaurant in Oklahoma City.

Former state Sen. Rice is the executive director of the Variety Care Foundation in Oklahoma that serves those with little or no health insurance coverage.

Cline is the Oklahoma commissioner of health.

College students who don’t have health insurance coverage through their parents’ policies will be required to purchase their own health insurance by Jan 1, both speakers agreed. Low-income students may qualify for a federal subsidy called an advanced premium tax credit to help with the cost.

“We are definitely getting a lot of questions,” Rice said when speaking of people visiting the Variety Care clinics. “Some people are a little bit more informed about the complexities of the law than others.”

Cline was asked if the state should be doing more to reach out to Oklahomans about what would be coming on Oct. 1 with the arrival of the healthcare marketplace.

“We are, in part, waiting for additional information.” Cline replied. “We have not received federal funding to disseminate this information or push this information. The federally qualified health centers have received some of that.”

Rice mentioned that the state’s Department of Health website has no information listed about the Affordable Care Act and all links go directly to the federal exchange site.

“(Gov. Mary Fallin) wants to make sure that people have access to accurate information,” Cline said. “The Affordable Care Act is the law. It’s a federal law. It’s in place. Whether you like that or not, this is the law of the land.”

The federal government has allotted grants to local organizations who will soon have trained employees available to provide answers on how to shop for insurance in the marketplace.

Variety Care is one of these organizations and has hired “navigators” to help the public find answers.

Some health insurance providers will be offering plans in Oklahoma.

Among them are Blue Cross Blue Shield, Aetna and Coventry Health. For HMOs, Global Health and Community Care will be accepting Oklahomans, Rice said. They won’t provide dental and vision plans, but will cover prescriptions, mental health counseling, physical therapy, laboratory testing and other medical necessities.

The enrollment period for coverage begins Oct. 1 and ends March 31. Coverage will go into effect Jan. 1. On that date almost everyone will be required to sign up for insurance or pay fines.

Exceptions to paying a penalty for not buying insurance coverage include those who are members of a Native American tribe, members of some religious groups, and those who would have qualified for coverage under the expansion of Medicaid, which Oklahoma chose not to participate in.

Undocumented immigrants will not pay fines, but will be ineligible for coverage. The Affordable Care Act only applies to legal immigrants and citizens.

Oklahomans caught in the worst squeeze are those who would have qualified for Medicaid, had Oklahoma opted to expand its Medicaid coverage to 133 percent of the poverty level, Rice said.

For some without medical insurance, the expansion of coverage can’t come fast enough, Rice said. He gave the example of a man came into the Straka Terrace branch of Variety Care asking questions about receiving insurance through the exchange.

The man began to cry when he found out that people would have to wait until Jan 1, because he had mounting medical bills.

Those who would have qualified under the expansion of Medicaid will receive no federal subsidies to help them pay for coverage. Those who live below the poverty level, but who don’t qualify for Medicaid in its current form may pay more for insurance than someone with a higher income, Rice said.

To find out if this applies to you, use the free calculator provided by the Kaiser Family Foundation to help in determining what individual payments will be and whether your income qualifies for a federal subsidy. The URL is kff.org/interactive/ subsidy-calculator.

There are 27 states, including Oklahoma, that have refused to expand Medicaid for those below the poverty level. Federal dollars would have covered 100 percent of the costs for the first three years and 90 percent per year after that, according to government websites.

According to the Census Bureau, in 2012 some 685,076 Oklahomans were uninsured and about half of those would qualify for subsidized coverage in the insurance marketplace.

The Affordable Care Act was written with the understanding that all states would expand Medicaid to cover those who could not afford to pay for insurance, but this requirement changed after a ruling by the U.S. Supreme Court in June of 2012 when the court deemed that the part of the law requiring that all states expand Medicaid coverage was not constitutional.

“This is the most expensive part of the population, the people who would be covered under Medicaid expansion,” Rice explained. “We are actually costing ourselves way more money by not covering them. It’s a huge, huge, bad mistake as far as an investment.”

The White House estimated that if all states implemented the expansion, 21.3 million Americans would have been covered by 2022. That number dropped to below 15 million after the Supreme Court’s ruling.

Insure Oklahoma is a statewide program that provides low cost insurance coverage to employees and some students if they work for a business where the employer has already been approved or if they are self-employed.

College students between 19 and 22 will continue to be covered on their parent’s Insure Oklahoma plan if they are listed as a dependent on their FAFSA application. Insure Oklahoma will be extended for one more year.

In order to receive insurance through Insure Oklahoma, an employer must first apply and be accepted. According to Cline, about 30,000 people are covered under this program that is strongly supported by the governor.

Anyone who receives insurance from an employer, Sooner Care, Medicare, or any other health insurance provider will see no changes on Jan. 1, Cline said. However, the exchange may offer lower rates than your current insurance.

For more information, visit healthcare.gov where you can chat live, call 1-800-318-2596 or go to insureoklahoma.org. Questions can also be sent through a link on the Oklahoma Watch website at oklahomawatch.org.