NAMI Texas and other organizations offer Enrollment Assistance in the Health Insurance Marketplace

*NAMI Texas Policy Intern, Maeve Hallman, wrote this post:

“As we progress through the final month of open enrollment in the Health Insurance Marketplace, over 4 million people have signed up to receive coverage through HealthCare.gov. These high numbers are due, in large part, to dedicated efforts by community volunteers who assist people with their enrollment. Under the Affordable Care Act (ACA), organizations can become designated to certify their employees and volunteers as Application Counselors. To become a Certified Application Counselor (CAC), an individual must complete training sessions and pass 2 exams on the Centers for Medicare and Medicaid Services (CMS) website. Then, CACs provide in-person assistance to individuals and families by helping them understand and complete the Marketplace application and by explaining the different health plan options so that they can make an informed choice about enrollment.

Through the application, an individual learns whether or not he/she and family qualify for a premium tax credit or other cost-sharing reductions that can make the cost of insurance more affordable. Eligibility for and size of this type of financial assistance is based on personal information like household size and income, which CAC organizations like NAMI Texas are required to protect and keep confidential for the people we help to enroll. It’s important to keep in mind that, under the Affordable Care Act, many people are required to have health insurance or pay a financial penalty. Consulting a CAC like NAMI Texas can help you and your family understand what is required of you by law and what types of assistance you may be eligible for.

NAMI Texas became a designated CAC organization because of the improvements that the ACA has made to health care for individuals with mental illness. Before the law went into effect, individuals with mental illness faced a wide gap in insurance coverage. According to 2013 data from the U.S. Department of Health and Human Services, about 20% of individuals with insurance through the individual market had no coverage for mental health services. Additionally, of the 47.5 million uninsured Americans, 25% had a mental health condition or substance abuse disorder or both. Under the ACA, “mental health and substance use disorder services” are included in the 10 Essential Health benefits that all new small group and individual market plans are required to cover beginning in 2014. The ACA also extends the Mental Health Parity and Addiction Equity Act of 2008, which requires mental health and substance use disorder coverage to be comparable to general medical and surgical coverage.

NAMI Texas has 2 CACs on staff, and together we have helped approximately 30 people apply for and enroll in health insurance so far. It is very rewarding to know that we are helping individuals and families, many of whom were previously uninsured, get access to affordable health insurance coverage. Our office is one of 484 application assistance centers throughout Texas. Open Enrollment ends on March 31, 2014. So, these organizations and community volunteers will be working in full-force over the next few weeks to help as many people enroll in health insurance as we can. Our office in South Austin is open from 9 am to 6 pm Monday thru Friday and appointments with our CACs can be booked by dialing 512-693-2000. You can also find local help in your community by visiting the following website: https://localhelp.healthcare.gov/”

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