Tonawanda News

November 13, 2013

Forum Tuesday provided 'Obamacare' details

By Michele DeLuca michele.deluca@tonawanda-news.com
The Tonawanda News

Tonawanda News — An expert on “Obamacare” tried to simplify what some consider confusing new laws Tuesday at a forum on the Affordable Care Act held by the Niagara Falls NY Chamber of Commerce.

The lightly attended lunchtime event at the Conference and Event Center Niagara Falls, provided some explanation of the health care changes and the way they will impact the lives of New Yorkers. 

“I’m going to make this real simple,” said Jonelle Marchese of Bene-Care of Amherst, who gave the presentation.

She said small business owners in New York State can chose one of two ways to purchase their health care.  They can buy it on the New York State exchange or purchase their insurance directly from a provider as they have always done.

There is one caveat. The only way to get a tax credit is to buy insurance from the exchange, she said.  “If you don’t go through the exchange, nothing changes,” she added.  (The state’s online exhange page is www.nystateofhealth.ny.gov.) Small businesses may qualify for a tax credit if they have 25 employees or less with an average annual wage below $50,000 and cover more than 50 percent of each policy.

“It’s really funny. With all the hub-bub you hear in the media,” she said, “that’s really all there is to it ... nothing has changed for the small business owner.”

Marchese’s company, Bene-Care, is the health care benefits advisor for the Niagara Falls NY Chamber. “Our job is working with the chamber to make sense of all of it for you,” she said. “That’s a service we provide at no fee.”

There were several points she made about the new Affordable Care Act, known as “Obamacare.”  They include these:

—There is a calculator on the New York State Exchange site to help people determine if they are eligible for a tax credit.

—Some people’s insurances were cancelled because they didn’t provide the “10 essential benefits” such as hospitalization, pharmacy coverage and ambulatory service, as required by the federal law, but New York state has been requiring most of those benefits for years. In this state, many providers who cancelled policies steered their clients directly to new policies with all 10 benefits.

— The Affordable Care Act may cut individual insurance costs by more than half, she said.   

—In January, the act mandates dental insurance for all children under age 19. 

Through the course of the question and answer session, Marchese explained that those who think insurance companies are pocketing huge profits should know that every health insurer must pay out 80 percent of all money collected to claimants. If the amount paid out to claimants is less than 80 percent, the difference has to be paid back to policy holders, she said.

While she stressed that not much changes for small business owners, companies that employ more than 50 employees will face some changes in 2015, such as being fined for every employee who doesn’t have health care. The same is true of individuals, who will also be fined up to $695 in the third year of the law if they don’t have health care. A few larger employers are saying publicly they’ll opt to pay the fine rather than provide insurance, she noted, of about $3,000 per employee.

To those big companies, she advised: “Do the math. You’re giving the government potentially half a million dollars for nothing.”

To residents and business owners, she advised three things: Do your homework. Pay attention to your health care costs. Shop around.

One resident in attendance, Diane Tattersoll, a retiree from Niagara Falls, said she believed the Affordable Care Act would increase competition among health care providers. She also noticed that since “Obamacare” has come into the national conversation over the last couple of years, her rising insurance bills have “calmed down.”

She also approved of the mandatory dental insurance for all children under 19. “It’s got a lot of heart in it, this ‘Obamacare,’ “ she said.

Candra Thomason, one of the founders of the two-year-old chamber, said both businesses and residents from throughout the region are welcome to join the organization and advised those who want to know more to visit the chamber’s website at www.nfnycc.com.  

HEALTH CARE INFORMATION For more information about the impact of the Affordable Care Act, nicknamed "Obamacare," visit the Niagara Falls NY Chamber of Commerce website at www.nfnycc.com or call the chamber's office at 285-5345. The Niagara Falls NY Chamber of Commerce is located at 1220 Main St.