News From Terre Haute, Indiana

February 1, 2014

ACA: Valley slow to add health insurance

More than 25,000 uninsured residents have until March 31 to sign up and avoid penalty

Howard Greninger
The Tribune-Star

TERRE HAUTE — While more than 124,000 people in a five-county area of the Wabash Valley are insured, an additional 25,000 people do not have health insurance, according to U.S. Census estimates released in December.

The uninsured range from 15.5 percent in Vermillion County to a high of 19.4 percent in Parke County, according to the U.S. Census Small Area Health Insurance estimates.

Wabash Valley residents, mirroring that of residents across Indiana, have been cautions when considering buying health insurance through the federal health exchange.

While Parke and Vermillion have the highest percentage of uninsured, the actual estimated number of people uninsured are the lowest among Vigo, Clay, Parke, Sullivan and Vermillion.

Parke County has an estimated 2,491 people uninsured, while Vermillion has 2,079 people uninsured.

Clay County has 16.2 percent uninsured, an estimated 3,688 people, while Sullivan County has 16 percent uninsured, an estimated 2,551 people, according to the Census.

Vigo County, the most populous county in the Wabash Valley, has an estimated 17.5 percent, or 14,984 people, uninsured. Most of those residents will be required to show proof they have obtained insurance by March 31 to avoid a penalty under the federal Affordable Care Act.

Wayne Knight, chief financial officer at St. Vincent Clay Hospital, said that through December, the hospital screened 87 patients; however 43 of those did not qualify “as most would fall in that coverage gap because of Indiana not expanding its Medicaid program,” Knight said.

Of the remaining 44 people, about 20 percent were not interested in buying health insurance through the federal health exchange, Knight said. “Some were still thinking about it. We only had a few complete the whole process so far, but the activity has been picking up in January,” Knight said.

“It is mixed because of the consumer behaviors and everyone is different for their health care,” he said. “What we expect to see as more people sign up is a higher demand for services from primary care physicians and see some increased business in the emergency room from those people who can’t get a primary care physician,” Knight said.

“It is a new product and is a federally run exchange, not a state run exchange, so like with everything else, you have to give it some time to work out and give people time to evaluate it and see what works best for their situation,” Knight said.

Four insurance companies offer individual health insurance plans through Indiana’s exchange. However, the Wabash Valley is only covered by two — Anthem Blue Cross and Blue Shield which is available in all 92, Indiana counties, and MDWise, offered in 45 counties. Physicians Health Plan is offered in 40 counties in northern Indiana, and Ambetter from MHS is offered in 10 counties.

In Vigo County, Anthem and MDWise have already entered into exclusive contracts with hospitals. Union Hospital has partnered with MDWise on the federal exchange, while Terre Haute Regional is an Anthem exchange provider.

Both hospitals would take a patient in an emergency room situation, said John Royer, managed care coordinator at Union Hospital. However, for routine or scheduled medical services, patients must go to the hospital in the network of their marketplace insurance. This only applies to insurance obtained through the federal health exchange, Royer said. Patients at Union Hospital, for example, are covered under Anthem for policies not from the health exchange, he said.

Anthem, the largest insurance provider in the state, is not releasing federal health exchange numbers by county or statewide at this time, said Tony Felts, spokesman for Anthem Blue Cross Blue Shield

“What is important to remember is the enrollment period lasts through March 31, so any numbers we have at this time are preliminary and there are still a couple of months for individuals to sign up for a plan through the health insurance plan,” Felts said.

Felts said that statewide, in general, “there has been a lot of interest. We have taken a lot of phone calls and are mailing out a lot of ID cards for individuals who have chosen an Anthem Blue Cross and Blue Shield plan on the health care marketplace. Our company views this as a transformational moment for the health care industry and a tremendous opportunity for those who have been uninsured to be covered with health benefits. We are optimistic about the long-term membership growth potential,” Felts said.

Nationwide, the U.S. Department of Heath and Human Services reports just 30,400 Hoosiers had bought plans through the exchange as of December.

That slow rate is consistent with what a hospital official in Sullivan County has experienced.

Terri Ralston, business office manager at Sullivan County Hospital, said the hospital so far has seen “a handful” of patients using health insurance obtained through the federal health exchange. “We have seen more Anthem than MDWise” policies, she said.

“Just because of the small percentage that we are seeing at this time, very few people have made contact as far as telling what they like and what they don’t like. The very few comments that I have heard, though, say is it is highly expensive,” Ralston said of the health exchange.

Ralston said hospitals as well outpatient and inpatient facilities are “seeing the effects of the economy as far as a lot more self pay. I think that we will see maybe a smaller percent of people come through our doors with self pay; however, I think we will still see a huge portion in comparison with years past.”

The health exchange “will help the self pay portion, but it will be minimal,” Ralston said, adding that she thinks people may likely take a penalty instead of buying insurance, at least in the first year of the program.

Reporter Howard Greninger can be reached at 812-231-4204 or howard.greninger@tribstar.com.