Questions surround new health-care laws and Erie’s low-income residents [Erie Times-News, Pa.]

Sept. 29--Lisa Kelleher is finding more questions than answers when it comes to the Affordable Care Act and what it means for the low-income Erie residents she sees at St. Paul'sNeighborhood Free Clinic.

Kelleher, the agency's director, said she also doesn't know what to expect when open enrollment for the Health Insurance Marketplace debuts Tuesday.

"We're doing business as usual," Kelleher said of the clinic, 1608 Walnut St. "Nobody knows yet how this will all unfold."

Health insurance can be a confusing road to navigate, area social-service workers readily admit.

Agencies here say the process is about to become more confounding for the uninsured, people who can't afford health insurance, and the groups who assist the Erie region's poor and low-income residents.

Specific details about policies and federal subsidies in the Health Insurance Marketplace will not be available until Tuesday, officials said.

Open enrollment closes on March 31. Coverage begins on Jan. 1. Plans and cost information will be available at www.healthcare.gov.

The health insurance exchange, as part of the benefits of the federal health-care law, is expected to allow low-income residents and the working poor to shop for policies that will offer them increased access to insurance coverage and medical facilities.

Government tax credits are expected to be available to those who purchase insurance through the marketplace, officials with the U.S. Department of Health and Human Services say.

Gov. Tom Corbett added to the confusion earlier this month, unveiling his plan to overhaul Pennsylvania's existing Medicaid program, an expansion that is not part of the Affordable Care Act.

Corbett wants the federal government to approve his plan and allow the state to use federal money to offer access to private health-care coverage options to those living just above the federal poverty level.

The timeline of the governor's proposals coming to fruition is still unknown.

St. Paul's clinic, a nonprofit that has provided medical and dental care to people without health insurance who don't qualify for government medical assistance, averages more than 700 patient visits a year.

Patients with recent appointments at St. Paul's declined to be interviewed by the Erie Times-News for this story, Kelleher said. She cited patient confidentiality as the primary reason.

Kelleher said she doesn't know the extent of how the health insurance exchanges will benefit Erie's low-income population.

"It doesn't talk about dental care, or the number of office visits allowed in terms of what the insurance will provide," Kelleher added. "There's still a lot of questions to be answered about the whole thing."

To be seen at the clinic, which has been open since 1993, a patient can't have any health insurance coverage and must live in a household whose income is less than double the federal poverty guidelines.

The poverty line is $23,492 for a family of four and $11,720 for an individual.

For an individual to be seen at St. Paul's, his or her household earnings cannot exceed $23,440.

When asked how giving people increased access to medical facilities, as the Health Insurance Marketplace intends, will impact St. Paul's, Kelleher said "the clinic will be here as long as there's a need."

"You're always going to have poor people," she added. "Many of the (Erie residents) we've talked to about this don't know anything about it. People aren't educated enough about the program."

Those local people are far from alone.

Results from a Washington Post-ABC News poll released Sept. 20 showed six in 10 Americans saying they don't have the necessary information to understand the changes the national reform law will bring.

"We've been getting calls from some seniors. They are concerned and questioning if they need to make changes to their health insurance," said Georgia Del Freo, vice president of operations for the Greater Erie Community Action Committee.

Del Freo said GECAC has been providing informational fliers to families involved with their Head Start program, because they would be agency clients most affected by the health insurance exchange.

"We're honestly waiting for more information from Health and Human Services, or anyone who would give it to us, so we can get more of the word out," Del Freo said. "We're hoping the (Affordable Care Act) gives people peace of mind, that they would have health insurance if they had a medical event."

Anne Bale, deputy press secretary for the Pennsylvania Department of Public Welfare, said the topic is "so complex. It's all brand new, and it's gigantic. As for getting the word out, we are primarily relying on the federal government to do that, as the health insurance exchange will be run by them."

Bale said the Health Insurance Marketplace will not mean the end of the Children's Health Insurance Program.

"The C.H.I.P. program will not go away," Bale added. "But we estimate that under the new law, about 50,000 children will be moved from C.H.I.P. into Medicaid."

The Corry Area Free Clinic, 108 W. Smith St., has about 70 patients, all of whom live in poverty, said office manager Tiffani Keener.

Keener said she's not sure how the health insurance exchange, or the governor's plan to overhaul Pennsylvania's existing Medicaid program, will affect the clinic.

"I'm sure we'll probably lose a few patients. Hard to tell if the clinic will still be around," Keener added. "I guess we'll see."

GERRY WEISS can be reached at 870-1884 or by e-mail. Follow him on Twitter at twitter.com/ETNweiss.

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