With the Idaho Health Exchange coming, who should shop for it?

With the Idaho Health Exchange coming, who should shop for it?

Print
Email
|

by KTVB & Doug Petcash

Bio | Email | Follow: @DougPetcashKTVB

KTVB.COM

Posted on September 25, 2013 at 11:20 PM

Updated Thursday, Sep 26 at 12:49 PM

BOISE -- Who should go shopping on the state health insurance exchange? Well, the answer is basically pretty simple.

It's anyone 18 and older who does not have insurance through an employer or other provider such as Medicare or Medicaid.

A more difficult question for some people to answer is whether to buy insurance at all or pay the penalty.

Dorian Willingham is a certified personal trainer and nutritionist who pushes his clients toward better health, and he loves what he does.

"If I can meet new people, help them learn something and literally change somebody's life then, yeah," said Willingham.

However, the 36-year-old health enthusiast doesn't have health insurance.

He owns his own business, Paramount Fitness, and is an independent contractor, and says fitness is a tough business filled with uncertainty.

"You know, I don't know how much money I'm going to be making next month, this month or this week, let alone in a year from now. So to be able to allocate money or dues toward something I don't use is not something that's feasible for me," said Willingham.

Willingham has investigated the health insurance exchange as much as he can before it actually goes online.

He believes, for him, paying the penalty is the best option, right now.

The first year that's $95 or one percent of his taxable income, whichever is greater.

The second year it comes out to $325 or two percent of his income.

"Obviously, if that gets to a point that it doesn't make sense to take that big of a hit then I'll go ahead and sign up with a provider, said Willingham.

State Representative John Rusche, who sits on the Your Health Idaho board, wants to remind Idahoans that there is financial support, tax credits, for most people based on income and other personal factors.

 "Anyone who is not covered should go through the exchange and see if they're eligible for tax credits," said Rusche. "All it takes is stepping wrong off a curb or having somebody open a door while you're riding, you're riding by on your bicycle for you to have an injury that can really be significantly devastating."

Willingham is one of tens-of-thousands of Idahoans who have to make the health insurance decision.

Basically, anyone who is uninsured now, will have to buy a policy or pay the penalty, and there are very few exceptions and exemptions.

According to the Your Health Idaho Website, the uninsured who will not have to pay a penalty are those who:

  • Are uninsured less than 3 months of the year.
  • Are determined to be low-income and coverage is considered unaffordable.
  • Are not required to file a tax return because their income is too low
  • Or those who are a member of a federally recognized tribe.

There is a lot of information to absorb, but you don't have to make a snap decision. You have time to do your homework, as the enrollment period for the state health insurance exchange just gets started on October 1, and it runs all the way through the end of March.

"It is a time to investigate what makes best sense for you and your family to protect their health and your financial situation from the effects of an illness," said Rusche.

Willingham says he can't live his life worrying about a catastrophic injury or major illness, but knows he's not invincible, and he definitely does not believe in what he calls dine and dash health care, where people go to emergency rooms and don't pay for the treatment.

"Now if something did happen where I was in a car accident, God forbid, or whatever, then I would be, I'd probably have a pretty big bill that I'd be paying off to one of the hospitals," said Willingham.

He says he's staying healthy, taking the necessary precautions and hoping for the best.

We know many of you have a lot of questions, and we hope to answer them in a special program called "Your Health Idaho" which will air at 6:30 p.m. on Saturday, September 28 on Idaho's Newschannel 7.

Print
Email
|