Local Attorney Is Helping People, Businesses Navigate Through The ACA

Patrick Kelly is the Certified "Obamacare" Navigator for the Roanoke area.
Patrick Kelly is the Certified “Obamacare” Navigator for the Roanoke area.

He’s not taking sides in the political debate over its merits; Patrick Kelly is only there to help. A lawyer with the Virginia Poverty Law Center in Roanoke, Kelly has taken a leave of absence to work as a Certified Navigator, speaking to groups, employers and others about the ins and outs of the Affordable Care Act: how to navigate the website, how to choose and sign up for a health care plan.

“I enjoy working in the community,” said Kelly, who was looking for an opportunity to do more public outreach. “I enjoy talking to people about these types of things.”

Kelly, who moonlights as a professional actor and improv comedian (Big Lick Conspiracy) also said he had a pretty good handle on the ACA – Obamacare if you will – and relished the chance to explain it to others. “We’re not involved in the [political] side, we’re just facilitators, helping people understand the legislation.”

He spends plenty of time assuring people that they can probably find a plan that the doctor they like accepts, and that those with health care plans already in place can keep them. And these plans are private – not a government run, single payer policy. 

It took Kelly about a month to be trained for his role as a Certified Navigator, courtesy of a program funded by the U.S. Department of Health and Human Services. Kelly serves the Roanoke Valley, Franklin County, Rockbridge County and the Alleghany Highlands. Enroll Virginia was awarded a grant for Kelly’s navigator position, along with a network of other navigators.

There are also “obligations and opportunities,” notes Kelly about the ACA, and it is incumbent on those currently without health care insurance to find out what their responsibilities might be. Virginians can go through the Enroll Virginia site to find out about plans “in plain English,” and to enroll when they are ready. There are also tax credits to help pay for premiums and co-pays.

Because Virginia chose not to expand Medicare at this time, all of the new health care options available in the state are from private insurers only and not Medicare-backed.  Kelly said the training was “fairly involved,” and left him with a good handle on how the ACA should work now that it is (almost) funded and going forward. Where he doesn’t know the answers Kelly can tap into other resources and a wide support network.

“Anybody that is not insured presently certainly has an obligation to seek out insurance or obtain an exemption,” notes Kelly, who is also speaking to small businesses about their obligations and opportunities. He’s also educating providers at this point, bringing them up to speed. The open enrollment period extends through next March; those who want a policy to start January 1 must have all the paperwork in place by December 15. There are also special enrollment periods, based on a loss of coverage or other events taking place.

Employers with fewer than 50 employees do not have to provide health insurance plans; businesses in general were given another year from the October 1 start date to comply with regulations regarding the coverage they must offer. “Let’s face it,” said Kelly, “health insurance is a valuable benefit that employees are looking for…in a competitive marketplace.”

Most of those who don’t have insurance will have to sign up for a plan; if your premiums are more than 9.5% of income after tax credits than an exemption can be obtained. There are also special hardships that may give people a chance to opt out. Those who do not participate and are not exempt are subject to a tax penalty, with enforcement by the IRS.

“All insurance policies rely upon risk pools. A healthy and sizable risk pool helps reduce costs for the participants,” said Kelly, who adds that the federal government has done a good job of providing navigators with the materials and training they need to explain the Affordable Care Act to the general public.

“We can get together to work through the system,” notes Kelly. “We’re not really advocating for the Affordable Care Act – we’re really helping implement it. My job is to get the right information out. I just want them to be informed. I want people to have the right information.”

Healthcare.gov, which has been plagued by frozen screens in its first week, is the primary gateway for looking at plans.  Locally you can also go to enroll-virginia.com for more information and to reach a navigator. Contact Kelly at [email protected].

By Gene Marrano

Latest Articles

- Advertisement -

Latest Articles

- Advertisement -

Related Articles