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PD Editorial: Why Oct. 1 is so important to so many

Open enrollment will run until March 31. Any plans that are purchased through the exchanges won't start until Jan 1. For those who wait until January or February to sign up, they will have to wait until the following month for their coverage to begin.

Given all the hyperbole offered in recent days by those in Congress trying to defund so-called Obamacare, here are some issues that need clarifying.

First, not all Americans who are without coverage will be allowed to obtain coverage. For example, roughly 20,000 of Sonoma County's uninsured are illegal immigrants who are ineligible for coverage under the Affordable Care Act.

Meanwhile, many others are not expected to take advantage of the new services, even though it may expose them to a fine next year of up to $285 per family or 1 percent of income, whichever is higher. (The fine goes up from there to 2.5 percent of income in 2016). In fact, the county is just hoping to insure about 25,500 Sonoma County residents during 2014.

County officials project that about 13,500 of those residents will be enrolled in Medi-Cal, where the eligibility requirements have been increased from 100 percent of the poverty line to 138 percent. (The federal poverty level is $11,490 for an individual or $23,550 for a family of four.) Meanwhile, officials hope to get another 12,000 residents signed up for insurance through the state exchange.

A coalition of health care professionals known as Covered Sonoma County is spearheading the effort to get locals signed up through the marketplace.

What about those who already have coverage and are happy with it? One of the biggest canards spread by Obamacare critics is that it will force people to find new doctors. Not so. At least there isn't expected to be any more disruption than already exists.

When patients now switch insurance plans or change jobs, they often have to find a new physician. That will remain the case going forward, including for those who buy health insurance through the exchanges.

But those who stay with their current coverage, including those on Medicare, should experience little to no disruption in care. The changes that are coming are the ones that are needed most — ones that require those who can afford insurance to obtain it while ensuring that private insurance companies no longer reject people because of ever-shifting rules about pre-existing conditions.

That's a breakthrough worth celebrating.


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