Timeline established for implementing parts of Affordable Care Act

When Chisago County Health and Human Services Director Nancy Dahlin stepped up to the county board dais to dicsuss the Affordable Health Care Act April 3, she said what many have been “reading about in the news” has finally come to fruition.

She explained to the board that timelines have been established when it comes to rolling out aspects of the Affordable Care Act, which was signed into law by President Barack Obama March 23, 2010.

Together with the Health Care and Education Reconciliation Act, it represents the most significant government expansion and regulatory overhaul of the U.S. health care system since Medicare and Medicaid passed in 1965.

Dahlin first noted, as of April 1, the state published the requirements for “navigators.”

She explained the rollout is somewhat dependent on these navigators, who are people in organizations that will help clients sift through the health care exchange so they can get the coverage they need.

“We’re going to take a look at it to see what that is and we’ll pay attention to whether there are adequate navigator services in Chisago County that can meet the needs of our population,” Dahlin said.

In the beginning of June and August, the county will need to demonstrate to the federal government that it is taking the necessary steps to ensure the act is being properly implemented.

After those checks are passed, open enrollment under the act will start Oct. 1.

This is when the county expects to see its health care workload spike.

“Based on available state data, Chisago County is advised to expect, with the rollout, an overall case increase of approximately 1,600 cases,” Dahlin said.

To put that number in perspective, Dahlin noted the average amount of caseloads for county financial workers is in the 200 to 300 range.

Dahlin’s department has not yet determined precisely how many additional workers—likely temporary—will be need to be hired during the rollout period, but she’ll be coming to the county board in a matter of weeks with a staffing request.

“We are concerned about the ability to recruit, hire and train people to be operational within the timelines of the exchange rollout,” she said.

Those new county staff members will need to be hired before open enrollment starts, and Dahlin said there could be up to a 75 percent reimbursement from the federal government for their training and wages.

However, additional costs associated with hiring and training them—such as supplying them with computers, phones and other devises integral to performing their jobs—will not be reimbursed.

The county will have to absorb that cost, likely paying for it with local levy dollars.


Hoping for technology funding

Dahlin explained much of the existing technology in Chisago and other counties could be using to rollout the health care exchange is very old, which is why she hopes the governor’s budget will have funds marked to help replace some of the aging computer systems.

“If you’re paying attention to the governor’s budget, you’ll want to pay attention to whether and how much is technology funded,” she said.  “That will probably dribble right back here for how much (of the work) is automated and how much is manual.”



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