In A.C., health care options a mix of confusion and promise for newly unemployed

From cooks to card dealers to servers to cleaners, some 8,000 casino workers are in the process of figuring out next steps after the closure of three Atlantic City casinos. And when it comes to health care options, people are encountering a mix of promise and confusion.

Neal Koushel, a longtime dealer at Showboat, says health insurance was his number one concern when that casino shut Sunday.

“It was a stressful situation when we closed after 27 years, so I’m trying to do as much as I can to help my family at this time,” said Koushel, adding that he and his wife couldn’t afford their necessary medications out-of-pocket.

Koushel sat with a broker inside the convention center in Atlantic City Monday, where several community groups are on hand this week and next, to help people navigate what can be a complex maze of services and supports for the recently unemployed.

ACA coverage through 2014 hinges on 2014 annual income

Insurance options for former workers may depend on several factors, including union contracts, family size and annual income. Some will be eligible for three months of extended health coverage at no additional cost, according to Unite HERE Local 54 organizer Ben Begleiter, whose group led the efforts to set up the drop-in center.

Many of the other workers not in that situation are turning to the new online marketplace under the Affordable Care Act for coverage. While the next enrollment period doesn’t start until November, those who experience certain qualifying life events, like losing a job, can apply right away.

Tom Shea, with the New Jersey Hospital Association, was one of several certifiied health care counselors assisting people at the convention center. He saw annual income playing a key role in determining what type of realistic options might be out there for people.

“The biggest issue is that today, [a lot of] these people have eight months of employment this year,” said Shea, while wrapping up on Wednesday.

Individuals who want to get coverage through the marketplace may be eligible for sliding scale subsidies or tax credits if they have an annual income less than about $44,000 a year. Shea says that may be a close call for some workers during this 2014 calendar this year.

“For example, in many cases some of the dealers have earned $32,000 for eight months. They’re now going to be eligible for unemployment for four months, which will amount to another $8,000 or $10,000 dollars,” said Shea. “Well, that bumps them right up against that tax credit.”

Without any discounts, a family plan on the online marketplace would cost Koushel, the Showboat dealer, about $1,600 a month. He says that’s about the same as what it would cost him monthly to extend his previous work coverage through a federal program called COBRA.

People typically have 60 days to decide whether to sign up for COBRA, with coverage taking effect retroactively, but Koushel says that’s not an option, as it would comprise too much of his current income.

Inside the convention center, he learned that his family of three would be eligible for some tax credits, bringing the cost of his selected health plan down to about $600 a month. He breathed out a heavy sigh, saying he’d hoped it would be cheaper.

“That’s a thousand dollars off, that’s better than $1,600. I can manage that, I guess,” he said.

Once next year hits, Shea says if Koushel and others are still unemployed or working part time, their annual income will low enough to be eligible for much cheaper coverage.

Koeshel, who’s put in several job applications already, hopes he can find a full-time job again soon.

Medicaid: A ‘surprise’ option

On the flip side, Shea has also seen a lot of low-income workers come in and qualify for Medicaid, also known as New Jersey Family Care. Eligibility for that is calculated based on annual or monthly income.

That included Danny Payamps and Jorge Berrio, who didn’t have coverage through their casino jobs to begin with and didn’t realize they were already eligible for Medicaid. Payamps and Berrio, who until relatively recently had worked in the kitchen at Trump Plaza, came to the convention center looking for job leads.

They both left with health coverage.

“It’s a surprise for us,” said Payamps, after meeting with a health counselor. “I can go to the doctor now and check myself and my friend.”

“I’m very happy,” added Berrio.

Eligibility for Medicaid expanded in January, as part of Gov. Chris Christie’s decision to opt in to an expansion through the Affordable Care Act. It means that anyone with an income of up to about $15,000 a year, or $30,000 for a family of four, is now Family Care eligible.

By the end of the first day of the drop-in center’s first day, Maura Collinsru with New Jersey Citizen Action reported that about a quarter of the some 200 people who sought their help signing up for coverage had enrolled in Medicaid.