Affordable Care Act to cover low-income, single adults

Illustration by Meghan Ryan Morris

Low-income residents living in Cook County like recent graduates and artists can now receive free, state assisted medical insurance through the Medicaid program CountyCare. Though in 2014 the Patient Protection and Affordable Care Act (PPACA), or “Obamacare,” will begin providing Medicaid services to uninsured adults (under age 65) who apply in participating states. Cook County was granted a federal waiver to allow an early start for these services. This program began accepting applicants in January 2013 and is an expansion of Medicaid that will cover thousands of uninsured Cook County residents who were previously ineligible for Medicaid or Medicare services.

According to the federal government, Medicaid was formerly only available to people who are parents, pregnant or disabled while possessing an income at or below 133% of the poverty line, the minimum required for daily survival, which is $15,281 for singles and $20,628 for couples; Medicare covered people over 65 or with disabilities. In contrast, CountyCare currently services Cook County residents (ages 16-64) who are either U.S. citizens or “legal immigrants” and have an income at or below 133% of the Federal Poverty Level. CountyCare provides a wide array of medical services, but only at medical centers in the Cook County Health & Hospital System (CCHHS) or at a limited number of participating Federally Qualified Health Centers (FGHC). These services cover emergency services, over-the-counter drugs, medical supplies and substance abuse treatment in addition to physician, social work and mental health services.

Critics have pointed out that CountyCare is unavailable to undocumented residents, and it does not cover routine dental or vision services, except emergency care. Both of these crucial medical services were once available through Medicaid but were cut to reduce spending costs in 2012.

In 2014, as a part of the PPACA, adults under 65 in participating states with an income level meeting or below 133% of the federal poverty level will also be eligible for Medicaid services through the state of Illinois, instead of through Cook County and CountyCare. Illinois was one of these states, with Gov. Pat Quinn (D) signing legislation this July, which would enact these changes this coming January. Illinois residents enrolled in CountyCare will be able to leave the program for this more general Medicaid service offered through the State of Illinois. Doing so will provide services at any medical center that accepts Medicaid, rather than only those in the CCHHS. But Illinois’ PPACA Medicaid program does not cover mental health and substance abuse services, so that patients leaving CountyCare will lose these benefits.

Illinois state officials expect around 200,000 eligible Illinois residents to sign up for Medicaid under the PPACA in the first year and for the rest to sign up by 2017. Regardless, thousands of US citizens and Illinoisans who need these services do not understand how the policy changes in the PPACA will affect them. A March Kaiser Family Foundation poll found that only 62% of U.S. citizens are aware of the government subsidies offered by the PPACA through services like CountyCare. Another March Kaiser Family Foundation poll found that 78% of the U.S. population is unaware of their governor’s decision to either expand or reduce Medicaid coverage.

CountyCare has set up an information line for applicants to describe their situation and personal information to a staff member. A transcribed copy of the application will then be sent to the applicant’s home for a signature and any additional information needed. Alternatively, individuals can apply in person at Stroger Hospital, Provident Hospital and the Oak Forest Health Center.

CountyCare has set up an information line for applicants, who can call (312) 864-8200 to apply by phone between the hours of 8:00 AM and 8:00 PM Monday through Friday and 9:00 AM and 2:00 PM on Saturdays.

Who is eligible for CountyCare?

In order to qualify for a CountyCare Medical Card, individuals must:

-Live in Cook County

-Be 19-64 years old

-Have income at or below 133% of the Federal Poverty Level ($15,281 individual, $20,628 couple – annually)

-Not be eligible for “state Plan” Medicaid (parent, pregnant, blind or receiving disability income)

-Not be eligible for Medicare

-Be a legal immigrant for five years or more or a US citizen

-Have (or have applied for) a Social Security number