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Back Local News Guam gets no fair share in Obamacare health plan

Guam gets no fair share in Obamacare health plan

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GUAM gets the short end of the stick in the Affordable Care Act, according to Frank Campillo, health plan administrator for Calvo's SelectCare.

Campillo said many of Obamacare’s key mandates will not apply to the territory while the contentious provisions will be imposed on the insurance industry.

While the House version of the healthcare reform law was promising for the territories, Campillo said the final version “left us out of many of the benefits that our people could have had.”

In terms of Medicaid expansion, for example, Campillo noted that Guam will receive only $3.7 million, representing a small fraction of the additional population that will become eligible for the program.

On the other hand, other states will get 100 percent subsidies to cover the full cost of expanded Medicaid eligibility that will extend to those making 140 percent below the federal poverty line.

Excluded

Guam is also excluded from the “individual mandate,” a cornerstone of the law that requires all Americans to obtain health insurance.

The requirement for the establishment of the insurance exchange for small group markets is another salient component of Obamacare that will not be seen on Guam.

This provision comes with federal funding that will be available to most states by Jan. 1, 2014.

The law instead assigned a default plan for Guam and the other territories, which consists of an essential health benefits package with coverage for general categories such as hospitalization, maternity and newborn care, prescription drugs, as well as ambulatory, laboratory and emergency services, among others.

Insurance reforms

The insurance market reforms will apply to Guam. By Jan. 1, 2014, insurers will be required to accept any employer and any individual applicant.

The law prohibits the exclusion of those with pre-existing conditions.

However, Campillo said this may hurt the industry because risk adjustment programs will not be available to Guam.

Campillo noted that Obamacare was originally designed to require everyone to buy health insurance, a concept that would result in a larger pool of people to spread the risk around and offset the cost of insuring people with pre-existing conditions.

But because the individual mandate does not apply, the industry will end up absorbing the cost, which will eventually be passed on to its clients.

More than 30,000 people on Guam are uninsured, but Campillo said Obamacare does not guarantee expanded healthcare coverage on Guam.

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