MOSES LAKE - People signing up for health insurance on the state's new exchange can get help locally. Hospitals or clinics in Moses Lake, Ephrata, Quincy and Othello have "in-person assisters" on staff to answer questions for customers, and help them with the sign-up process.

Enrollment for the exchange, mandated by the Affordable Care Act, opened Tuesday, but wasn't accessible most of Tuesday and part of Wednesday. The in-person helpers need access to the exchange, Alice Rendon, benefit specialist at Moses Lake Community Health Center, said. But the staff will be contacting people who have asked for help as soon as the system is accessible, she said.

Moses Lake Community Health has eight people on staff to help people signing up, and five on staff in Quincy, Rendon said. There's one on staff at Confluence Health, Moses Lake Clinic, and four others completing the training, benefit enrollment counselor Sandra Lopez said.

There are two people on the staff at Columbia Basin Family Medicine in Ephrata, Alayna Lodi, public relations director for Columbia Basin Hospital, said. The hospital operates the Columbia Basin Family Medicine.

Columbia Basin Health Center in Othello has five assisters on staff, explained Roger Borden, the administrator in charge of the project, including its offices in Connell and Mattawa.

The ACA requires all Americans to have health insurance by Jan. 1, 2014; people who are enrolling in plans offered on the exchanges must make the first payment by Dec. 15 to ensure coverage by Jan. 1, Lopez said. The payment must be made electronically, she said.

People can qualify for free coverage, tax credits or a subsidy to help them pay for coverage, Rendon said. Others will be eligible for enrollment in the Medicaid program.

What plans people are eligible for, whether or not they will be enrolled in Medicaid, depends on income, Rendon said. People below 138 percent of the federal poverty level will be enrolled in Medicaid.

People are eligible for a subsidy, on a sliding scale, up to 400 percent of the poverty level, she said.

People should decide how much they can afford to pay for insurance, Rendon said, before they meet with the assisters. People should bring employer and income information for every person in the household who needs health insurance, she said. Other required documents include Social Security numbers for everybody in the household who needs coverage, and policy numbers for any current insurance plans, she said.

Employers are required to provide an explanation of coverage to all employees, and people signing up should bring that too, Rendon said.