Are you a health care worker? We’d love to hear from you. Email editor at northcarolinahealthnews.org
More than three-and-a-half years after being passed into law, the Affordable Care Act finally allows consumers to sign up for health insurance.
By Rose Hoban
Ariella Anderson has really been looking forward to having insurance, especially on days like Monday, when she ended up at the doctor’s office trying to get treatment for the cough she’s had for a month.
“I was almost hoping that they’d tell me I had pneumonia or tuberculosis or something so that it’d be worth the $300 that I spent,” Anderson said.
It turned out that Anderson had been plagued by allergies. The sting of the price tag was somewhat mitigated by the free nasal spray and other samples the doctor gave her.
Anderson, a part-time reporter who also tutors, is married to a Raleigh teacher who has insurance coverage through the State Health Plan. Because of the so-called “family glitch” in the Affordable Care Act, she’s not eligible for a subsidy to help cover health insurance because she could buy coverage through her husband’s insurance.
Unfortunately for her, to add family members onto the State Health Plan costs more than $600 a month.
When Anderson looked at an online calculator, it showed that she wouldn’t be eligible for a subsidy. So she thought she would not be able to get on the health insurance marketplace that launched Tuesday as part of the Affordable Care Act and buy insurance at all.
“Then one of my friends on Facebook told me I could get insurance through the exchange, just that I wouldn’t qualify for the subsidy,” Anderson said. When she looked, it turned out the new Bronze plans come in at about $200.
“We could afford to pay about $200 out of pocket every month; we probably could make that work,” said Anderson, who added that her employer might be willing to give her a little help toward the premium. “Obviously, we were hoping for a subsidy so we could get it cheaper, but we could probably afford that.”
Anderson is just one example of the challenge still remaining for advocates hoping to get as many people as possible enrolled in insurance before the new year.
“We’re going to be very, very busy,” said Sorian Schmidt, head of Enroll America, a privately funded not-for-profit that’s helping people get signed up for insurance under the ACA.
Schmidt said Enroll America’s research shows that many people know about the penalty for not buying insurance but, like Anderson, might not be as clear on their ability to buy insurance or get a subsidy.
“And a lot of North Carolinians will qualify for extra help,” Schmidt said.
One of those is Carrboro resident Jenny Chafe, 42, who’s a self-employed voice and wellness coach for performers. Chafe has been buying her own insurance from BlueCross BlueShield of North Carolina for the past two years, and is pretty happy with it.
“It’s got good copays for emergency room visits and doctor visits,” Chafe said. But she said the cost had gone up about 10 percent annually. Currently, it costs her about $250 a month.
“My plan was to check out the exchange, but I hadn’t done any actual looking. Then I had this letter last week, and based on what that said, my premium would be $75 more,” she said.
Chafe didn’t realize she might be entitled to a subsidy, and, in fact, she is. Individuals who make $45,960 or less are eligible for a tax credit.
Schmidt said Chafe and Anderson are not unique; many people are not yet aware of their options.
“When 78 percent of people don’t know that the health insurance marketplace is even going to be there, there’s a lot of work to do before the open enrollment period ends in March,” Schmidt said.
She said Enroll America will be phone banking, canvassing, sending out mailings, setting up tables – going where they think the uninsured will be.
Busy first day
Anderson is one of thousands of North Carolinians who tried to get on the new online marketplace Tuesday to look for her insurance options. She was also one of many who was unable to complete her shopping because the federal website that services North Carolina consumers was inundated by visitors.
“We’re hearing it’s been pretty busy,” said Ben Money, head of the North Carolina Association of Community Health Centers. “Those websites are jammed because there’s people out there looking to get insured.”
Many reported the federal website was slow or down intermittently throughout the day Tuesday, including late into the evening.
According to the Triad Business Journal, the BlueCross BlueShield of North Carolina websites had a thousand quote requests by 9 a.m. Tuesday. As of Tuesday night, federal officials had not announced how many people from North Carolina had tried to get insurance during the first day.
The state government got into the act Tuesday as well, when Gov. Pat McCrory released an informational video about enrollment.
“As most of you know, I’m opposed to Obamacare,” McCrory said. “But as your governor, I feel it’s our duty to be as helpful as we can.”
“To help you understand the new federal insurance requirements, the state has provided informational resources to your local departments of social services. In addition, some private and nonprofit agencies will have federal navigators, people specifically trained to help individuals navigate the federal exchange,” he said during the two-minute YouTube video.