Sunday, April 22, 2018
Health

Some success, some frustration as area residents deal with Obamacare

Monday marks an important milestone under the federal health care law: It's the date by which shoppers on healthcare.gov need to pick an insurance plan if they want coverage to begin Jan. 1.

Though it continues to have problems, the website has finally been working for many Americans after a rocky debut on Oct. 1. So nearly three months later, are people starting to get the coverage they need in time for the New Year?

The Tampa Bay Times checked in with some of the bay area residents it interviewed over the past three months. Some of them had good luck with the marketplace, some did not, and some decided not to even to try.

Pat Chevalier, 62, St. Petersburg

Just two weeks ago, Chevalier began to fear she'd made a terrible mistake by retiring from her social work job in August. She had assumed she could find affordable insurance pretty quickly through the online marketplace but ended up struggling first with the website, then with the federal call center.

Then came the really bad news. The federal call center incorrectly told Chevalier that her $18,000 income left her too poor to qualify for subsidies to help pay her premiums. It was an obvious mistake, but Chevalier said she was told her only option was to file an appeal, which could take up to 90 days.

But the day after Chevalier shared her story with the Times, she went back onto healthcare.gov and found she could cancel out her old applications through the new "reset" feature on the website.

She started a new application and got the news she'd expected months earlier: She qualifies for $6,300 in federal tax credits. Chevalier enrolled in a Humana "silver" plan and paid her share of the first premium, a little less than $7.50 a month.

Cindy McNulty, 59, Largo

For McNulty, a health advocate who works with young pregnant women, the Obamacare marketplace promised a remedy to her most embarrassing problem: She can't afford health insurance.

In September, she vowed to log onto healthcare.gov at the stroke of midnight Oct. 1 and start shopping for coverage. "I can't wait to be more responsible," she told the Times then.

Fast-forward three months, and McNulty remains locked out of the marketplace. "Sooooo frustrated," she wrote in a recent email to the Times.

Like Chevalier, McNulty used the website's new "reset" feature to get rid of old applications and start fresh. But when she tried to log on again last week with her new information, she said, "it said I didn't exist."

McNulty, a single mom who believes she'll qualify for a small subsidy, said she would keep trying before Monday. She plans to go with the lowest-price bronze plans as she's relatively healthy and goes to a community health center for low-cost services. She said she'll sock away money to help pay her deductible should she need specialist care or have an emergency.

And her 17-year-old son will stay on Florida KidCare, which costs her $148 a month and carries no deductible — a much better deal, she said, than adding him to any plan on the marketplace.

Justin Gray, 28, Tampa

When Gray talked to the Times in September, he said he might skip out on insurance next year and just pay the $95 fine. A bartender at the upscale Anise Global Gastrobar, Gray wanted to persuade fellow Tampa Bay bartenders to get together and purchase a group plan.

That effort has been slow getting off the ground, and Gray figured going through the marketplace would be too complicated. "To be quite honest with you I was intimated with the process," said Gray, with a chuckle. "We bartenders don't like to grow up."

But about two weeks ago, he said, "something really cool happened."

A bartender friend who also sells insurance talked to the Left Coast Bartenders Guild about the Affordable Care Act. Gray finally felt like he was starting to understand it.

After the meeting, his friend helped him log onto healthcare.gov. Turned out Gray qualified for a federal subsidy. He enrolled in a Humana plan, which will cost him only about $15 a month.

Ann Orr, 50, New Port Richey

Orr has been selling furniture and running up her credit card debt to pay for doctors visits and prescription medications. It doesn't look like much will change.

After her ninth time on the phone with the federal call center, Orr finally got a determination: She's too poor to qualify for federal subsidies to help buy insurance through the Obamacare marketplace.

Orr, it turns out, falls into the Medicaid gap. Because her income falls below the federal poverty level, she can't get subsidies. But she also can't get Medicaid because Florida chose not to expand eligibility for the program to include people at Orr's income level. Without Medicaid or a subsidy, she cannot afford insurance.

Orr had to quit her job at a doctor's office due to back and neck injuries from a car accident. She also has painful rheumatoid arthritis, for which she takes medications.

Orr has applied for disability but been denied twice. She's appealing but worries a new ruling could take as long as a year.

"I've depleted my life savings," she said. She's not sure what more she can sell out of her house, which now has two empty rooms.

Ed Bradley, 62, St. Petersburg

From the start, Bradley wasn't sure if he should spend much time at healthcare.gov. A retiree from the medical equipment industry, Bradley knew he would qualify for a very small subsidy, if he qualified at all.

All the trouble with the government website sealed the deal. He went ahead and bought a plan directly from Florida Blue.

Bradley currently remains on his former employer's health plan through COBRA. It's an unusually good deal — about $530 a month in premiums and an ultra-low $500 deductible — but those benefits expire in May.

In his new plan, he'll be paying about $130 a month more in premiums than he does now through COBRA and also faces a much higher deductible, $6,250. He has decided to start drawing Social Security benefits next year, which will help offset the new costs.

"It's been quite an experience," he said.

Jodie Tillman can be reached at [email protected] or (813) 226-3374.

 
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