Starting Oct. 1 the last, best piece of health care reform will be in place. People will finally be able to buy health insurance for coverage beginning in 2014 through state online marketplaces. (Don't call them "exchanges." That word didn't poll well.) • Here is my prediction: It's going to be a mess, an epic wall of confusion and frustration. • But not for long. The kinks will be worked out and once people get through their first enrollment, they will be sold on Obamacare.
I compare it to buying an iPhone. Initially it is a foreign object of suspect utility. Then, as the functions become more familiar and downloading an app no longer makes you scream, the device becomes easy to use and essential.
Getting millions of uninsured Americans into affordable health coverage — when options and pricing will vary by state and any federal subsidy depends on household income — is bound to be a minuet of missteps. Think the Medicare Part D rollout was tricky? This will be worse.
That said, some of the shoals could have been avoided. The public is still hugely misinformed. Four in 10 Americans say they don't even know if the Affordable Care Act remains the law, according the Kaiser Family Foundation.
Certainly a big chunk of blame falls to bomb-throwing Republicans with their endless votes for repeal and other obstructions. Under Gov. Rick Scott, county health departments across Florida have been barred from helping people sign up for subsidized health coverage on the online marketplace — a nasty bit of sabotage that will harm Florida families.
Florida Republican Sen. Marco Rubio wants no one to know anything useful about the law. His obsessive anti-Obamacare press machine recently blasted Kathleen Sebelius, secretary of Health and Human Services, for a $8.7 million advertising purchase to educate the public on the law. Rubio's political prospects brighten when people are kept uninformed.
But the Obama administration has been remiss, too. People needed more specifics earlier. Navigator programs in every state should have been up and running, supplying consumers with personalized details on plans, their cost and what subsidies they qualify for. Instead, we are just weeks away from the marketplace launch and in many states there is no individualized information available.
In Florida, you still can't get the name or contact information for a navigator, the helpers who will walk people through the process and get them enrolled. Navigators won't be ready to assist until Oct. 1, according to Jodi Ray, a health project director at the University of South Florida, who is monitoring the navigator program for 64 of Florida's 67 counties. She said the federal money to build the program wasn't released until mid-August — a seriously short time-frame.
People who want answers now are told to go online to "healthcare.gov" or call the toll free number 1-800-318-2596 and start asking questions.
That's what I did. I called the national hotline with one question: Can you help me locate a navigator in my area? I wanted to see if the person answering knew that the information isn't available yet.
Here is what happened during the three calls I made:
The first call was dropped as soon as it connected.
The second call was answered by a woman who put me on hold to research the question.
She came back on to say she wanted to "reach out" to her supervisor and put me back on hold. I waited. She returned to ask my name, then put me on hold again and the call was disconnected.
The third call was answered by a man who asked for my name, address and phone number (I hope that means if we got cut off he would phone me back.)
After I asked about navigators near me, he started reading from a script that instructed me how I could apply to become a navigator.
When I repeated that I needed a navigator he moved to another script that told me that navigators will be equipped to help people beginning Oct. 1. He couldn't tell me anything about where to find one then.
This isn't promising.
So we can expect frustrations as the country takes a giant leap toward universal coverage. In the end, I am confident that the inconvenience will be more than worth the medical security gained.