At A Midpoint, Health Care Market Gets Mixed Reviews
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The Affordable Care Act's health insurance marketplaces offered nothing if not hope.
Hope spurred a
A 60-year-old
Three months went by.
Now, it's halftime for the marketplaces - the government-run hubs where people can purchase private insurance plans on the individual or small-group markets.
The open enrollment period continues until
For lower-income people, a major perk of the marketplace was supposed to be the opportunity to qualify for government assistance with premiums or out-of-pocket costs.
However, many ended up balancing potential benefits with the immediate frustrations of a broken website and flawed bureaucratic process; in the first two months, fewer than 5,000 Virginians selected a plan through the marketplace, out of hundreds of thousands who could have.
The number of enrollees is higher now, federal officials say.
The improved website saw a December surge, logging at least seven times as many enrollments for the federally run marketplace as in the previous two months. Virginia's numbers for December weren't available.
More people are contacting Virginia's specially trained helpers, too. More are completing applications. More are exploring their options.
With technical obstacles largely resolved, more people are closing in on an answer to their most pressing question:
Was my hope justified?
The self-employed
He completed an application in the first week but got hung up on identity verification. Over three months, Cohen visited the website more than 40 times. He completed the application several more times - first because the website wasn't working, then to modify family information.
Still, Cohen feels he's found a good deal.
For him and his three children, a marketplace policy would charge a monthly premium of
Cohen currently pays
The main reason he hasn't bought a plan yet is that he wants bariatric surgery. He must decide whether to: find a marketplace plan that would cover the surgery, get the surgery under his current policy then switch, or switch now and forgo the surgery.
"In any way shape or form, I should be switched over by March," he said.
What about all that time on the website and the phone?
Cohen, a self-described liberal, said he was impressed at how quickly the government fixed severe problems with a large system launched under a tight deadline.
"I didn't mind being part of a social experiment," he said.
His wife,
Then came a shock: The lowest-price plan for the
It didn't come close to being affordable for them.
"If you take that premium and you subtract it from my monthly, I would only be bringing home
Am I doing something wrong? he wondered.
He made some phone calls and finally learned the answer from
People with an income between one and four times the federal poverty standard - about
People with incomes below the federal poverty level - like the Maddens - don't qualify for the assistance.
The Affordable Care Act had intended for them to receive coverage from
The Maddens now plan to seek an exemption from the tax penalty for being uninsured this year. Otherwise, as far as health coverage is concerned, nothing will change for them.
"I'm kind of numb," he said. "When they said affordable health care - in the state of
Her husband, who is 71, is covered by
She showed up at the O.V. Medical and Dental Center in
What Kershaw minded was the confusion that followed.
"I haven't gotten anything in the mail," she said. "Nothing has been sent to me."
An insurance agent working with the health center gave her a quote for a couple of plans. One cost more than
"I said, 'Well,
Now, she's considering signing up for insurance through a company that advertised on television.
"You wait so many years and years and years," she said. "It's very disappointing."
After her first informational session on
Although Small works two jobs, she logs too few hours to qualify for insurance through her employers and has sought health care at a free clinic. Now, she's looking forward to seeing specialists.
Asked if her plan is affordable, Small, 54, said, "Very." But she declined to quote an exact rate.
"I mean, cheap, cheap, cheap, cheap, cheap," she said. "Cheap!"
inside Updating coverage under the health care law for the birth of a baby and other common life changes is not doable - yet. Page 6
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