The cost of health care [The Record-Eagle, Traverse City, Mich.]

Sept. 29--TRAVERSE CITY -- Jane Bates said she and her co-workers like to joke that "you've got to be a redneck if you have to get a second job to pay for the gas for your first job."

Bates works about 24 hours a week, driving from Fife Lake to clean two medical buildings at night. She hasn't had health insurance for 15 years.

"I am afraid to go to the doctor, to the hospital or anything. It's scary. I'm so far in debt right now," said Bates, 58.

Bates is close to finishing a probationary period for a full-time dental assistant job, which pays health insurance.

The Grand Traverse region is a highly touted living destination, prized for its beauty, yet nearly 20,000 people -- many of the area's waitresses, ice cream scoopers, coffee pourers, construction and manufacturing workers -- are uninsured.

On October 1, they can start singing up for insurance on the Michigan Health Insurance Marketplace by logging onto www.healthcare.gov.

"I'm blissful that it's here," Bates said of the Affordable Care Act. "But a lot of people are leery about what it will cost."

The "affordable" in the law's title is just that for the neediest. Individuals with an annual income of $17,000 will pay a monthly premium of $57,after tax credits, according to the Kaiser Family Foundation.

Sign-up must be completed by Dec. 15 in order for coverage to start Jan. 1. Enrollment effectively ends on March 31, except for special circumstances.

Those who decide against buying health insurance must pay a penalty. An individual must pay 1 percent of his or her annual income in 2014 or $95 a year, whichever is greater, and an additional $47.50 per child. By 2016, the penalty soars to 2.5 percent of income or $695 per person, whichever is higher.

Dave Hall, a licensed electrician who lives in Cedar, would pay about $300 a month for individual insurance on the exchange.

"I don't think I can squeak that in. I really don't. It's cheaper to not buy it. But now we're getting older, (health) is a major concern," he said.

Hall recalled that in January of 2010, he spent a night at Munson Medical Center's cardiac unit after passing out in church. He was given a stress test two days later and was diagnosed with high blood pressure.

"I got a bill for $14,000," Hall said. "I almost had a heart attack when I saw that. I couldn't believe it. I should have been eating filet mignon or something. There should have been nurses fanning me with palm leaves."

Hall couldn't work out a payment plan with Munson and still owes the bill. He thinks health care might be covered through his auto insurer and plans to check out his options.

Rochelle Radlinski plans to sign up on the Market Exchange, but doesn't know where she'll find the money.

"I owe my dentist more than $3,000," said Radlinski, 62. "I'm already in the hole $200 a month. This is kind of embarrassing. I never thought I'd be in this place."

Radlinski, who was at Northwest Michigan Health Services on Thursday, said her husband passed away 18 years ago. She now lives on a $1,400 monthly stipend for a widow's Social Security benefit, as well as substitute teaching jobs.

She recently discovered a potentially cancerous lump on her side, and wants to ensure she has catastrophic coverage.

Despite her squeaky tight budget, Radlinksi said she'll find a way to pay the premium. She recalled a June incident when she severely reacted to something she ate at a fundraiser and collapsed in the bathroom. An ambulance was called, but she refused a ride to the hospital, fearing the cost. A friend picked up the $800 ambulance bill.

Some employers are trying to help their staff make the transition. Poppycocks Manager Chrissy Sterling said the owner checked out group plans versus individual plans.

"She knows we're coming up to to the date and wanted to help find us the best deal," said Sterling, 39, who intends to buy catastrophic insurance on the exchange.

About 40 percent of the Traverse Health Clinic clientele will be eligible for the health exchange, said Programs Director Sue Murchie.

"We have a staff in training, as do a lot of other agencies in town, to assist folks," she said.

Linda Hutchinson, an outreach/enrollment specialist, plans to take a laptop and work "shoulder-to-shoulder" at the Goodwill Inn, food pantries, and at her Northwest Michigan Health Services office.

"Hopefully this goes smoothly, and people won't freak out about it," she said.

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