Deadline looms for Healthcare.gov enrollment

Dec. 08--Despite the uncertainty surrounding the future of the Affordable Care Act, Crossroads residents are still looking for coverage on the Health Insurance Marketplace via healthcare.gov.

"I'm starting to have clients come in during my lunchtime, too," said Jeanette Rojas Flores, an independent insurance agent in Victoria.

Open Enrollment for 2019 Marketplace insurance ends Dec. 15, which means consumers only have a week left to enroll in or change their insurance plan.

So far, nearly 3.2 million consumers have selected plans on the exchange since Nov. 1, with 414,350 of them living in Texas.

Flores is hosting free workshops at her office Saturdays so she can provide assistance to those needing help choosing the right insurance coverage. Spanish speakers will be available.

She used to work from Citizens Medical Center, but now shares a space with insurance agent Fabian Ramirez of The FR Group.

Although the cost of health insurance plan premiums has increased, the majority of people qualify for subsidies that offset the cost. Flores said many of her clients are paying even less next year.

"Ninety percent of my clients pay zero to very little," she said. "I think so many people think, 'I can't afford insurance. I'm on a limited income.' But they can."

According to the 2018 poverty guidelines, a single person would have to make at least $12,140 annually to be eligible for a tax credit.

The New York Times reported Thursday that fewer consumers are enrolling in plans through the federal website compared to this period last year.

"We don't know how much longer this will be here, but there's a lot of cancer in our area, and without this insurance, people can't afford the medical treatment they need. This is their only option."

Blue Cross Blue Shield plans is the only insurance provider available through the Marketplace in this region, she said, but most doctors take it.

Because the Trump administration has loosened restrictions on standards set by Obamacare, more consumers are reportedly tempted to seek skimpier plans.

Flores cautions her clients against these limited benefit plans, because they may not provide enough coverage when the consumer really needs it.

Goliad resident Paula Martinez, 57, suffered a heart attack in July and learned that she needed a triple bypass. She doesn't know what she would have done if she didn't have insurance at the time.

"The insurance took care of everything. My bill was $147,000 and they almost paid it off," Martinez recalled. "I never would have been able to pay for it." She found out last month, that she now qualifies for Medicare.

Martinez had signed up through the Marketplace a couple of years earlier after a friend told her that Flores could help her.

When Victoria resident Emily Gomez first went to see Flores a few years ago, she could barely walk in the door.

This year, her $1,108 per month plan cost her $4.63 a month thanks to a government subsidy under the Affordable Care Act.

Thursday, she met with Flores again to renew her coverage.

Still healing from the total hip replacement she received last Valentine's Day, some days are better than others. But coming in before the deadline was crucial.

"I need insurance," Gomez said. "A lot of people don't go to the doctor because they just can't afford it."

Laura Garcia is the Features Editor for the Victoria Advocate. She may be reached at [email protected] or 361-580-6585.

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