Though a League of Women Voters presentation on the Affordable Care Act on Monday sounded more like talking points from the Obama administration than a current assessment of the national healthcare law’s impacts and flaws, some uninsured people in attendance said the session was informative.
But many at the workshop at the Orange County Public Library main branch said they wanted to explore their options further and wait until the infamous glitches with the Obamacare website are resolved before making a decision.
Janet Hoy, a member of the League of Women Voters’ Durham-Orange-Chatham unit, gave the presentation to about a dozen people. Hoy, of Chapel Hill, has worked in the insurance industry and is now an Obamacare certified application counselor.
“We’re not scared of [Obamacare] in any way. There’s very little that scares us any more when you get to our age because there’s nothing we can do about it,” said a Hillsborough woman who attended with her husband. She did not want her name used in this story because of privacy concerns.
“We both have no insurance at the moment. It’s been for a while,” and they hope Obamacare will help them afford it, she said. They don’t know whether they qualify for the subsidies that are a main selling point of the law.
“We were waiting until they worked out some of the kinks” before trying to log onto the beleaguered and malfunctioning Obamcare federal exchange, she said.
“We’re actually going to go to an insurance broker so that we can sit down and speak one to one with somebody to answer the rest of our questions before we answer any information on line,” she said. That was one of the recommendations Hoy gave to session participants.
Across the nation, health care exchanges are not working properly. Policies are being canceled despite repeated promises from President Obama over several years that policy holders would be able to keep their insurance plan if they liked it.
In addition, part-time hours are being reduced by many employers to avoid having to pay for employee insurance as Obamacare-induced premium costs rise.
Yet the Hillsborough resident said she has confidence in the program, and believes it is time the insurance industry gets shaken up because “it’s gone out of control.”
“I’d feel better if North Carolina had more options because it’s basically Blue Cross and Blue Shield,” her husband said. The state’s largest carrier, BCBSNC controls 85 percent of the individual market and is offering 26 plans statewide. Coventry Health Care of the Carolinas is offering 25 plans in select metro markets only.
Another uninsured Hillsborough resident, who also didn’t want to be named due to privacy concerns, said, “I’m on that borderline. … I’m on Social Security, but I’m not full retirement age, so I’ve had no insurance for the last two years since I quit work.”
She is uncertain whether she will qualify for a subsidy.
“All I know is I’m living paycheck to paycheck, and it’s a struggle,” she said. Obamacare’s individual mandate that requires most Americans to have insurance after Jan. 1 “scares me as far as cost because I know I’m on such a limited amount of extra income after bills are paid.”
She has yet to try to get on the health exchange.
“I do not have access to a computer. There’s another problem for me,” she said.
It is “hard to say” whether Obamacare is the right prescription to fix the country’s rising health costs, she said.
“What I hear on the news [about Obamacare’s negative consequences] concerns me,” such as insurance companies raising premiums or canceling policies due to their noncompliance with Obamacare coverage mandates, she said.
Her daughter works part-time for a grocery store, she said, “and now that all of this has taken place they’re cutting part-time workers back enough they don’t have to provide them with insurance, and they’re going to hire more part-time workers to make up the hours.”
Hoy’s presentation stayed close to a script that maintained Obamacare is a move in the right direction “to help cover those millions of people who are uninsured.”
Its insurance market reforms include removing pre-existing condition limitations for children and adults, and providing many preventive services at $0 copay, she said.
“My personal favorite” is guaranteed child coverage up to age 26 on a parent’s plan, she said. “That was a really big one for people” because previously children had to be a full-time student and were covered only up to age 22 or 23.
Hoy acknowledged there is an abundance of uncertainty about Obamacare. She said there have been repeated attempts by U.S. House Republicans to repeal the law, “which is why people are confused about it.”
And while the Manhattan Institute has estimated the cost of insurance premiums in North Carolina will rise 136 percent due to Obamacare’s effects, Hoy said, “I am happy to pay some of my income to get other people covered.”
Higher premiums “offset those of us who are in the system,” Hoy said, the same way automobile insurance works. Individuals pay into the system, but if they have no accidents, they get no benefits, and their premium money goes to pay for those who do have accident claims.
Under Obamacare, “that means young people are going to be paying more, and older people will be paying less,” she said. Hoy did not note that many younger, healthier people appear to be opting to pay the $95 penalty for not having coverage rather than signing up for insurance under the Affordable Care Act.
As The Wall Street Journal and others have noted, that could be devastating because those signing up are likely to be older, sicker people with much higher medical costs.
And while Hoy touted the subsidies that could be available on the health exchanges for those making between 100 and 400 percent of the federal poverty level, subsidies in that all-important, 18-34 young invincible market do not extend beyond 300 percent of the federal poverty level in two-thirds of the states, and 309 percent in North Carolina.
The federal health exchange is “having a little trouble as all of you know,” Hoy said. “It does work. You have to be patient but it does work.” When she called the exchange she was told the best time to apply was “early in the morning, like 4 or 5, or late in the evening, 11 or 12, or very early morning like 1.”
The well-documented website woes are responsible for low enrollment numbers.
Early revelations include one person enrolling in the federal exchange in North Carolina, none in Oregon’s state exchange, five in Washington, D.C., three in Alaska, and “very low” numbers expected overall when released this week, according to Health and Human Services Secretary Kathleen Sebelius.
Though Hoy touted the line, oft-repeated by Obama, that navigating Obamacare exchanges is like using Travelocity or Amazon.com, there have been numerous criticisms of that oversimplification now that many of the bells don’t toll and whistles don’t blow.
And the layers of information requested even to get to the plan-selection option are much more complicated than what Travelocity requires when booking an air flight, a hotel room, or a rental car.
“They’re going to verify my income with the IRS. They’re going to verify my citizenship with DHS, and my immigration status, and then they’re going to get other information from the state” before disclosing whether someone is eligible for subsidies or other programs, Hoy said.
Dan E. Way (@danway_carolina) is an associate editor of Carolina Journal.