I spent more than a decade of my adult life yearning for health insurance (and access to normal healthcare) that I could afford, so I take healthcare reform pretty seriously. And after the last month of hoo-ha about the falterings and failings of the “Obamacare” website(s), I decided to try it out for myself.
I’m lucky to have a good job that offers me a health insurance policy that covers doctor visits, emergency care, referrals to specialists, and other medical costs. I get frustrated with ridiculously opaque terminology that I shouldn’t need a degree in medical insurance policies to decipher, “co-pays” that nickel-and-dime me, and medical services that seem like they should be covered, but that I end up paying for out-of-pocket. But. I spent enough years in my 20s working for employers that didn’t offer health insurance to know that it could easily be much different.
Back then I tried to purchase a minimal health insurance policy, but found that it would’ve cost me more than twice what I paid in rent–and about 2/3rds of my monthly income–to be insured. And that was as a 22-year-old without any medical problems. During those years, I was lucky enough to only rarely get sick or need a doctor (although when I did, it was both terrifying and expensive). I knew other people who went into debt to pay for medical care when they weren’t insured, and some ruined their credit completely because they couldn’t even begin to pay huge medical bills that they never meant to incur. It wasn’t until I went on active duty in the Army at age 31 that I learned what it was like to be able to see a health care provider and not panic about how much it was going to cost.
Which is all to say that I feel pretty strongly that America needs a solution that enables regular people to access the health care they need, using policies they can understand, and at prices they can afford. Will the Affordable Care Act get us any closer to that? I have some doubts, but I certainly hope the benefits far outweigh the negatives. Ultimately, I think the most important component of the ACA is the mandate for employers with 50 or more employees to offer health insurance policies (not for free–but at an affordable rate to employees, and covering at least 60% of medical expenses). A lot of working people are currently uninsured, and it’s worth looking at the demographics of the uninsured.
So instead of just reading about the ACA and the new health insurance marketplaces it mandates, I logged on to see what I thought on my own. Healthcare.gov is the main “Obamacare” website that’s gotten all the attention lately, and it offers a lot of information about how the ACA’s changes affect everyone. First, a few things to note:
- Healthcare.gov guides Americans from all 50 states through the process of purchasing health insurance through private insurance companies in their own states. (Each state independently regulates insurance companies, so there is no federal marketplace for insurance.)
- There is no “socialized” or government-offered insurance policy. If you’re already on existing government programs like Medicare, Medicaid, Veterans Administration healthcare, or military healthcare, there is no change to what you’re receiving. The ACA will expand eligibility for Medicaid (which currently only applies to very-low-income adults with dependent children, with few exceptions), but otherwise everything the ACA does takes place in these marketplaces where private insurance companies offer their policies.
- Before anyone goes shopping on an exchange, they should study up on the basics of shopping for health insurance policies, because we are all still at the mercy of overcomplicated insurance industry terminology, rules, and practices.
- Even though every state had the option to establish its own insurance marketplace, only 17 states opted to do so. If you’re in one of those 17 states (like New York, where I live), you will be directed to your state’s marketplace. It may be great, or it may be junk. Ultimately each state’s government should be held accountable for whether they opted to let healthcare.gov field the applications they could’ve established a portal for, or whether they made a piece of junk or a functional system.
- You don’t have to use the website. You can apply for private health insurance policies offered on your state’s marketplace by phone or by mail, and you can talk to someone who can walk you through the website if you need help.
- For all of the real problem areas of the ACA-mandated marketplaces, there is a world of crazy lies being put out about “Obamacare.” It’s worth your time to at least fact-check the claims before buying into them, I think.
- I’m particularly bothered by misinformation being spread to veterans about the ACA affecting their VA healthcare. Please help spread the word to veterans who are enrolled at VA hospitals that they do not have to do anything to comply with ACA requirements and that their VA benefits will remain the same. Click HERE for answers to frequently asked questions about VA healthcare.
It’s true that the Healthcare.gov website has been running for a month, and maybe they’ve made some dramatic fixes to correct the problems that existed on Oct 1. But I just didn’t see where it was all that unworkable. Here’s what I did:
1. I went to Healthcare.gov and clicked to “see plans now,” but it then asked me which state I lived in (as it should). I answered New York, and was then directed to the New York marketplace.
2. The only choice on the NY State of Health marketplace is to “get started,” so I did:
- First, I tried to create a new login, but discovered that New Yorkers can use the same account they use for the DMV, voter registration, and other state services. To my pleasant surprise, I was already registered.
- Next, I entered my Social Security number, with accompanying privacy/disclosure information.
- It then asked me if I wanted assistance with paying for insurance. I selected “yes.”
- I then had to enter information about my income, and I found that the state already had my employer information in the system from my tax returns. I verified the amount I expected to make this year. Another surprisingly easy feature.
- It determined that, based on my income, I am ineligible for financial assistance toward the cost of any insurance policy I select, and it explained why. I think that’s fair.
- It then asked me some details about the policy I have through my employer to determine whether it is both affordable and adequate. It is both, although I’m interested in alternatives.
- I then looked for policies on the marketplace to see if there was anything out there better than my current policy that I’m not crazy about. The interface sort of looks like Orbitz.com, and I could select a price range or certain features for my search. I just looked for the cheapest.
- The cheapest policy available to me would cost more than $300 per month, and I would have to pay 50% of any type of cost, including emergency room care. Not as big a proportion of my income as that quote I got when I was aged 22, but it would still hurt to pay this much out-of-pocket, especially for something catastrophic like an emergency room visit.
- No magical solution for me, but overall this was pretty user-friendly and no more difficult than using something like TurboTax.
3. I didn’t want to be done with Healthcare.gov, so I went back to apply:
- I claimed residence in Florida (which is where I lived for most of my life), which let me stay on the Healthcare.gov site. Florida is one of the many states that opted not to establish an independent marketplace for its citizens (thanks, Rick Scott), so Floridians must navigate the entire Healthcare.gov process to find a private insurance policy.
- To set up an account on Healthcare.gov, it’s a bit of a hassle with selecting a login and password that meets the site’s requirements, then those infuriating secret questions and answers linked to your account. But I got through it with far less effort than anything I’ve ever had to do on AKO.
- I then entered my Social Security number, an old Florida address, and then I answered a series of eerily accurate questions to validate my identity. I was actually surprised at what a smart system this seemed to be.
- It asked for more personal information like my employer and income information, and I didn’t want to run afoul of the information-gathering authorities, so I stopped at this point since I don’t really live in Florida anymore.
- Overall, for the portions of Healthcare.gov that I used, I found it to be mostly user-friendly and highly sophisticated in how it verified my identity.
I didn’t find anything better or cheaper than my current policy I get through my employer, but that’s ok. I am encouraged to work through my HR folks at work to see if I can get a better policy that way. Freedom isn’t free, and neither is health insurance.
Private insurance policies aren’t cheap, but it seems to me that the ACA marketplaces are a step in the right direction. Just like with any new product or technology, everything’s expensive at first, then hopefully prices will come down. There’s a lot of talk in the media and from politicians about the Affordable Care Act and what it means for you. My recommendation is to take a look for yourself and see what you think.