Millions on the sidelines for big health care push
WASHINGTON (AP) — Alan Thacker wants health coverage, but he can’t get help in his home state of Georgia. Mary Moscarello Gutierrez no longer can afford insurance in New Jersey. Justin Thompson of Utah refuses to be forced into the president’s health law.
Millions of people in the United States will remain uninsured despite this week’s final, frenzied push to sign them up under the health law. Their reasons are all over the map.
Across the country, many of the uninsured just don’t know much about the health overhaul and its March 31 deadline for enrolling in plans that can yield big discounts, researchers say.
An Associated Press-GfK poll found that only one-fourth of the uninsured had tried to sign up through the state or federal insurance marketplaces, also known as exchanges, by late January. If they don’t enroll in time, many will face a fine and be locked out of the subsidized plans until next year.
President Barack Obama and a phalanx of advocacy groups, insurance companies and volunteers are scrambling to spread the word about HealthCare.gov as the deadline dangles.
But the complexities of the Affordable Care Act can stymie even the well-informed.
New York tap dancer Jessica Wilt just missed being one of them.
She lost her health coverage last summer when she was laid off as education director of a small dance company. It wasn’t easy being uninsured — when Wilt slashed her fingertip slicing lemons one night, she avoided an emergency room bill by sealing the cut herself with a super glue.
Wilt, 37, was eager to enroll in a marketplace plan but found the premiums too costly for a freelancer doing arts-related jobs. That would have been the end of it, if the accountant doing her income taxes last week hadn’t prodded Wilt to try again. She went online, realized she had erred in projecting her 2014 earnings and qualified for a much bigger subsidy.
“I’m feeling a little embarrassed that I interpreted things the wrong way the first time,” said Wilt, who signed up Friday for a midlevel “silver” plan for $150 per month, a price that reflects a $224 tax credit. “It just goes to show how confusing all this is.”
There’s a story for everyone who will remain on the sidelines of Obama’s big enrollment push.
These are some of them:
THEY CAN’T GET IN
Richard Kelleher, long-term unemployed and uninsured, spent five months sorting through the confusion in Phoenix. He tried to sign up for a marketplace plan and then the state’s newly expanded Medicaid program, getting shutdown online, at state offices and by phone. At the same time, he was piling up employment rejections.
Kelleher, 64, felt invisible.
On Friday he got a letter accepting him into Medicaid — and an entry-level job offer the same day.
That puts his insurance situation in limbo for now. He thinks his earnings will end his Medicaid eligibility. But Kelleher says he’s grateful for “an opportunity to at least be somewhere every day.”
In Thomaston, Ga., it took Alan Thacker two weeks to get his answer online. It wasn’t the one he wanted.
“I don’t know how many expletives I hurled at the computer — ‘Why are they doing it this way? Morons!’ and other choice words,” he recalled.
Thacker, 43, works for $7.55 an hour at Burger King, not enough to qualify for a discount plan for himself and his wife through the federal marketplace. People who don’t earn enough for the marketplaces plans were supposed to be eligible for expanded Medicaid.
But because Georgia declined to enlarge its Medicaid program, the Thackers can’t get help there, either.
Thacker said he likes the law, only wishing it could reach everyone in need.
“It’s a great law and it’s doing good stuff for people,” Thacker said. “It’s not doing anything for me.”
IT’S TOO EXPENSIVE
In theory, Rebecca Carlson has access to health insurance through her job. The marketplaces are mostly for people who don’t.
A single mother in Asheville, N.C., she earns $11.50 an hour, around $23,000 a year, doing office work at a nonprofit agency that helps people suffering from mental illness or substance abuse. She makes too much to qualify for the aid programs that support many of her agency’s clients.
Covering Carlson and her 14-year-old son under her workplace plan would cost close to $5,000 per year. That’s out of reach on her squeeze-every-nickel budget.
Depending on details of her workplace’s offering, it’s possible Carlson, 43, might qualify for an exception that would open the door to a marketplace subsidy. But she had so much trouble getting through online and by phone that she gave up trying; it seemed unlikely to help.
“They could offer me health care for $20 a month and I wouldn’t be able to do it,” Carlson said. “I have other responsibilities. I can’t tell the power company that I can’t pay the bill.”
In New Jersey, Mary Moscarello Gutierrez, 44, could barely afford her catastrophic insurance plan before the Affordable Care Act.
Now she has no coverage.
She and her husband, Jorge, used to be insured through their small business: PatriaPet, a website that sells dog and cat collars decorated with world flags. They were falling behind on their $400 monthly payments and their insurance agent advised them not to bother catching up because their type of mom-and-pop business policy wouldn’t be allowed under the new federal rules.
With her salary from various freelance writing jobs, the couple earns too much to qualify for a marketplace subsidy. She’s priced bare bones policies at $900 to $1,200 per month, more than they can pay. Luckily, they can keep their 12-year-old daughter in an affordable state-run plan.
For now, the Gutierrezes are uninsured and facing a year-end penalty of about $800, or 1 percent of their earnings.
“If I need some kind of major surgery, if I get hit by a crosstown bus, my family is sunk,” she said. “It’s scary.”
THEY DON’T WANT IT
“I love paying taxes,” declares Justin Thompson of Provo, Utah. “I think it’s the most patriotic thing I can do.”
And he’s pleased to help others through substantial gifts to his church and charities.
But buy insurance to prop up the law? No way.
“It is an injustice that our president can tell us to do something like this,” Thompson said. “It’s everything our Founding Fathers fought against.”
Thompson thinks going uninsured is a reasonable risk for him. After all, he says, he’s 28 years old, healthy and financially secure, making about $250,000 selling home automation and security systems last year.
Living on the central Florida coast, Jim Culberson, 63, has weathered heart attacks and cancer and says he barely scrapes by selling military histories and collectibles.
He would like health insurance if he could afford it, Culberson says. Just not through Obama’s law.
He has no plans to look into the subsidies in Obama’s law or its promise of coverage for pre-existing conditions.
“To me it looks like a load of hogwash,” said Culberson, whose younger brother, John, is a Texas congressman pushing for repeal of the health care law. He adds: “I don’t believe a whole lot the government says.”
Culberson says he’ll pay the uninsured penalty until he can enroll in Medicare in two years.
MAYBE NEXT YEAR
Need a 12-foot-long, flower-bedecked model plane for a wedding reception? Jose Espaillat will get it done.
He likes the challenge of setting up concerts, fashion shows and other flashy events in Miami, but it’s part-time, seasonal work that doesn’t come with a health plan. Espaillat, 26, hasn’t seen a doctor in five years.
He found HealthCare.gov easy to use, but the $150 to $250 monthly premiums seemed too high. A cheaper option covering only major emergencies wasn’t appealing. He decided to wait until next year.
“This year I’m just trying to get rid of as much debt as possible, student loans and stuff,” Espaillat said.
Svetlana Pryjmak of Dade City, Fla., has been uninsured for about eight years, which she acknowledge “is really strange — because I’m a licensed insurance agent.”
Companies that offer multiple insurance options hire Pryjmak to help workers understand their choices. She weighed her own options and decided to save the $70 or so a month she would pay for a heavily subsidized policy. The early troubles with the enrollment websites weren’t encouraging, she said.
But Pryjmak, 47, expects to sign up someday.
“Next year I’ll probably get in on one of the exchanges,” she said, “if the problems are ironed out.”
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