Affordable care act and what it means

The Affordable Care Act

The Affordable Care Act, also known as “Obamacare,” has generated debate, confusion, anger and relief nationwide since its passage in 2010.

“I think healthcare has always been a hot button issue,” said Patricia Kiszler who presented a lecture on the subject to Orcas this month. “Anytime you make any changes you are going to have human outcry.”

On Orcas, islanders are navigating through the changes and finding how it will affect their futures.

What is Obamacare?

According to www.obamacarefacts.com, the ACA increases the quality, availability and affordability of private and public health insurance to 44 million uninsured and curbs the growth in healthcare spending.

People – who can pay – are required to obtain health coverage by 2014 or pay a per month fee.

“The law eliminates pre-existing conditions, stops insurance companies from dropping you when you are sick, protects against gender discrimination, expands free preventative services and health benefits, expands Medicaid and improves Medicare,” according to the website.

Proponents of the act say that although not perfect, the ACA is far better than the healthcare options prior.

Opponents say that what they were promised has not been delivered and that the act is hurting the economy by forcing small businesses to provide employees with insurance they can’t afford. Others complain that their insurance costs are increasing and now they have higher deductibles. Other problems include using the websites for signing up for Obamacare. After launching the ACA websites on Oct. 1, news reports across the country showed people could not access healthcare online. According to Forbes magazine, only six people were enrolled on that first day.

Navigating the system

Despite national news reports that the ACA website was almost impossible to complete, Orcas islanders like Hilary Canty and Mary Parkerson found the process manageable.

Canty said she was able to navigate the website fairly easily in 45 minutes.

“We were surprised by how simple it was,” she said.

Her perspective may be slanted as she has recently gone through the Application for Federal Student Aid for her son’s college tuition, which she said was much more difficult. She also said that some ACA websites in certain states may not be as easy.

Each state had the option to design their own exchange, and create their own website. Washington was one of the states to take this action and its website for the ACA is wahealthplanfinder.org.

People can pick a plan and enroll now, but plans will not be effective until Jan. 1.

“It’s important for people to know they can shop by themselves for a plan,” said Erin O’Dell of Orcas Family Connections, who is also a certified navigator for the Orcas Affordable Care Collaborative.

When Parkerson tried to enroll for healthcare she hit a few speed bumps.

If people like Parkerson, whose initial attempt at the website was not smooth, need help they can contact a member of the Orcas Affordable Care Collaborative for help. The collaborative includes representatives from Orcas Family Connections, Orcas Medical Center and Orcas Family Health Center, who are trained to help islanders navigate through the ACA.

Parkerson knew that she was eligible for federal assistance, but after completing her information the website notified her that she was not eligible. So she contacted O’Dell. Parkerson was grateful for the assistance. After meeting with O’Dell, she was able to clear up the incorrect information and about a week later the issue was resolved.

“You have to be like a bulldog …. there is help to walk through it, and, if you hit a bump, seek their help,” said Parkerson. “The minute Erin stepped in I become un-anxious.”

Now Parkerson has an insurance plan comparable to her last one, but it is $125 cheaper, partly thanks to tax subsidies.

According to a USA TODAY article quoting the Congressional Budget Office, tax subsidies will cost about $350 billion from 2010 to 2019, but taxes and savings built into the law will offset them.

Parkerson was also happy that she was able to continue to be covered by her previous health insurance provider Lifewise.

For Canty, who is also not insured at work, the ACA provided not only a cheaper option but better coverage.

Earlier this year her insurance provider alerted her that her plan would increase from $680 to $1,083 per month and would offer less coverage.

After signing up under the new ACA, her plan costs $800.

“People talk about the ACA with the implication that you don’t have a lot of choices, but  there was not a lot of choice before,” said Canty.

The reality is there are three doctors here and they all take the insurance offered by the ACA, added Canty.

For other islanders, the process of applying for new insurance has been an arduous task taking up to three weeks to complete.

One reason O’Dell said the website can be “glitchy,” is that it is linked to the IRS and U.S. Immigration and Customs Enforcement databases to verify information. Also the fact that so many people went on the site in the first weeks, the website may have been overloaded and as time goes on the number of people on the site at one time may decrease.

Family Connections has helped several people a week, some people have needed 45 minutes where other situations require hours because of error messages or  long holds on the helpline.

One woman, who was pregnant, needed O’Dell’s help throughout a three week process in order to enroll for Medicaid through the new website because of glitches in the system. Another man O’Dell worked with initially found a gold plan with a great tax subsidy making his plan very affordable. According to O’Dell he enrolled and walked away happy. Then he received a letter in the mail saying that there was a mistake and his subsidy would actually be much less then was originally calculated. He had to come back to Orcas Family Connections and find a different plan.

Michael Marchand, communications director at the Washington Health Benefit Exchange, which operates Healthplanfinder, told the Seattle Times in October that a calculator on its website (wahelpfinder.com) mistakenly overestimated tax credits for about 6,000 applications that cover about 8,000 people.

“This is the largest reform since Medicare, this is huge, it’s not perfect, it takes time and there are lost of challenges,” said O’Dell about how the ACA is affecting islanders.

Battle of classes

At a previous job, Canty recalled that she had insurance but 45 percent of her take home funds went to pay for her husband and son’s insurance.

“I appreciate that there has been an attempt to address the devastation that happens to the low and middle classes when it comes to health insurance,” she said.

According to the  American Journal of Medicine, more than 60 percent of all bankruptcies in the U.S. are attributed to the cost of medical care.

Kiszler said it’s important for people to know the truth about Obamacare for two big reasons. For those who don’t have insurance they can learn what opportunities they may have. If you do have insurance information could open your eyes to what Obamacare will not provide. At the lecture she handed out a pamphlet describing how financial help can be provided. For a household income that is less than $32,500 for a family of four Medicaid pays for coverage and the family pays $0. For a household income of $40,000 for a family of four federal tax subsidies pay for $426 a month and the family pays $164 per month.

Also, all health plans must include emergency care, preventative care, maternity care and mental and behavioral services.

“Often the fury over health care is not really grounded in health care, all the sound and fury is grounded in bigger issues of social justice … the battle of the classes,” said Kiszler.

As an EMT, Canty has seen the affects of people who are uninsured and experience health issues and do not have the money to pay for it.

“It’s not a perfect system,” she said about the ACA, “but we are heading in the right direction.”

O’Dell added, “This is just the beginning. We have to see what happens when people try to use their insurance, that is the next step.”

Support center

A Customer Support Call Center is available to help in 175 languages, weekdays from 7:30 a.m. until 8 p.m., toll free at 855-923-4633.