Several locals said recently they are ready for today’s deadline to enroll in health coverage through the New York State of Health insurance marketplace.
On Nov. 22, the Obama administration gave consumers eight more days past the original deadline of Dec. 15 to enroll in a plan, as mandated by the Patient Protection and Affordable Health Act.
The state reported last week that 363,258 people had completed applications and were deemed eligible for coverage through the NYS Health exchange, according to Bassett Medical Center Public & Media Relations Director Karen Huxtable Hooker. Among that group, she said, 134,622 New Yorkers were fully enrolled on the exchange, with 95,196 enrolled in private insurances and 39,426 in Medicaid.
The goal of the Patient Protection and Affordable Health Act, commonly known as Obamacare, is to ensure that everyone in the nation is covered by health insurance and that no one is left uninsured.
According to U.S. Census data, about one in every six New Yorkers younger than 65 lacked health coverage. The New York State of Health exchange was designed to offer a marketplace of plans for uninsured individuals to choose from, as well as to people who buy their own coverage or anyone who may want to switch from an employer’s insurance plan.
Last week the Obama administration announced that anyone whose policy has been canceled can obtain one that offers minimal coverage or bypass the individual mandate entirely by claiming a “hardship” exemption.
The tiered levels of coverage being offered by the state exchange were promoted as being low in cost. Several local people interviewed by The Daily Star in the fall expressed concern over whether the plans would actually be affordable.
Richard Giles and his wife, Holley White, were among the estimated 50 million Americans who were uninsured. Together, they operate Lucky Dog Farm in Hamden. In September, they told The Daily Star that, although they were generally healthy, they were going to be looking into the health exchange to get insured. They were hoping they would be able to afford insurance.
On Dec. 16, Giles said his family was finally insured. He said he went to the New York State of Health marketplace online, but had experienced trouble. Giles said the site was difficult to navigate, so he finished the process over the phone with a woman he called “very helpful and cheerful.”
Giles said the cost of insurance through the marketplace seemed better than what he had been expecting.
“We’ve been without insurance costs for so long that any price would have seemed expensive for us, but the prices were overall reasonable,” Giles said.
Giles said he believes in the program, but decided to put off insurance for his workers for another year. He said the crew has their own insurance and, even though he could probably get a good rate for the group, he will hold off a while for several reasons.
“The process takes time and with a crew of only five people, to take a day off to do that is hard,” Giles said. “I heard that small-business insurance would not be available until next fall anyway.”
The Affordable Care Act also requires employers with more than 50 workers to offer health care plans. According to the Henry J. Kaiser Family Foundation, only six percent of large employers offer no health insurance.
In September, The Daily Star spoke to Rebecca Lloyd, vice president of Oneonta Block Co. She said her company had been preparing for months for the Affordable Care Act, making sure that it complied with all requirements. Lloyd said the company would continue to offer health coverage to its 48 employees, though it would be up to those employees as to whether they wanted to go shopping on the New York State of Health exchange or stick with the company’s coverage.
Lloyd said on Tuesday that her company renewed its insurance for employees outside the New York State of Health exchange. She said she looked at rates on the business exchange and found they were more expensive than the company’s current policy.
Lloyd said her company covers 100 percent of individual policies.
“Our employees are our family,” Lloyd said. “When you take away their health insurance, employees get stressed and we don’t want that.”
The Oneonta Block Co. requires all employees to have insurance, and if they don’t, Lloyd said, the company buys it for them. She said the company’s policy is through CDPHP and is free for employees.
Lloyd said she spent a lot of time in 2013 reading about the marketplace and tried to stay on top of the rules, which she said change frequently.
According to Lloyd, the company’s policy goes from December 2013 to November 2014, so they were able to secure the 2013 rates. She said she had no idea if the company will stay in the private sector once its policy is up because she doesn’t know what the rates will be.
Betsy Babcock, 55, of Handsome Brook Farm in Franklin, said she purchased insurance for herself and her husband, Bryan, through the state health exchange and was pleased with the process.
Babcock said after leaving her previous job that included group insurance to run the farm full time, she and her husband were left uninsured.
“We both are at an age where it’s important to have it,” Babcock said. “I went online the first day the exchange was up.”
Babcock said she found that the prices were the most reasonable for the insurance she and her husband needed. She said because she was one of the first people to use the website, there were still some glitches that needed to be worked out, so she finished up the process with the help of the Delaware County Chamber of Commerce, to whom she gave a great deal of credit.
Maurice Isaac, an account executive for Mang in the village of Clinton, has assisted the Delaware and Otsego Chambers of Commerce in enrolling many small businesses in insurance plans through the New York State health exchange.
Isaac said he has met with 25 clients a week over the last six to eight weeks, not including clients handled over the phone. He said he sometimes spends two hours with clients, making sure their insurance plans are in place for Jan. 1 and answering any question the clients may have.
According to Isaac, the most frequently asked questions from proprietors have been whether or not they would be able to maintain their previous policies. The answer was most often no for New Yorkers, Babcock said, because the plans did not meet the criteria of the Affordable Care Act. Proprietors were also interested in what their new subsidies would be.
Isaac said administrators of the Affordable Care Act provided a helpful Excel sheet for executives such as himself to find plans that would be comparable to a proprietor’s previous plan.
“Some plans cost the same as proprietor’s previous ones, down to the penny,” Isaac said. “Other plans cost more or less, with more or less coverage. It varied and depended on the case.”
As previously reported, insurers participating in the exchange offer four tiers of coverage. Plans with the lowest monthly premiums have the highest out-of-pocket costs for medical services or prescription medicines. Costs are based on deductibles, co-payments and cost to the consumer.
All plans are supposed to cover emergency care, hospitalization, prescription drug coverage, mental health care and maternity and pediatric care. Plans also must provide preventative care like routine vaccinations, mammograms and flu shots for free.
Isaac said the health exchange website had some trouble getting off the ground when it was first introduced, but that the kinks have been worked out.
“Each time it was closed,” Isaac said, “it got better and better.”