Experts expect a surge of new health care signups

sjones@thesunnews.comJanuary 25, 2014 

Michael Leonard sits in his Sunset Beach, N.C., living room on Jan. 24. Leonard said the Affordable Health Care Act is saving him thousands of dollars annually.

BY JANET BLACKMON MORGAN — jblackmon@thesunnews.com Buy Photo

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    Characteristics of the 24,611 South Carolinians who have gotten health insurance through plans made possible by the Affordable Care Act

    • Age 18-34, 23 percent

    • Age 35-44, 15 percent

    • Age 45-54, 22 percent

    • Age 55-64, 35 percent

    • 57 percent female, 43 percent male

    • 81 percent eligible for financial assistance, 19 percent not eligible

    • 64 percent have purchased the silver tier plan, 17 percent bronze, 19 percent gold and 1 percent catastrophic. No one in South Carolina bought a platinum tier plan.

    Source: U.S. Dept. of Health and Human Services

Only about 10 percent of the 11,000 uninsured patients at Little River Medical Center had signed up for Obamacare as of last week, a figure that’s in line with the turnout across South Carolina.

But local and state officials involved in the effort are pleased with the results and are expecting a surge of new enrollees before March 31, the deadline for people to get health insurance through the Affordable Care Act until enrollment opens again next fall.

“We have even been working on Saturdays lately just because we have so many people who want to come in,” said Jessica Doyle, an enrollment counselor at Little River. “My schedule right now is pretty much booked for the next two weeks.”

Doyle and Becky Fowler, spokeswoman for the S.C. Primary Health Care Association, said that early computer problems were just a minor hassle. Counselors shifted to submitting paper applications during that time.

Critics of the program say the numbers show that few people either want or can afford health insurance through the federal government program. They oppose the mandate that requires all eligible uninsured to get coverage or face fines, and they believe that government subsidies for coverage of low-income people will severely damage if not ruin the U.S. economy.

Those helping people to enroll and at least some of those who’ve gotten health insurance through the program see things differently.

“I think they’re just selfish,” Mike Leonard of Sunset Beach, N.C., said of the program’s opponents. “People only care about themselves.”

Leonard and his wife paid nearly $1,000 a month for health insurance before the rollout of Obamacare. His wife has diabetes and other pre-existing conditions, so they had no options but a COBRA policy when he was laid off as a contractor for General Electric.

Leonard said he had problems trying to figure out what subsidy he and his wife might be eligible for when he first tried to enroll in October. But he then got help from an insurance agent who had spoken at a community event.

“He found a plan through Blue Cross/Blue Shield that’s just what we needed,” Leonard said.

He and his wife will save about $750 a month on premiums under the ACA plan, money that will come in handy as he looks to replace his 10-year-old car.

The federal Department of Health and Human Services said that 86,371 people in South Carolina had applied for coverage through ACA as of Dec. 28. But only 24,611 selected a plan by the same date, with others not enrolling for a variety of reasons, according to local and state officials.

Fowler said that a significant number of those who haven’t enrolled had incomes between 100 percent and 138 percent of the federal poverty level. They would have been eligible for Medicaid coverage if South Carolina had accepted federal funding to expand its program to the new level allowed under Obamacare.

But because the state was among nearly half in the U.S. that refused the funding, South Carolinians in that income bracket cannot get into Medicaid. Because the ACA provides for them to get Medicaid, no subsides are available for them to buy their own insurance, and they can’t afford a policy on their paychecks.

Others, said Celeste Bondurant-Bell of Little River Medical Center, may have a family member who has health insurance through work or some other place, but not enough income to cover other members of their families. They, also, are not eligible for subsidies and still can’t afford additional coverage.

“It’s frustrating because people come in excited about having insurance for the first time and they leave very disappointed,” Bondurant-Bell said. “It’s disheartening to see that.”

Others, though, learn for the first time that they are eligible for Medicaid and leave with that safety net under them.

Bondurant-Bell said Little River has been able to enroll about two-thirds of the people it has counseled with a policy through the ACA or Medicaid.

One of the two-thirds is Jimmy Kirchmeier of North Myrtle Beach, who works for an employer that doesn’t offer health insurance. He said that before his policy through ACA, he had been trying to take care of himself and getting care at Little River Medical Center, which has a sliding scale for fees. Low-income patients will pay less for their care than those who can afford more.

Kirchmeier said the first thing he did when he got his insurance was to have a physical exam. It was through that he found a problem with a bone in one of his legs that had been giving him pain. Doctors ordered an MRI so they could precisely identify the source of the pain.

Now, Kirchmeier said he will need minor surgery to correct it.

“If I didn’t have this insurance,” he said “none of that would have been possible.”

Kirchmeier, like Leonard, acknowledged that some people are opposed to Obamacare. The number of opponents appears to be declining, according to a recent survey by Rasmussen Reports.

Forty-two percent of those surveyed now believe the federal government should require people to obtain health insurance versus just 33 percent who thought that in mid-December. The 56 percent of Democrats who support required health insurance is unchanged in the last month while Republican opposition has plummeted from 84 percent to 64 percent in the same time.

The reason the government insists that all be insured is so that the premiums paid by those who don’t need much healthcare pay for the cost of those who do. Eventually, those whose premiums subsidize the care of others will need more care, and that will be possible because of the premiums of new, healthier enrollees.

Kirchmeier, 60, pays $18.25 a month for his new health insurance policy. The federal government gives Kirchmeier another $500 a month in tax credits to cover the balance, a cost that the ACA provided to be paid by an increased tax on some health care equipment.

Kirchmeier said the body needs regular maintenance in the same way that a car does. Without that maintenance, things are bound to go wrong.

And, he asked, “What’s it going to cost in healthcare if people don’t have insurance?”

Contact STEVE JONES at 444-1765.

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