Tue April 15, 2014
Two Young North Carolinians Navigate Healthcare.gov
Tuesday is the final deadline for people to sign up for health insurance this year through healthcare.gov. The online exchange, or marketplace, is a signature part of the Affordable Care Act, and it's supposed to make shopping for health insurance as easy as shopping for other products online. Over the past six months, WFAE's Michael Tomsic has been meeting with two young North Carolinians as they tried to use the exchange. Here are their stories.
Danielle Brockington was pumped for October 1.
"We are at the Charlotte public library, and I am about to log onto healthcare.gov and venture into the newly opened health care market," she said.
Brockington was 28 years old, and she didn't like her insurance – emergency coverage, she called it, that left her paying for doctors visits out of pocket. So she rarely went.
"Right after Halloween last year, I got a cold - it was full on, sniffles, runny nose, fever, all that stuff," she said. " And I couldn't go to the doctor. So it just kind of lingered and lingered and lingered until January. And my friends would be like are you still sick, what's wrong with you?"
Brockington finally went to urgent care and found out she had strep throat. That visit cost her more than $200.
So she was ready for healthcare.gov – the federal exchange that North Carolinians use since the state's leaders chose not to set up their own.
But Brockington couldn't even get past the log-in page without an error message.
"There are too many people in the marketplace right now – it is over fire code," she said with a laugh. "There's a line basically outside, it's like the Apple store kind of."
And to beat the line at the Apple Store, sometimes you have to set an alarm.
"My name is Princess Small, and we're at Starbucks on the corner of East and Scott," Small said at 5:00 on the morning on October 4. (We were actually outside the Starbucks because it hadn't opened yet.
Small is 32 years old and has dental and vision coverage through her part-time job, but nothing else. She has an autoimmune disease that insurance companies have called a preexisting condition.
"It's the preexisting condition that they usually say, oops, sorry, we can't cover you," she said.
The Affordable Care Act now prevents insurance companies from doing that. So she was anxious for healthcare.gov.
"The system is down at the moment! We're currently performing scheduled maintenance," she said with a laugh. "Scheduled maintenance, please try again later. Wow. And I thought we were smart."
Small and Brockington kept trying in October. When Brockington was almost done setting up her account on the 15, she let out a big sigh once she saw this message:
"Your account couldn't be created at this time," she read off her computer screen. "The system is unavailable."
And this how it goes for weeks. Along the way, Brockington, whose income is below the federal poverty line, gets some bad news.
"I won't be eligible for tax credits in the exchanges," she said.
A quick explainer here: Obamacare was designed to help low-income people get insurance in two ways – by giving tax credits and expanding Medicaid. The Medicaid expansion was supposed to take care of everyone below the federal poverty line. Above the line, the tax credits kick in - they're for people who make between one and four times the federal poverty level.
But the Supreme Court made the Medicaid expansion optional for states, and North Carolina opted out. That put Brockington in a gap – she can't get Medicaid, and counter intuitively, she doesn't make enough money to get a tax credit.
She says it doesn’t make sense.
"If the whole point of this was for lower income people to be able to afford health insurance and make it accessible for everyone, then why create this space where you have, I'm sure like you probably have a good number of people who fall into this gap," she said.
The Kaiser Family Foundation estimates there are more than 300,000 North Carolinians in the same position as Brockington.
For a while, Princess Small thought she was, too, based on her part-time salary. But when she started working on her taxes, "I remembered that I had worked for three months full-time at the beginning of 2013."
That income pushed her above the federal poverty line and out of the gap. So on April 4, Small signed up for health insurance.
"It's going to cost me almost $19 a month, so it's like $18.50 or something like that with the subsidy," she said. And the subsidy is around $240.
When her coverage kicks in May 1, Small will have comprehensive health insurance for the first time in about three years.
She says it's a relief. She manages her autoimmune disease by living a healthy lifestyle, but now if something happens, she can afford to see a specialist.
"I really hope I don't have to use it, but it's nice to finally have something that I can use," she said.
On the other hand, Danielle Brockington is still in the same place she was before the health insurance exchanges opened – with skimpy insurance, unable to afford something better.
She's still frustrated about the Medicaid gap. But she's staying upbeat.
"I kind of got left out, but you know, I guess I'm in the same boat that I've been in the past two years, so it's not really – nothing changed for me," she said. "But I see it changing for a lot of other people, and that's a good thing."
She says a bunch of her friends signed up at the last minute.
But Brockington also has young friends who, like herself, wanted to use the exchange but ended up in the Medicaid gap.