Yesterday, the state unveiled its new insurance options, called Covered California. These market places, known as exchanges, are a new way for people who are uninsured to purchase health insurance plans that meet the new requirements of the Affordable Care Act. Consumers who log on should find standardized, easy to compare health plans, plus information about federal subsidies to help pay for them.
About half of the states are using a federally run exchange. California is the largest of the 17 that chose to set up their own systems. In the Bay Area alone, over a half million people are uninsured. One family in San Francisco was among the first online – literally and figuratively – to buy health insurance.
I’m in Jennifer Alexander’s living room just hours after the website for Covered California went live. While her 16-month-old daughter, Lucia, naps in the back of the apartment, Jennifer sits behind her laptop waiting to apply online for health insurance. She laughs at how long she has been waiting for the next page to load; she’s carved out a narrow window of time for herself to shop for insurance for her family. Jennifer and I are both staring at her computer screen, and we’re waiting…and waiting.
The Golden State has the country’s highest number of uninsured people with seven million, and many are online for today’s rollout.
“We’ve had huge interest,” says Peter Lee, Director of Covered California. “We’ve had literally as many as 10,000 hits a second, not a minute, not an hour, a second. Californians are hungry for coverage they can depend on, they can rely on to give them piece of mind. But I want to remind everyone they don’t all need to enroll today. They have three months to get enrolled to have coverage that will start January 1st.”
But a lot of people, like Jennifer Alexander, don’t want to take any chances. Right now, Jennifer is self-employed and purchases health insurance for herself and her daughter privately though Blue Shield.
“I've spent most of my career working as a freelancer,” she says. “So I've been on the individual insurance market for about 18 years now, and the offerings that have been available for someone who does the work that I do have been very poor.”
Her frustrations have included high deductibles and having to fight for reimbursement of her medical expense.
“This past January,” she says, “I noticed that I had a mole that had enlarged and I knew that I wanted to go to the doctor. The whole cost of everything, the lab work and seeing the doctor, was $1700.” Even with her insurance, she says that she paid between $500 and $600 for the care she received. Her health plan is ending on December 31st because of the Affordable Care Act. To remain insured, she will need to purchase health insurance soon through Covered California.
Jennifer continues filling out the online application. “How many people are in your household?” she reads. “I can answer that. There are three. Age of head of household. Do they mean me or my husband? I’m not sure.”
The Affordable Care Act is supposed to help out people like Jennifer’s husband Kiko Aumond. He’s a 44-year-old software engineer, who doesn’t have any health insurance coverage at all.
“I have a pre-existing condition,” he explains. “I used to have high cholesterol, but I changed my diet and started exercising, and now I have normal cholesterol, but I still cannot get insured. Every time I tried to sign up for an individual plan, I got turned down, by five different insurers because of this pre-existing condition.”
Under the Affordable Care Act, insurers cannot deny coverage or charge higher rates because of pre-existing health conditions. Kiko must get insurance by March 31st, or he’ll face a financial penalty. That isn’t likely to happen with the amount of energy his wife has already put into researching the new healthcare exchange before it even opened.
After filling in the rest of her demographic information, Jennifer has one question left before moving on to the next part of the application.
“Okay, income per year,” she says. “I guess I have to pick something out to put in here now. I will go with this year, and so I’m going say we are probably going to fall in this category right now. I'm going to say $70,000.”
Jennifer does the best she can to answer each question, but the answers aren’t always clear to her. She finishes putting in her demographics and starts to answer questions about how much health care her family uses.
“This allows me to browse plans and they are going to help me to compare insurance health plans,” she explains. “So they're going to estimate our costs.”
Betsy Imholz is the Director of Special Projects at the Consumer’s Union, a non-profit which lobbied for the Affordable Care Act. She has advice for people like Jennifer.
“In most places around the Bay Area, for example, there are about 5 different plan companies and then within that there will be multiple policies as well available,” she says. She suggests that Jennifer “go in with a provider in mind if they have a specific doctor or other provider that they want to stay with or have a particular drug that they need. Have that all right in front of you and then go explore and see what’s available in your area and how much it may cost.”
Jennifer has that information ready as she navigates the system.
“Okay, find your doctor,” she says. “Yes, I do have a doctor that I prefer. I just typed in my doctor's name but it didn't find the record so I am going to have to go back and try and type her name in differently. I'm going to type in her full name. Here we go. No matching records found.”
Eventually, the data entry into a slow website overwhelm Jennifer.
“I think I am going to wait for a couple days,” she says, “until the traffic has died down a little bit and then revisit.”
The enrollment part of the Covered California website was suspended later that day to make improvements, so Jennifer had to wait at least another day. She has time before her health insurance runs out December 31st, but for her and millions of other Californians, the clock is ticking.
NOTE: You can find California’s new health exchange online. If you need help you can reach a “navigator” at 800-300-1506.