Enrollment surge expected in Triangle for health insurance

jmurawski@newsobserver.comDecember 22, 2013 

  • Where to look

    To learn about subsidized individual insurance and to apply, go here: www.healthcare.gov

    To set up an appointment with a “navigator,” call: 1-855-733-3711

    To find an insurance agent, go to: http://www.healthcarenc.org/

Insurance companies and local nonprofits are preparing for a last-minute surge of interest Monday in subsidized insurance as the first major enrollment deadline approaches for the Affordable Care Act.

Those who sign up for coverage by midnight will have health insurance starting Jan. 1, if they can get through the process without glitches. Triangle nonprofits that have trained insurance “navigators” and counselors on staff say their appointment schedules are quickly filling up for insurance application tutorials.

Linda Cantine of Durham, uninsured for the past three years, had lost sight of health insurance after spinning her wheels on the crash-prone federal website – until the other day.

Cantine, a 53-year-old temp worker, was among the last-minute insurance shoppers this weekend at the Lincoln Community Health Center in Durham to explore her health care options in advance of the fast-approaching deadline.

After repeatedly experiencing failure and giving up on the federal website, some applicants are returning now that the site has undergone intensive repairs and is more reliable. The navigators are advisers trained to explain the requirements of the law and coach people through the application process.

“I tried three or four times and then I kind of forgot about it until yesterday,” Cantine said of the federal portal. “That was a nightmare.”

Because of the delays, enrollments for subsidized insurance have only recently gotten underway in earnest here. North Carolina is one of the 36 states without its own health insurance exchange, depending instead on the bug-riddled federal marketplace.

Too soon for ‘final judgment’

The notorious failures of healthcare.gov have set back the federal insurance timeline by about two months, and Monday’s deadline is being downplayed by some as anticlimactic. Those who miss the deadline, or haven’t even gotten around to thinking about it, can still buy insurance until March 31, the final deadline for 2014 coverage, so there is no pressure to apply now.

“We won’t be able to make any final judgment about Affordable Care Act enrollment from the Dec. 23rd deadline,” said Adam Linker, a health care policy analyst with the N.C. Justice Center, a public policy and lobbying organization in Raleigh. “Essentially you’ve had barely a month to sign up – if that.”

More than 1 million people are eligible for subsidized insurance in North Carolina, but fewer than 9,000 signed up through the end of November, according to federal figures. Federal officials expect a surge of interest in December, but nothing close to original targets that had assumed a seamless online application system from the beginning.

The first deadline, originally set for Dec. 15 and extended by President Barack Obama, is one of several that had to be delayed under the new federal insurance law that’s commonly called “Obamacare.” Insurance companies have also agreed to accept the first month’s payments for insurance from Jan. 1 to Jan. 10 to accommodate customers.

“A lot of people are feeling these deadlines are very fluid,” said Nyi Myint, navigator program coordinator at the Alcohol Drug Council of North Carolina. “There’s a lot of wait-and-see.”

A new insurance policy doesn’t kick in until the insurance company receives a premium payment. With the federal website still experiencing glitches, insurers are calling up extra staff to validate applications and to weed out duds and duplicates that get stuck.

The federal law requires most Americans to have health insurance or face penalties that would be taken out of tax refunds. Because most already have insurance through their employer, Medicare or Medicaid, the health care law has direct effect only on those who are uninsured or those who buy individual policies.

The law also provides federal subsidies for households within certain income levels. And it prohibits insurers from charging women more than men, from charging older customers more than three times as much as young customers, and from refusing to sell insurance to people with pre-existing medical conditions.

The Lincoln Community Health Center has processed more than 100 enrollments in recent weeks, said Ricardo Correa, the organization’s outreach and enrollment coordinator. Correa said an applicant will know his or her enrollment is successful when a bill arrives in the mail for the first payment.

Process ‘complicated’

In a typical scenario, with the website functioning properly, it takes no more than an hour to process an enrollment, Correa said.

Linda Cantine had been insured most of her life through her career as an administrative assistant, but lately has gotten medical care through the Lincoln center since she’s worked as a temp.

She’s applying for several jobs and expects to be hired in January and have insurance through her new employer. But she’s applying for subsidized coverage just in case those jobs fall through.

“There’s so many options,” she said of the array of plans. “You have to look at the deductibles, the premiums, the co-pays. I didn’t think it would be that complicated.”

Cantine didn’t want to disclose her annual income but said she would qualify for a subsidy. Individuals qualify for insurance subsidies if their annual income is between $11,490 and $45,960.

The subsidies are awarded on a sliding scale, with the most generous financial aid going to those with the lowest salaries.

That means that Julia Corbitt of Durham will pay just $10.27 a month in premiums for a Blue Cross Blue Shield Blue Value 3000 “silver” plan. Corbitt, 59, is a part-time food prep worker at a day care center and has never been insured.

But she worries about coming up with a $500 deductible before her insurance starts covering her medical care. Corbitt has received medical care through the Lincoln Community Health Center, and said she sometimes can’t afford the discounted $20 fee.

She discussed her situation as she awaited her navigator appointment at the Lincoln center Saturday. Her bills include gasoline, water, electricity and cable TV, she said.

“How can I pay $500? I don’t have that kind of money,” she said. “Obama is not thinking about the ones that are single, that have half an income and all the other bills.”

Murawski: 919-829-8932

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