ObamaCare makes it more difficult to buy insurance year-round

Here's more fallout from the health care law: Until now, customers could walk into an insurance office or go online to buy standard health care coverage any time of year. Not anymore.

 

 

Many people who didn't sign up during the government's open enrollment period that ended Monday will soon find it difficult or impossible to get insured this year, even if they go directly to a private company and money is no object. For some it's already too late.

With limited exceptions, insurers are refusing to sell to individuals after the enrollment period for HealthCare.gov and the state marketplaces. They will lock out the young and healthy as well as the sick or injured. Those who want to switch plans also are affected. The next wide-open chance to enroll comes in November for coverage in 2015.

 

It's a little-noted consequence of President Obama's health care overhaul, which requires nearly all Americans to be insured or pay a fine and requires insurers to accept people with health problems.

 

"I have people that can buy insurance, but the companies shut them down. They won't take the applications," insurance broker Steve Bobiak of Frackville, Pa., said. "We're a free country. You should be able to buy anything anytime you want."

 

Those who act now may still be able to get in, depending on where they live. Following the lead of the government marketplaces, some companies are extending off-marketplace sales for a week or a month to help people who hit snags trying to enroll by this week's deadline. Rules vary from state to state.

 

After those extensions, eligibility for coverage during 2014 is guaranteed only for people who experience certain qualifying life events, such as losing a job that provided insurance, moving to a new state, getting married, having a baby or losing coverage under a parent's health plan.

 

The federal law doesn't prevent companies from selling policies to everyone all year. But insurers consider it too risky now that the law prohibits them from rejecting people in poor health.

 

"If you didn't have an open enrollment period, you would have people who would potentially enroll when they get sick and dis-enroll when they get better," said Chris Stenrud, spokesman for insurer Kaiser Permanente. "The only insured people would be sick people, which would make insurance unaffordable for everyone."

 

Bobiak, whose NICA Benefits company helps people buy insurance in New Jersey, Ohio and Pennsylvania, said he learned only a couple of weeks ago that insurers were cutting off new policies.

"It's lousy communication out there," he said. "If we don't know, my God, how do they expect other people to know? It's terrible."

 

A survey by the Kaiser Family Foundation in mid-March found that 6 out of 10 people without insurance weren't aware of the marketplace deadline on March 31. The Obama administration, insurance companies and nonprofit groups scrambled to spread the word, often with messages that focused on the cost savings available to many people through the government marketplaces.

 

There wasn't much public discussion about people who prefer to buy policies outside the marketplaces, sometimes finding better deals or options more to their liking.

 

Health and Human Services spokesman Aaron Albright pointed to a cryptic note on the HealthCare.gov website: It says "in some limited cases some insurance companies may sell private health plans outside the marketplace and outside open enrollment" that satisfy the law's coverage mandate. It doesn't say how to find any companies doing that. Albright had no further comment.

 

Gary Claxton, a health law expert at the Kaiser Family Foundation, said it's "highly unlikely" that companies will offer such coverage after the deadline window fully closes. Some do still offer temporary plans, lasting from a month to a year. But those plans don't cover pre-existing conditions and don't get buyers off the hook for the law's tax penalty.

 

Nate Purpura, spokesman for eHealthInsurance.com, which sells policies from 200 companies across the nation, said at this point he knows of none planning to offer major medical insurance after this month, except to people with qualifying life events.

 

For people trying to get an off-marketplace plan through an open enrollment extension, some insurers are selling them through April 15, and others through the end of the month. Purpura said eHealth will offer such plans in at least some areas of these states: Arizona, California, Georgia, Hawaii, Louisiana, Maryland, Michigan, Nevada, New Mexico, Ohio, Oregon, Utah, Virginia and Washington state.

 

Kaiser Permanente will offer extensions that mirror the state or federal marketplace in the area where a plan is sold, Stenrud said. The federal marketplace extension for online enrollment is April 15. But Oregon, for example, is giving marketplace buyers until April 30.

 

After that, Stenrud said, without a qualifying life event, the door closes until Nov. 15.

Connecticut is only state enrolling more in private insurance than Medicaid under Obamacare

Connecticut is the only state in the country in which more people have applied for private coverage than Medicaid through the health insurance exchange, an exchange official said Tuesday.

 

James Wadleigh, Access Health CT’s chief information officer, said the state’s exchange has taken more than 11,000 applications for individual and small-business coverage. About 6,000 are for private insurance customers, and about 4,700 will receive Medicaid.

 

As part of the health law commonly known as Obamacare, the Medicaid program in Connecticut and many other states will expand Jan. 1 to cover more adults without minor children. In addition, exchanges like Access Health are selling private insurance plans that, for many people, are expected to come with discounted premiums, subsidized by the federal government.

 

A major reason for Connecticut’s unique balance of applicants, Wadleigh said, is that the state began expanding Medicaid in 2010, shortly after the health law passed. That means fewer people are becoming eligible for Medicaid in Connecticut than in other states.

 

Connecticut currently provides Medicaid coverage to adults without minor children earning up to 56 percent of the poverty level. As of Jan. 1, that level will rise to 138 percent. Officials expect that will add between 55,000 and 60,000 more people to the program. (For adults with minor children, the income limit for Medicaid is already higher, and that will remain largely unchanged.)

 

Wadleigh reported the state’s enrollment trends during a meeting Tuesday morning of the state’s Health Care Cabinet.

 

Of the private insurance customers so far, 27 percent have selected “gold” plans, which have the highest premiums but pay the highest share of members’ medical costs. The majority, 55 percent, have selected the midlevel “silver” plans, while 16 percent have chosen “bronze” plans, which have the cheapest premiums available to most customers but leave them with higher expenses if they seek medical care.

 

Two percent of the customers chose catastrophic plans, which are available to people under 30 and carry low premiums but high out-of-pocket costs for most medical care.

 

Wadleigh said that of the people signing up for coverage, 19 percent are between ages 18 and 34. He did not say whether that referred to people signing up for Medicaid and private insurance, or just private insurance. Figures released last month showed that most of the young enrollees were signing up for Medicaid.

 

Access Health also provides coverage options for small businesses, but that portion of the exchange’s activity has been smaller than expected, Wadleigh said.

 

People can sign up for private insurance through Access Health through March 31, but the deadline for getting coverage that begins Jan. 1 is Dec. 15. Lt. Gov. Nancy Wyman asked whether there has been talk of extending the application deadline for getting coverage that takes effect Jan. 1. Wadleigh said there has been talk of doing that, including during a conference call with the White House last week, but said there's been nothing definitive.

Your guide to Obamacare: Frequently asked questions about the Affordable Care Act

This FAQ provides expert answers to the key issues about exchanges, enrollment and more.

Americans have many questions about Obamacare. Here are the answers to some of the most common ones.

Here are answers to some frequently asked questions about the exchanges.

 

Q. Who can buy on the marketplace? Can I buy on the exchange even if I am not eligible for subsidies?

A. The exchange can be used by individuals, families and small business owners who have 50 or fewer employees.

Q. If I have insurance from my employer, do I have to do anything?

A. You don't have to, but if you choose to do so, you can drop your employer's coverage and buy a plan from the exchange.

Keep in mind, depending on the type of employment coverage available to you, you might not qualify for certain savings offered by the exchanges.

Q. Can I buy insurance through the marketplace if I already have a serious health problem?

A. Yes. The amount you pay for a health plan will not be affected by your health status.
This means that you can't be charged more because of your health problem.

RELATED: YOUR GUIDE TO OBAMACARE: AFFORDABLE CARE ACT TO OPEN OCT. 1
It also means you will not have to wait to get the coverage you need.

Q. If I have Medicare, can I purchase a plan on the exchange?

A. Yes, but you can't get help paying for it.
Also, getting extra coverage on the exchange may not make sense.
That's because Medicare will be your main coverage, but you would still have to pay for a full health plan at New York State of Health.

Talk about this with an exchange helper to figure out the right strategy for you.

Q. Some groups are exempt from being required to have coverage. Who are they?

A. The categories include people who would have to pay more than 8% of their income for health insurance, people with incomes below the threshold required for filing taxes, those who qualify for religious exemptions, members of Indian tribes, undocumented immigrants, and people who are incarcerated.