Last week we asked you to tell us your stories about using the Affordable Care Act’s newly unfurled health exchanges. We whittled down the responses we received to seven Obamacare guinea pigs. They live all over the country and represent a variety of political and socio-economic backgrounds. This is the first in a series of dispatches from Slate readers telling us about their experience using the new health care exchanges.
Small-business owner, 32
I grew up a staunch Republican, voted for Bush twice, but the combination of Sarah Palin and the baffling Republican response to Obamacare has caused me to have a major identity crisis in my political beliefs.
I grew up in House Speaker John Boehner's district, and we're longtime family friends. My grandpa held the same congressional seat, my dad was a township trustee with him when they both were starting out, and I went to school with his kids. I've honestly never disagreed with any significant Republican positions until this one, but I voted for Obama in 2012—the only Democratic vote I've ever made.
I spent an hour or so Tuesday morning browsing plans at the Colorado insurance exchange. My goal was to find coverage for myself and my two children for less cost than we’d incur through my wife’s employer. My children are currently on my wife’s employer-based plan, and my coverage is through the state’s soon-ending high-risk pool. While my wife’s employer coverage is inexpensive for herself, covering our entire family would cost us an additional $1,000 per month out-of-pocket (for a less-than-ideal $3,500 deductible plan).
Browsing and filtering plans is fairly straightforward, and I was impressed by the number of options. For myself and my two children, I was shown a total of 78 plan options from about 10 different carriers. The plans ranged from $357 to $1,024 per month (some including dental coverage), and it was pretty clear that we’d find substantial savings compared to insuring our entire family through my wife’s employer.
Out of curiosity, I also looked up plans just for myself to compare rates. Plans with similar coverage levels were a little more expensive on the exchange than what I’m paying now through the high-risk pool but still would be significantly cheaper than what I’d pay on the open market pre-ACA.
One thing that struck me as I browsed the plans was that I knew the price was THE PRICE. In the past, when I’d browse individual plans, I knew whatever price I was shown would not be the price I’d pay due to my pre-existing condition. It was comforting knowing that I wouldn't have to endure some complicated application process with much uncertainty about my final rate or approval.
I did hit a few snags though. I attempted to create an account on the site. After completing the required information and hitting “submit,” the request seemed to hang and eventually timed out. After speaking with a few friendly but overwhelmed customer service reps, it would seem that my account is in some sort of partially created limbo where I’m unable to either login or register again. They explained that systems were overwhelmed and suggested I try again in a few days, which I’m looking forward to.
Finance consultant, 34
I have a 4-year-old son who was born with a serious defect of his GI tract. Oliver spent his first two months in intensive care racking up more than $400,000 in medical expenses. We order medical supplies online, are very familiar with Levine’s Children’s Hospital, juggle three doctors, and hope to complete Oliver’s final surgery before he starts kindergarten. We are also very fortunate to have a normal, thriving boy with the potential for a long, happy life.
I have political opinions regarding Obamacare (against), but I don’t have the luxury of putting ideology ahead of what is best for my family. Currently, our high-deductible plan from Blue Cross Blue Shield of North Carolina limits our annual medical spending to $13,700, including premiums. I also made sure that we kept the grandfathered status of our plan so we had options when Obamacare took effect.
After spending much of Tuesday on the Internet, I was able to create an account but could not access the North Carolina exchange to learn if we qualified for a subsidy. Blue Cross Blue Shield will be the main insurer in North Carolina, and their website is providing quotes for their new plans. After seeing the plans, I was shocked. The bronze plan that most closely matches our grandfathered plan has a premium of $676 versus $294 for our current plan. The bronze plan also has higher out-of-pocket spending—$11,000 vs. $10,000—and does not provide a health savings account.
Higher expenses for more than twice the price is not progress for my family. We would need a subsidy of at least $5,000 to make the bronze plan competitive with our grandfathered, unsubsidized plan. It appears that families and individuals with low incomes should benefit, but at great cost.
Part-time jobs, 55
My name is Kevin Mims. I am 55. My wife is 62. We've been married for 33 years, and for most of that time we had excellent health insurance coverage through my wife's work. (She was an escrow officer for 30 years.) She got laid off in 2010, and since then we have both been working at multiple part-time jobs, none of which provide health insurance. We are both freelance notaries public. My wife also works part-time for my stepdaughter's home business (which has only three employees). What's more, she works several days a month at a local antiques co-op. In addition to my notary work, I am a freelance writer, a fill-in clerk at a local bookstore, an antiques seller, and do a lot of other odd jobs such as house-sitting, pet-sitting, even baby-sitting.
Life without insurance has been scary. In June I went out jogging one day without checking the temperature. I thought the temperature was in the 80s, but a mile or two into my run, I began feeling really sick, as if I were coming down with heat stroke or something. On the way back home, I passed a building whose time-and-temperature display informed me that it was 104 degrees outside. I felt sicker and sicker as the day went on. By 11:30 p.m., I had the dry heaves and was retching uncontrollably. At midnight my wife took me to the emergency room of the U.C. Davis Medical Center. They did a quick EKG on me, determined I wasn't having a heart attack, and then assigned me a very low triage priority.
Next they sent me to the finance department to try to figure out how I was going to pay for any treatment I received. I was asked about the value of my home, the value of my cars, and other personal property. I was asked about the value of my bank accounts, about my annual income. All of this increased the stress I was under. After signing some papers agreeing to reimburse the hospital for any treatment I received, I was sent to the emergency waiting area. After sitting in the waiting area for three hours without being seen by a doctor or nurse, I began to feel better, so I left the hospital. Later I got a bill from the medical center for $850.
I visited the Covered California’s website Tuesday morning at 9:15. I clicked the button that said "Start Here." I got a message that said, "Problem Loading Page." Repeated attempts yielded the same result. At 9:30 I dialed Covered California's 1-800 number. I got an automated message saying that the call center was handling a higher than expected volume of calls and that my approximate wait time would be 292 minutes. I left my name and phone number and requested a callback.
I’m not worried. I still have three months in which to enroll in a health plan. Considering that the federal government has shut down and millions of people are in need of the health coverage Obamacare offers, it isn't surprising to me that I wasn't able to get assistance on Day One. I'll try again tomorrow.
On the bright side, I was amazed by the affordability of the plans on offer at Covered California. My wife and I are leaning toward Kaiser Permanente's Bronze 60 plan, the premiums for which are only $2 a month.
IT manager, 36
Ours is the quintessential traditional nuclear family, married for 13 years with four children and one on the way. I am a salaried IT manager for a small company, making a little more than $50,000 annually and am the sole breadwinner for the family.
For years, my wife and I have gone without health insurance (save CHIP for the kids) because the plan offered to us by my employer was ridiculously overpriced: $5,000 premium, with another $2,000 deductible before anything really kicked in, then 30 to 50 percent coinsurance with a lifetime maximum of $1,000,000. Individual plans availed us nothing: My wife is uninsurable due to asthma. When the ACA was signed into law, we actually did shed some tears of joy. It’s not the single-payer plan we had hoped for, but it is better than nothing. We’ve waited four long years for this day.
Living in the West, I took advantage of the time-zone difference and tried to sign up at 11:00 p.m., thereby hopefully beating the rush. My plan failed; it now occurs to me that I am part of a large network of people perpetrating a denial-of-service attack on government computers. (We’re all going to jail for a very long time.)
Thankfully, the companies participating in the exchange here in Utah have their own websites, with explanations of benefits and cost calculators. So while I can’t sign up yet, I can get a sense for what I’m signing up for and make comparisons. The interesting thing I’ve noticed is that, regardless of whether I sign up just myself, my spouse, or my children, we’ll pay the same 5 percent of gross income in premiums, because the subsidy gets larger as we add people on. I also noticed that the Silver plans are far better values than the Gold or Bronze.
Our story isn't terribly exotic, but it's ours. My wife and I (42 and 39) are both freelancers working at home, which means—among other things—we've been blessed with being able to raise our 7-year-old child without outside child care. Although solidly middle class by dollars, we don't earn health care through our employment, which means a large chunk of our money ($600 per month) goes toward health insurance, despite being mostly healthy nonsmokers.
We're most interested in the provision of the ACA that requires insurers to cover maternity. It's nearly impossible for single buyers to purchase in our home state of Indiana: one-year waiting period, an extra $10,000 in annual premiums. Basically, you're prepaying for a standard delivery. Because of the lack of coverage—and earnings that have kept us from being certain of Medicaid benefits—we've limited ourselves to one child (which has been tricky, since we're practicing Catholics). We hope for coverage that's either better or cheaper than what we have now—and preferably both!
I tried to register starting at 7:30 a.m. on Tuesday. I got almost all the way through, but it timed out after I entered my answer to security questions with a red-boxed error message: "Important: Your account couldnt be created at this time. The system is unavailable." (The lack of proper punctuation on "couldnt" irked me as a writer.) Throughout the rest of the day, I got a variety of error messages as I tried to register: security questions failing to display, "The system is down at the moment," locked Web pages, and even "Please note that two or more answers to the security questions cannot be the same. You must provide distinct answers to the chosen security questions" (despite my certainty that there WERE different answers). I appreciated the website's eagerness to give me a variety of error messages, no matter how nonsensical.
Finally, at 6:03 a.m. Wednesday, on my 19th attempt in 23 hours, I successfully registered. I then tried to log in. Unfortunately, I got stuck on the first page. It wanted my legal name (is my middle name used on legal documentation?), so I logged out. I waited for my wife to wake up, since she has a better accounting of my life than I do. With access to my personal info at hand, I tried logging in again, only to receive a NEW red-boxed error message: "Unexpected error. Error ID:" (No error ID listed.) If there's a silver lining so far, it seems so many people are itching to sign up as soon as possible that they're crashing the system. Bigger pools are good for insurance, and this gives me cautious hope for its long-term prospects—presuming, of course, that I can ever log in again.
Steven Harris Scott
Ph.D. student, 35
George Mason University
My wife and I got married four years ago, at slightly above-average ages—I'm 35 and she's 32—so we have wanted to start the baby-making process for a couple years. A lack of money and health insurance has prevented us. She's worked part-time since earning her M.A. five years ago, mostly as an adjunct professor. I'm finishing my Ph.D. (we met in class!) and am still making grad student money. I've got health insurance through school but to add her would cost $6,000 per year—20 percent of our annual earnings! We need Obamacare so she can get affordable health insurance. We will literally start trying to have a baby the next day!
In light of this, I may have gotten my hopes up too high. I visited healthcare.gov at 12:36 a.m. on the morning of Oct. 1—minutes after turning 35! I was unsuccessful. The sign-up process got stuck on the security questions page. No problem, I'd try again later that day.
I remained unsuccessful the rest of the day—I tried at 10:30 a.m., and this time, I tried Live Chat but couldn't get through after waiting 20 minutes. I tried again at 4:45 p.m. because, well, I like to beat my head against walls sometimes! I tried a third time at 9:25 p.m., again seeing if Live Chat would work. It did! I explained my problem to "Kimberly" and got the following response:
Thank you for your patience. I do apologize for the inconvenience. Thanks for your interest in the Health Insurance Marketplace. We have a lot of visitors trying to use our website right now. That is causing some glitches for some people trying to create accounts or log in. You might have better success during off-peak hours, like later at night or early in the morning. We’ll continue working to improve the site so you can get covered!
That's about all I got from Kimberly. I will keep trying, at least a couple times a day until I get through. This is important enough; I don't mind beating my head against this very hopeful wall.
Small-business owner, 45
I woke up extra early on Tuesday to sign up for insurance through California’s health care exchanges. Even though I really wanted the single-payer system, I am willing to take whatever break I can get from the oppressive monthly premium I’m currently paying for my individual plan insurance ($617 a month, Blue Cross Blue Shield) and the surprise out-of-pocket expenses. I own and run a small business, but I didn’t qualify for a small-group plan originally because insurance companies require 51 percent of employees to be based in California, and only 50 percent of my employees are. (The other half lives and works in Washington.) When I added a second California employee, I looked into getting small-group insurance, but the cost was prohibitive.
The website opened 8 a.m. I expected the site to be inundated with traffic and somewhat slow, but I wasn’t expecting it to take 20 minutes just to create my account. I stuck it out and spent nearly two hours trying to get through the online application. Then the site went down completely.
Around 2 p.m. I went back to try again, and alas, my intermittent persistence pays off, and I complete the application in a stupefying 2½ hours. The site offered me 30 different plans in four different tiers and more than five insurance companies. The only problem was half of them weren’t branded, so I couldn’t see what’s Blue Cross or what’s Kaiser Permanente and so on.
The short story is I ended up contacting the coveredca.com staff via chat, phone, and even Facebook over the course of the day. While all they could really do is apologize and ask for my patience, they were all knowledgeable and courteous. Because there was so much traffic to the site, they were unable to access the system to complete my enrollment for me.
What I didn’t know is that eligibility is determined by tax-filing status, so I thought my significant other and I would be on the same plan, but we’re not because we’re not legally married and we file as “single.” He will have to get insurance on his own. It also means I don’t qualify for the subsidy, despite being the one bringing home the bacon at the moment. Even though I won’t get financial assistance, the most expensive plan they offer me is still 30 percent less than what I’m paying now.
I am still trying to enroll in a plan, so the adventure continues ...