Welcome to Obamacare’s Ground Zero

Who's winning, who's losing, and why.
March 9 2014 11:30 PM

Obamacare’s Ground Zero

Florida’s 13th congressional district may be where Democrats learn to live or die with the Affordable Care Act.

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Jackson can’t find the initial letter that broke her coverage, but she has spent plenty of time clicking around for a replacement, and she had the numbers down cold. “The closest one to my old plan was $129 a month and a $6,300 deductible,” she said. “Nothing is paid until you hit that deductible. So, what is the point of me paying 75 percent more with a triple deductible? They offered one plan that was right around the same price, $60, but the deductible was $7,000, and everything else was out of pocket. That wasn’t even close. And it didn’t even cover dental.”

Will some people benefit from the law? Sure. Her “boyfriend—now ex-boyfriend” had no insurance. He navigated healthcare.gov and found a plan. “Yeah, $53 a month—oh my God, this is awesome. Well, that may be great for people with crazy pre-existing conditions, but do you have that deductible? I don’t know anyone with $6,000 just sitting around.”

No one really knows how many Carie Jacksons there are in Pinellas. There are estimates of hundreds of thousands of canceled plans in Florida, generally—those are the numbers that appear on-screen in the TV ads from the national Chamber of Commerce. The Chamber has been relentless, focusing on Obamacare to the exclusion of all other issues: “Canceled plans, higher premiums, Medicare cuts, people losing their doctors.”

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Some of the other independent groups have gone granular. When the Congressional Budget Office estimated that millions of people would reduce their hours thanks to the health care law—a goal of both parties, for years—Republicans held it up as proof of incipient job-killing. Sink didn’t bite. Leaving a job because you no longer needed it to insure you was “an exciting prospect,” she said.

Trackers and the NRCC turned that into a campaign spot within microseconds. An #ExcitingProspect hashtag was born; a later ad made it look as if Sink called Obamacare itself an “exciting prospect,” as if any clueless person would.

Jack Hickman, 57, actually agreed with Sink. He was a software engineer until 2012, when he started to ponder early retirement.

“My wife challenged me about it,” Hickman said, after ordering a craft beer at the counter from Pinellas’ Rapp Brewing. “She said, ‘I’m ready to retire. Do you think we can do it? Do you think we can retire in our 50s?’ That’s when I got really serious. Knowing that you’re not going to have to pay more than $10,000 a year is a reasonable gamble. We made a moral choice. We invested; we saved like maniacs the last 30 years. And we retired. We live off capital gains and dividends.”

Hickman and his wife had it relatively easy. Signing up for new insurance, determining whether they’d get subsidies, meant plugging in details about their income. They could adjust their income, take what they needed in a year, without making the number so low that they’d grab the subsidies.

“We’re paying a couple hundred bucks a month to Aetna for a $10,000 deductible,” said Hickman. “We plugged that in and it worked. It was fine. It’s perfect! It’s perfect for retirees, for entrepreneurs, for people who hate their jobs, and are just doing them for the health insurance. I’m always amazed at the crap people think about it—you know, I don’t even think they’ve looked at the options. The year before, their premiums went up 15 percent. Now it goes up 10 percent and they’re like”—he shook his fist in a mock gesture—“goddamn Obamacare!

To Hickman it all sounds incredibly naive. He’s a registered Republican now, but he signed up mostly so he could cast a protest vote for Michele Bachmann. It seemed, two years ago, that the GOP had reached an insurmountable peak of farce. It doesn’t seem like that anymore.

“Marco Rubio came here on a campaign stop,” said Hickman, “put his arm around Jolly, and said: If you elect David Jolly to the House, he is going to come to Washington, D.C., and repeal Obamacare! I just about lost it. They’ve already repealed Obamacare, what, 35 to 40 times? That is the most insane statement, to tell everybody in Florida–13 that he is going to go to D.C. and waste everyone’s time.”

Not far from the microbrewer, next to a Starbucks, volunteers were making phone calls for Jolly. Barbara Stephens, a 78-year-old retired teacher and Republican activist, had a few minutes to talk about her own nightmare. She’s invited Jolly to Republican events, and determined that “he could be another Ronald Reagan,” what with his easy charisma. That makes her optimistic. Nothing about the health care law does that.

“I had United Health Care Advantage,” she said. “I’ve had to take out insurance for eyes, and teeth, and hearing. Advantage, for no cost, covered that. Now I pay $400. Can I afford it? Yes. But I’d certainly like to use that $400 for something else in my life, and not something I didn’t have to pay for before. The idea that we’re using our monies for health care for these illegal aliens, who are here illegally—that’s for the birds. I’m at an age where I’m expendable. Let’s say I got a terrible disease. Would I get any coverage? The death panel would probably decide—we’ll give it to them, not to her.”

Stephens leaned in to share her larger, encompassing theory of the law. Why would the Democrats get behind something so obviously kludged and doomed? What would possibly make him do that, even at the cost of hurting his fellow Democrats?

“I think Obama put this in to bring America down economically,” said Stephens. “Just like in Germany, so people had to depend on him totally. You get people so poor that they have to depend on the government. You’re probably too young to remember that.”

This wasn’t the end of Stephens’ theories—she had her doubts about the president’s religion, and his citizenship—but none of it was about health care. Paranoia like this frames the health care discussion, for some people, but not enough people share it to swing an election in a county like this.

So I left Pinellas for half a day. One morning, a short drive across the bridge, I joined a chipper and busy group of doctors and activists for what could best be called an Obamacare enrollment party. Members of Doctors for America, which claims 15,000 members across the country, were traversing Florida in a van decorated with enrollment slogans, to promote the law. In Tampa, they’d be joining Get Covered America, which is itself a product of Enroll America, which is a 501(c)3 founded to max out coverage by the March 31 deadline. The goal, nationally, was to enroll 7 million people by then. The most optimistic count of the enrollments by the end of February: 4 million.

Not good enough, not yet, but Florida’s reportedly bailing out the rest of the country. Any activist you talk to in Pinellas, anyone familiar with the numbers, can tell you that the state has signed up 300,000 people, and that this is a surge second only to California, which wasn’t cursed to use healthcare.gov, and that Florida didn’t expand Medicaid coverage to people above the poverty line.

I arrived at the enrollment party around 9 a.m., just when it was scheduled to start. The health center was right off I-275, where the roads open up into strip malls and housing to serve Floridians who are barely making it. People wait for the bus here, in a city that doesn’t run them around the clock. People walk to the corner store, though the corner is an embankment en route to another highway. The health center is located on the nicest and best-paved lot, which is being decorated by ambitious volunteers who imagine a full, fun, inspiring day of sign-ups. On the way in, one Get Covered worker is putting together a sort of instant Skee-ball set. Inside, a table is piled high with fresh fruit, provided gratis; another table shows off some sensible kitchen tools that will be raffled off as the day proceeds.

All that’s missing is a crowd. The Doctors for America and the Get Covered helpers—clad, respectively, in smocks and in maroon shirts—vastly outnumber the walk-ins. Twenty navigators sit behind laptops, ready to help people research their options, and for a half hour only a couple of them find takers. After 44-year-old Kristal Williams gets up from her table, a member of Doctors for America brings me outside, to meet her. Williams, she said, is a prime example of the people who’d have coverage if the state would only expand Medicaid.

“I was trying to see if they had insurance that would help somebody that actually don’t have a job,” said Williams, who had moved from Orlando to Tampa a few weeks earlier. She wore a bedazzled red sweatshirt and gray sweatpants. “I don’t have a steady income to pay for insurance. I learned about the expansion, but I guess I don’t qualify.”

I thought the people with Doctors for America had already told her, but to be safe I repeated it: Florida hadn’t expanded Medicaid.

“Oh, OK,” said Williams, visibly perplexed. “Oh, wow, they should. There’s a lot of people out here that needs, and I know I need it. I have to have back surgery. I’ve needed it for about three years. I have sciatic nerve damage and I have scoliosis in my lower back. It’s mild to moderate right now. They want to fix all that up before it gets worse. I have carpal tunnel in both hands, which has gotten really bad. Sometimes my fingertips turn like a slight blue because I guess whatever is going on here and here. I’m bipolar. Paranoid schizophrenic. So there’s medication I have to take for that. I can’t yet. Even though I’m not on it, luckily, my friend, he paid for it for me, but I had to go in the mental hospital. They asked me how I’m gonna pay for it, I said, who? I have no money and I have no insurance. And then I have high blood pressure. I have to take medication for that.”

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