One 47-year-old cancer survivor thinks the Affordable Care Act could save her life. But a 28-year-old real estate agent sees the law requiring health insurance for everyone as a safeguard he doesn’t need. And for an immigrant nursery worker in southern Miami-Dade County, health insurance is a luxury she never thought she could afford — and is afraid she still can’t.
South Floridians are sifting through information about the most sweeping social program to affect Americans since Congress enacted Medicare in 1965. How will the law, with all its complexities, affect them? For many, the most important question to be answered is: How much will it cost?
One group the Obama administration hopes will sign up for health insurance in the new marketplace opening next month are young adults between 19 and 34, the so-called “young invincibles,” whose attitude about health insurance was presumed to be: “It won’t happen to me.”
But a Kaiser Family Foundation poll finds that more than three-quarters of young adults regard health insurance as important. Carmella Guiol is one.
“I’m worried because in a few months I’ll no longer be on my parents’ health plan. I’m using the time I have left to go to the doctor as much as possible,” says Guiol, 25, who makes preserves and raises chickens at her Coconut Grove home. The Affordable Care Act enabled Guiol to remain on her parents’ insurance plan after college — but that benefit ends when an adult child turns 26. Now, under the latest provision of the law, she’ll be able to sign up for individual insurance on the marketplace.
“My only alternative would be not to have health insurance,” she said.
She hopes the health plans on the new exchange will be compatible with her preference for alternative treatments, a preference shared by four in 10 Americans, according to the National Institutes of Health. The ACA encourages those benefits with a clause requiring insurance companies to reimburse any health provider with a state-recognized license. Cigna, for one, will cover the treatments when they’re medically necessary and offer a discount program for people who want to use them to maintain their health, a company spokesman said.
Accidents or sudden illnesses concern two-thirds of the young invincible age group, according to Kaiser. But Guiol — who has worked as a farmer, a baker and a nanny, all without an employer health plan — doesn’t have hundreds of dollars a month to spend on coverage.
Her income may qualify her for a federal subsidy. Subsidies will be offered on a sliding scale for those between 100 percent and 400 percent of the federal poverty level. The poverty level is $11,490 for an individual and $23, 550 for a family of four.
Guiol is also considering enrolling in a catastrophic plan, available for people 30 and younger. Under the healthcare law, such a plan would cover essential health benefits, but only after out-of-pocket cost sharing reaches a high deductible. Her backup plan? Having a French father, she was able to obtain a European Union passport to have access to European healthcare.
But other “young invincibles” aren’t so interested in spending money for insurance. At 28, Edward Escobar has been uninsured for two years, but not for lack of funds. “The idea of just giving away my earnings to an organization that doesn’t have my best interest at heart isn’t a good definition of using my hard-earned money wisely,” said Escobar, a Miami real estate agent.