Surge in healthcare shopping as Obamacare deadline looms

 

Key health care deadlines

Dec. 23: Enroll by this date to have health coverage effective Jan. 1.

Jan. 10: If you enrolled in a health plan to start Jan. 1, pay your first month’s premium by this date. Check with the individual insurer to make sure they offer this extension.

Jan. 15: Enroll by this date to have health coverage effective Feb. 1.

Jan. 31: If you are covered under the federally-run Pre-Existing Condition Insurance Plan (PCIP), enroll in an ACA marketplace health plan by this date.

Feb. 15: Enroll by this date to have health coverage effective March 1.

March 15: Enroll by this date to have health coverage effective April 1.

March 31: Enroll by this date to have health coverage effective May 1, and to avoid the penalty. In 2014, it will be $95 per person and $45.50 per child under 18, or 1 percent of your yearly household income, whichever is greater.


pborns@MiamiHerald.com

Christmas carols filled the Mall of Americas in Miami earlier this week as 10 insurance agents hunched over laptops connected to the Healthcare.gov. welcome screen. They all wore T-shirts that read, in English and Spanish, “Ask me about health care.’’

After a stumbling start that has proven a political embarrassment for the Obama administration, people are taking up that offer in growing numbers.

At the mall and other sign-up locations around South Florida, a surge of holiday healthcare shopping is underway — sparked by a Dec. 23 deadline to ensure coverage kicks in on Jan. 1, the earliest possible date. For most uninsured people, the final deadline to sign up without incurring a tax penalty is March 31.

“This weekend is going to be a madhouse,’’ predicted Odalys Arevalo, a co-founder of Sunshine Life and Health, whose agents have been enrolling five to 15 people a day this month at the mall off West Flagler Street. “People have been sitting on the floors waiting. We’ll have to get more chairs.”

Despite the increasing interest, the Obama administration late Thursday rolled out yet another revision to the Affordable Care Act. Bowing to pressure from both parties, Health and Human Services Secretary Kathleen Sebelius announced a limited “hardship” exemption to the individual mandate that has been a lightning rod for critics. The change will give millions of people whose previous and often less expensive plans were canceled a new option to buy bare-bones “catastrophic’ policies —without being hit with a tax penalty. Previously, that cheaper choice with minimal coverage had been reserved only for people under 30.

The administration estimated that about a half-million people could qualify for the hardship, but others estimate the number could be much higher. Florida Blue alone, for instance, issued 300,000 cancellation letters.

The restructuring — on the heels of other delays and the bungled rollout of the government’s healthcare website — was only the latest fodder for Obamacare critics.

“The Administration is recognizing the grim reality that more Americans have lost health insurance than gained it under Obamacare,’’ said Sen. Marco Rubio, R-Fla., in a statement. “Holding a fire sale of cheap insurance is not a responsible fix for a broken program.”

Even with the ongoing debate, more than one million Americans signed up for Affordable Care Act health insurance in the first three weeks of December — 500,000 of them enrolling through the federal exchange, President Barack Obama announced today.

At Doral-based Epilepsy Foundation of Florida, which received a $637,686 federal grant to assist with health plan enrollments around the state, Nini Hadwen, a trained navigator, summed up the activity:

“In a word, hectic. We’re enrolling about 10 to 20 people a day compared with the whole month of October. Some people are desperate to meet the deadline,” she said. One such client, a Miami man diagnosed with prostate cancer in 2013, had to mortgage his house and sell two cars to pay his medical bills. For him, coverage can’t start soon enough.

In Midtown, Borinquen Medical Centers extended its hours on Tuesday and Thursday and added Saturday hours to accommodate the crowds.

“We’re slammed,” said Borinquen navigator Jason Connor, who’s adding two full-time and four temporary enrollment staff members to help handle the load.

Although state and federal ACA enrollment websites officially opened Oct. 1, the now notorious technical failures of Healthcare.gov kept most people in 36 states including Florida from enrolling that month.

By October’s end, only 26,794 Americans had been able to enroll using the bug-ridden website, including fewer than 4,000 out of Florida’s 3.8 million uninsured. After around-the-clock repairs, enrollment numbers rose to 17,908 in Florida and 110,000 nationally in November, while another 1.9 million people were able to apply and determine their eligibility for a subsidy, according to the U.S. Dept. of Health and Human Services’ official count.

The botched launch did win consumers a reprieve, as the White House extended its original Dec. 15 deadline to Monday for most people to enroll in plans with an effective Jan. 1 coverage date.

Insurance companies also added an extension of their own this week, allowing those who enroll by Monday to pay their first month’s premium by Jan. 10 instead of Jan. 1. Most uninsured have until the end of March to enroll.

“It’s not the end of the world if you don’t complete your enrollment by Dec. 23,” said customer care director Carrie McLean of online health insurance giant eHealth.com. “You still have time to get out there and shop without fear of being declined.”

At the mall, many people seemed grateful for the chance to finally secure coverage.

Kettely Mesidor, a nursing home employee from Haiti, waited patiently with her income statements in hand. Why was she enrolling? Her partner Willem Muller, who accompanied her to help translate, said, “Because we have nothing. Because life is vicious for our family, and if you have nothing, anything can happen to you.”

Business was so brisk that Sunshine’s Arevalo passed around a paper bag of tequeños and papas rellenas — savory Latin pastries — for the agents, who didn’t have time to stop for lunch.

While the federal website has improved, Josue Arevalo, for one, wasn’t having such a stellar Healthcare.gov day.

“I’ve been kicked off six times,” the Sunshine agent frowned as he and 58-year-old Juan Hernandez worked on an application.

Although they’d been at it for two hours and counting, Hernandez, a chef at Salvatore D. Restaurant in Miami, wasn’t giving up. “Believe me, if you don’t have insurance, you’re dead,” he said.

The sole breadwinner for his household of four, he had put his son through college on $24,000 a year, just above the federal poverty line, but healthcare costs weighed him down: “It’s $50 every time one of us has a doctor’s visit, $350 for a specialist and $3,000 for a simple hospital visit,” he said.

Suddenly, his agent called out: “We’re enrolled!”

Hernandez had qualified not only for a subsidy, but also for cost-sharing assistance covering 94 percent of his out-of-pocket expenses. His Preferred Medical Silver plan will cover his wife, son, mother-in-law and himself for a $0 monthly premium with no deductible, and doctor's visits will cost about $15.

“When I first heard about Obamacare, I thought it might not be the best, but at least it’s something,” Hernandez said.

But now: “I love it. I’m a lucky man.”

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