Rolling out Obamacare

For years, Chico resident Dorothy Lee had no health insurance. Employed as the office manager of a business that was too small to provide coverage, she earned too much to qualify for Medi-Cal, was too young for Medicare, and couldn’t afford to purchase expensive individual insurance.

When Lee became ill, she went to prompt-care clinics and paid cash. She worried constantly that one day she might need hospitalization, which would destroy her financially.

She was, in other words, exactly the kind of person the Patient Protection and Affordable Care Act, otherwise known as Obamacare, was designed to serve. Covered California, the quasi-governmental agency implementing the program in this state, estimates there are more than 100,000 people like Lee in rural farNorthern California.

A widow who is now 53 years old, Lee was fortunate that she had no medical emergencies. “I’m lucky to be in good health,” she said during a recent phone interview. “I take care of myself.”

When Obamacare went into effect in California, Lee was quick to take advantage of it. She saw a newspaper ad for an insurance agent, Bruce Jenkins, a certified Obamacare adviser who offers free consultation. She called him up.

With his help, she went to the Covered California website and plugged in her income figures. To her delight, she discovered that she was eligible for subsidies that enabled her to obtain “an amazing Anthem/Blue Cross plan” for $143 per month.

Negotiating the system involved “a little back and forth,” she said, but it was easier than doing her taxes.

One of the lesser known aspects of the Obamacare rollout in California is that thousands of independent insurance brokers have taken the training that qualifies them to assist people in signing up. There are 46 of them just in Chico. They’re paid on commission, so there’s no cost to the client.

In Butte County, signing up is relatively easy because only two companies—Anthem/Blue Cross and Blue Shield—offer plans in this area.

Jenkins, who has a law degree, would stress the word “relatively.” Before Obamacare, when a client wanted to purchase a policy, he would go directly to the insurance company. Now, because of the subsidies offered, he first has to go through Covered California.

“This is a new agency that has never handled insurance that’s staffed by new people,” Jenkins said during a phone interview. It’s been frustrating at times, he said, especially when certain sign-up deadlines are nearing. “At the end of December, I had to get up at 4 a.m. [in order to beat the crowd using the Covered California website].

“It’s a pain in the ass for everybody,” Jenkins continued, “but it’s a great thing. People finally have health insurance they can afford.”

Some of his clients’ earnings are less than 138 percent of the federal poverty level, which qualifies them for the expanded Medi-Cal program that is also part of the Affordable Care Act. He refers them to the county Employment and Social Services Department.

Statewide, twice as many people are qualifying for expanded Medi-Cal than are signing up for insurance, said Arlene Hostetter, the department’s assistant director in charge of Medi-Cal eligibility. Statistics released last week show that, while more than a half-million Californians had enrolled in insurance plans as of Dec. 31, 1.2 million had qualified for expanded Medi-Cal.

On Friday, Jan. 31, Covered California released data for Region 1, the 18 counties in far Northern California, including Butte. As of Dec. 31, 2013, 19,732 people in the region had signed up for insurance, with 17,723 of them being eligible for subsidies. Data regarding the number who had qualified for expanded Medi-Cal were not available, but it’s safe to presume that it was considerably higher.

“The technical part has been challenging,” Hostetter said during a recent phone interview. The county got off to a rocky start when its computer system’s connection with Covered California was nonexistent at first and later unreliable. Eligibility workers turned to taking “old-fashioned paper applications” and later entering them into the system.

It’s gotten much better since then. “This will work,” she said. The problems are a matter of degree only. “The wonderful thing is that I’m totally committed to getting health insurance to people. I’ll be telling my grandchildren about this. It’s historic.”

Roy Kennedy is the spokes-man for Covered California. From his perspective, the rollout of Obamacare has gone “relatively smoothly. It’s not a perfect system yet, but it’s doing well.”

The agency is also happy with the turnout of young people. They’re signing up “at a rate consistent with their population,” he said. This is important because they will need less medical care and therefore will cost less, thereby subsidizing older people, in a modern version of taking care of one’s elders.

Kennedy agrees that insurance agents are a good way to go, and notes that a list of qualified agents, organized by zip code, is available on the Covered California website (CoveredCA.com).

The final deadline for signing up this year—March 31, for coverage beginning May 1—is fast approaching. Those who fail to have insurance by then will pay a penalty at income-tax time, $95 or 1 percent of their reported income, whichever is more.

Meanwhile, Dorothy Lee is waiting for her insurance card to arrive in the mail. As Jenkins and others have noted, the insurance companies can be frustratingly slow at processing sign-ups. But Lee is unfazed. “Everything has its quirks that you have to iron out,” she said philosophically.

What matters to her is that for the first time in her adult life she’ll enjoy health-care security. As she put it, “I know I can get care without having to pawn my wedding ring.”

Independent reporting for this story was made possible through a grant from HealthyCal.org.