Less than 100 days away, beneficiaries start to take notice


Dedicated to affordable, quality healthcare and coverage for all Americans.

By Consumers Union on Friday, June 28th, 2013

Less than 100 days remain before the new Affordable Care Act’s (ACA) state Marketplaces open their doors for people to apply for health insurance coverage. The nation remains split on opinions about the ACA, with many even unaware that the ACA is the law of the land. Americans don’t understand the benefits of the ACA, what the new Marketplaces will do or who they will help.  But once people know that the upcoming new Marketplaces can help them get affordable health coverage, support for the ACA rises.

I’ve realized that there are probably a lot of people I know personally who will directly benefit from the new Marketplaces – they just don’t know it yet.  One such example is my hairdresser, we’ll call him “Jeff.” A couple of weeks ago I visited Jeff for my semi-annual cut.  I was getting over a cold, so happy to close my eyes and relax, not talk, and just indulge myself a little bit.  About five minutes after I sat in the chair, Jeff says to me, “I know you’re not feeling well, but I’m dying to hear about the health insurance.”  He’s hungry for information.

Jeff buys his own health insurance on the individual, non-group market.  He is self-employed, makes good money and is more than willing to pay reasonable insurance premiums. But today Jeff pays more than $1,300 per month for his current coverage.  Hence his enthusiastic hope that I may have a sprinkle of good news to tell him about how Obamacare may make his life a little bit easier.

Until now, to get health insurance, Jeff had no trusted place to turn to for help.  He had to figure out who might sell him insurance by just randomly looking online for insurance companies, landing on websites run by groups of insurance companies or brokers who really wanted his business (or not).  He then would apply for insurance and keep his fingers crossed that they would offer him coverage, because he has a pre-existing condition (until January 2014, insurers can refuse coverage because of your health status).

The good news for Jeff is that under the ACA, starting in October of this year, he will be able to go to the new insurance Marketplace in California to learn about, apply for, and enroll in health insurance.  He won’t be denied coverage because he has a pre-existing condition.  He won’t be able to be charged more because he has a pre-existing condition.  And he won’t pay anything near $1,300 per month!

We talked about a strategy for what he could do. He could call his physician and ask if she participates in any of the new plans offered on California’s new insurance Marketplace “Covered California.”  He could talk to the pharmacy to be sure that his regular medications will be covered under the plan formulary.  And, he could tell all his friends who are self-employed or freelancing the good news about the ACA!

— Julie Silas, Senior Attorney in our California office, who has been collecting stories from her family and friends about the benefits of the ACA

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