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Local insurance seekers eye marketplace with optimism, caution

Published: Saturday, Oct. 19, 2013 11:25 p.m. CDT • Updated: Sunday, Dec. 8, 2013 11:27 a.m. CDT

(Continued from Page 2)

CRYSTAL LAKE – Holly Thurston and Jeanie Sandore have been waiting for October.

After losing their jobs around the same time a few years ago, the two have been going to informational meetings and workshops about the Affordable Care Act, hoping the coming changes in the law would help them.

By the time they sat down at an Oct. 2 informational meeting at the Crystal Lake Public Library, the question no longer was whether they would sign up for coverage through a government-regulated marketplace, but how they would sign up.

“I’ll definitely be signing up through the marketplace, and I am glad it is finally available to people who have lost their jobs or have pre-existing conditions,” Thurston said. “I think it’s a great idea.”

Thurston and Sandore are two of roughly 814,000 of Illinois’ 1.8 million uninsured expected to take advantage of the government marketplace, according to health care researchers at Robert Wood Johnson Foundation.

The Affordable Care Act, signed in 2010 with provisions being phased in through 2020, will make health care more accessible and affordable while requiring most Americans to have insurance and businesses with a certain number of employees to offer it or pay a fine.

Estimates show that 32,058 McHenry County residents under 65 years old are uninsured, according to the McHenry County Health Department.

The Health Insurance Marketplace, or Exchange, opened Oct. 1. It’s a website that will serve as a central location for residents and small businesses to compare and choose from dozens of insurance plans. Coverage will kick in Jan. 1.

Sandore said the website – www.getcoveredillinois.org – had an overwhelming amount of information and was difficult to access and navigate during its debut Oct. 1. Through only two days, the website had more than 230,00 visitors and nearly 800,000 page views with more than 5,000 applications submitted.

The high traffic caused glitches and down time, Sandore said.

“I’m holding off for a few weeks before buying any insurance,” she said. “It’s a little crazy right now.”

The policies are divided into four levels – bronze, silver, gold and platinum – that offer different levels of coverage and services. The Exchange aims to get thousands of uninsured residents health insurance coverage; depending on income, some people will get subsidies to help offset costs, while others could be enrolled in Medicaid. Anyone can use the Marketplace to look for insurance, but not everyone will qualify for subsidies.

Some of those with insurance remain skeptical of how helpful the new law will be and are concerned it could be a burden for employers who already offer benefits.

Crystal Lake resident Sean Gilmore said he already has seen rates start to creep up and believes the scope of running a health insurance marketplace will be too daunting for state and federal governments.

“I know it’s already affecting rates as well as deductibles,” Gilmore said. “I’m concerned it is going to change a lot of things and not for the better. It will only cause more problems, and they will only become more difficult to address.”

Some concern stems from the possibility that young people will not buy health insurance in large enough numbers to subsidize the older population in the system. Those who choose not to carry any insurance face a $95 fine the first year – cheaper than health plans – but those fines increase with each passing year.

Jessica Palys, a faith initiative director at Campaign for Better Health Care, said she believes young, healthy people who do not have insurance would still be inclined to buy a plan through the Marketplace because it offers preventive benefits.

She said it also helps that the government provided a $500,000 grant to educate and inform residents about the changes to the health care law and assist people in signing up for a plan.

“We definitely want young people to get into the system, and I think they will as they learn more about it,” Palys said. “For those who don’t, after the first year of paying a fine they will likely decide to get insurance anyway because it is going to be cheaper.”

Senior citizens such as Harold Collier are just as on the fence about the new law as many younger residents. He said he is not sure how rates will shake out over time and is not sure how it will affect what his company provides.

Should someone such as Collier who receives insurance through an employer decide to buy through the Marketplace, fines would apply. Palys said there are disincentives built in to encourage those who have access to health insurance to pursue that option before the Marketplace.

“It’s so new I just want to learn how it is going to work,” Collier said. “I don’t know if it is going to affect what my employer offers, but it seems like it might.”

For those who have an early start on buying insurance, the plans will not take effect until January.

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