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HealthBeat

Tales from the front: enrolling in Obamacare in New Hampshire

Despite Obamacare’s rocky rollout, almost 17,000 people in New Hampshire had signed up for health insurance through the federal exchange by Feb. 1.

Many received subsidies to help pay for coverage, and they say the financial help – and their peace of mind – more than make up for the headaches of enrolling.

But the headaches were plenty – with the website, with the technical difficulties and with Anthem Blue Cross Blue Shield, the only insurance company selling plans on New Hampshire’s exchange this year.

And for many people, they’re not over yet.

Uncertainty looms

Headaches – technically, a neuropathic itch – are exactly why Lyn Betz of Bradford was eager to sign up for health insurance through the exchange. The itch is a side effect of the tumor removed from the base of her brain four years ago.

Betz is an interning minister at the Unitarian Universalist Church of Concord and doesn’t have employer-sponsored insurance.

With insurance companies hesitant if not hostile toward writing policies for her, she’d have to wait 10 years from her first clean MRI to get a plan on the open market.

“That’ll be 2020. That’s just too long to go without insurance. I’m 52. There’s a decent likelihood I will need health care before then,” she said.

When she quit her full-time job in 2011 to go back to school, she got insurance through the state’s high-risk pool. She expected to transfer to the exchange when it opened this year.

She sat down at her computer right after the website went live last October.

“I quickly surrendered,” she said. “I watched the news for signs that the website was working before I tried again.”

When she did, in November, her application went smoothly. A snag over entering her sons’ names was resolved with a quick phone call. Her new plan is about $540 a month, instead of the $700 she was paying last year.

It looked like blue skies ahead, she said, until Jan. 1 came and she didn’t have her new insurance cards.

She had medication she needed to pick up, and no proof of coverage to offer the pharmacist.

The medication can’t eradicate her neuropathic itch, but it does help, she said. While she waited first for her insurance cards and is now waiting for Anthem to approve her prescription – it’s not on the covered formulary – she pays $100 a week out of pocket.

“I do kind of resent the fact that in order to get a medication approved, you have to go backwards and prove that you’re unhealthy on other meds. I’ve already tried everything under the sun, and I expect they will approve it. But it irks me to think I will have to pay for all the weeks that my appeal was sitting in the backlog,” she said.

She expected some hassles, the kind that happen whenever you switch insurers. She just didn’t expect the hassles to be quite this hard.

“I dissolved in tears the day before yesterday, on the phone with Anthem,” she said last week. “When it’s your health, when you’re uncomfortable, and you’ve got somebody on the phone who can’t answer your questions, that was a definite low moment of feeling like I was up against a corporation that was much more concerned with their bottom line than with my well-being.”

She doesn’t know yet if her doctor will take the Anthem plan, which uses a limited network that doesn’t include Concord Hospital or its physician practices.

She doesn’t know if she’ll get reimbursed for the weeks of paying out of pocket for her prescription, and she doesn’t know if she’ll have to go through this all over again when she – hopefully – gets employer-sponsored coverage at a Maine church this fall.

She hesitated before answering when asked if the $200 a month savings was worth the fight.

“It’s all very exciting, that’s what I keep telling myself. I’m doing a job I completely love, and I wouldn’t have gone back to school if I didn’t know this coverage was coming. But it still feels, to me, like tweaking a bad system. I don’t think the Affordable Care Act goes far enough, because I’m a firm believer that healthy people are a social benefit that’s worth paying for with our tax dollars.”

‘Time to breathe’

Keri Wolfe, 27, didn’t start looking at HealthCare.gov right away when it went live in October. She was hoping the state would expand Medicaid to healthy low-income adults, as allowed under the Affordable Care Act, and that she might qualify for health care that way.

Despite working and volunteering between 55 and 60 hours a week teaching history and writing courses at NHTI and Granite State College and providing child care, she was making just above the federal poverty limit last year, she said.

When a special legislative session failed to reach a consensus on an expansion plan in late November, she sat down to enroll in an Anthem plan on the exchange.

By then, the technological kinks had been worked out and the one glitch she ran into was solved with a 10-minute phone call to a government hotline, she said.

Her premiums went from $680 a month – more than her rent and heating bill combined – to $66.

“It’s been a godsend. My car needed a significant amount of work at the beginning of February. I was barely breaking even in the fall. With the car troubles, I would have been really bad,” she said.

But, she said, “it’s been a little bit of a different story dealing with Anthem. They clearly had some backlog. It sounded like they were not quite prepared to handle the rollout.”

The company lost her check paying her first premium, so her coverage was delayed. Like Betz, she didn’t have the insurance cards she needed to get her prescriptions covered in January, but with a pre-existing endocrine disorder, she couldn’t wait. So she has her receipt and she’s waiting for reimbursement, without any sense of how long it could be.

And like Betz, she’s happy to be doing work she loves, even though it’s work that doesn’t come with health insurance.

“This is where I was hoping to be,” she said. “Having my current coverage, it will afford me the opportunity to start saving and even to start considering changing my life that drastically” by settling down or starting a family.

“In my current state, how I’ve been living with the added health care costs, that hasn’t been something I could even consider. I haven’t had enough of a financial back-up. This will allow me to plan, to take some time to breathe and re-evaluate.”

‘Nightmarish’

Kurt Steelman is still waiting to exhale, waiting for word that his family of four will have health insurance this month.

“It’s been a nightmarish time trying to make this all work,” he said.

After logging on Oct. 1 and spending an hour going around in circles while the pages tried to load and kicked him out, he waited until after the new year to try logging on again.

That time, the system deleted the entire profile his wife created for their family, which is in Keene. After she re-created it and the government system sent a letter approving them for a subsidized plan, Anthem contradicted the letter, saying the family doesn’t have approval yet.

“So we’re probably going to live the month of March without insurance,” he said.

With two sons ages 12 and 7, not having insurance during snowboarding season is “not a very welcome thought.”

He’s going to keep working to get through the bureaucracy, though. He and his wife both run their own businesses, one a concert production company and the other an event rental company.

The plan he thought he bought from Anthem was $774 a month. Last year, they were paying about $1,200 a month for insurance – “just slightly less than my mortgage.”

“It gets to the point that you’re working just to pay the insurance policy,” he said.

“I won’t give up. It’s a typical government agency,” he said. “If it comes through, I’ll be impressed, but at the moment, I’m not very impressed.”

(Sarah Palermo can be reached at 369-3322 or spalermo@cmonitor.com or on Twitter @SPalermoNews.)

This article has been corrected as follows: Lyn Betz had a non-cancerous tumor at the base of her brain. It was incorrectly described in an earlier edition.

Legacy Comments10

Monitor - after the March 31 deadline, it would indeed be interesting and instructive to see what the net change is in number of people with health insurance. What happened to those who "lost" their insurance? Why were those policies cancelled? How many were cancelled because they weren't compliant, and how many because they simply didn't make enough money for the insurance companies?

People who "lost" their policies have been able to sign up for others, on or off the exchange. Those policies were ones that violated the guidelines under the ACA, such as by capping yearly or lifetime benefits -- which translates to taxpayers subsidizing the costs of care beyond the insurance. Republican interference with the law's implementation has helped to cause the problems. States that set up their own exchanges have had more sign-ups and less problems than NH. It is and has been Anthem's failure, not the government's, nor the law's, when it comes to problems with enrollment.

One has to ask the obvious. If you cannot handle enrolling folks, how the heck will you implement their plans? Something as simple as mailing out insurance cards is an issue. Leaving folks hanging about what drugs will be covered is another issue. This woman pays 100 a week for her drugs now and that is a partial payment. Those drugs she is on could cost 300 a week if they are not on Anthems list of drugs covered. The ACA does not dictate what drugs an insurance company has to cover. And the Cap does not apply if you go out of network. If I was to buy anything and right from the start there were problems, I would be inclined to go elsewhere and hopefully get a firm that provides better service on all levels. In NH you have Anthem. Otherwise known as a monopoly. So basically like the Cable Company with a monopoly, they will start out with great deals, then down the road they will change their packages. When that happens you pay more. Do you actually believe that Anthem is doing this out of the goodness of their hearts? They are an insurance company. They made a deal plain and simple. But the obvious fact that folks are lured by the price and have no clue what is in these plans, is astounding to me. Especially the fact that we are dealing with insurance, and we all know how insurance companies manage to hide everything from the consumer. You find out when you need the insurance what is actually covered.

I'm the woman paying $100 a week out of pocket - it's the full price. And I had no choice but to find insurance through the ACA eventually; I was covered by the NH high risk pool which will be discontinued in June. I am not able to buy insurance on the open market. Hopefully next year other companies will join the market and there will be some competition for Anthem. This is why our health care system should not be run by for-profit companies; I believe it is immoral.

Of course you could have purchased coverage on the open market. Anthem may be the only company offering insurance through the exchange, but there are other companies offering coverage off exchange. For the same price you are paying with Anthem you could have purchased a plan with another carrier that would have given you an instant approval. You would also have received a policy # and ID cards within a matter of days. AND, you would have access to a full open network that includes every hospital in NH and most, if not all of the major hospitals in Boston. Before commenting that you had no other choice but to purchase Anthem, you should have done a little more research and that there are alternatives out there.

When is the Monitor going to start reporting all the facts instead of slanted articles purporting to be news? This article starts with the comment that 17,000 signed up for Obamacare. However, the reporter neglects to mention that 22,000 NH citizens had their insurance policies cancelled. Granted, Anthem gave folks a week and a half to renew their old policies after the outrage but the Monitor has failed to report the net results. So far, it appears that, as a result of Obamacare, 5,000 fewer people in NH have health insurance. Nor is there any comment about the socially irresponsible act of Ms. Betz who quit her full time job and now wants the rest of us to subsidize her health care. Seems as if all the stories reported in this article involve reduced premiums as a result of subsidized health care.

You nailed it capthall! The sad truth is that government is punishing those of us who have made choices that made sure we had insurance and are subsidizing others to get small policies, quit their jobs and not work as hard, etc. It is like government came in and said: "YOU have had it too good because you have had insurance and health care, so in fairness, you will now pay more so that John next door can have health insurance and OH, by the way, you will now get less coverage so that everyone is equal and you will stand in line behind John. You are correct, the Monitor is dredging for positive stories. Imagine if Medicaid kicks in? Now you will be paying for those folks after the feds are long gone and pull back from subsidizing the state. The UCA (unaffordable care act) is truly unfair to responsible people and overly coddles those who made poorer choices.

I fail to see how it is socially irresponsible to go back to school in order to improve your lot in life. According to you, once someone's got a full time job they should never back out of it - even if leaving work for a while means making more money in the long run or, God forbid, doing some kind of work that actually makes them happy. I'm sure that whatever job Ms. Betz left was probably filled pretty quickly, possibly by someone who didn't have health insurance. Or at the very least someone in the chain of job-changing dominoes left the ranks of tax-payer supported insurance, so it probably evens out in the long run. I also agree with her - the ACA does not go far enough. We need single-payer, tax-supported insurance for all. I say that as someone who currently has affordable employer- supplied insurance, and knowing it might cost me more in the long run to support others.

How many people have held day jobs and went to night school to get their degrees? How many people have worked their way through college? It is not irresponsible to go back to school to better your lot in life. It is irresponsible to ask the rest of us to subsidize your life so you can do it.

capthall - the article says she's 52 and she has kids. How long do you think it would take to go to get her degree if she continues to work full time and take care of her kids? Maybe she'll get her degree when she's 60. It also says she's doing an internship. You can't do a decent internship and work at another job full time. I understand the principle you're standing on, but individual circumstances often do not fit the neat mould you're offering.

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