Just Before Six: Will Obamacare hurt you?


It has been more than a month since the launch of the health insurance exchange website but many are still left in the dark when it comes to their options. Millions of people have been unable to sign up for coverage due to glitches on the site.

The technical difficulties are only part of the story. January 1, 2014 is fast-approaching and it is a date that will bring major changes to the healthcare industry because aspects of the Affordable Care Act, also known as “Obamacare”, go into effect.

The main question on many people’s minds is: “Will Obamacare help or hurt me?”

It depends on who you ask.

Over the next three days, WNDU will introduce you to people who are trying to figure out their health insurance situation with the Affordable Care Act in place.

While there has been much debate about the implementation of the Affordable Care Act, there is an aspect that most people feel is a positive move. The ACA prohibits insurance companies from denying coverage to people with pre-existing conditions.

Kathy Walther had not worried about insurance before because she was getting coverage through her husband’s employer. But, now the couple is gearing up for some life changes.

“He wants to retire,” Kathy said.

While her husband’s age makes him eligible for Medicare, Kathy still has a few years to go. She has faced some added challenges in the past while applying for health insurance because of problems with her liver.

“I called and put in an application but was denied because of a pre-existing health condition,” she said.

So, she thought logging on to healthcare.gov, the website for the federal health insurance exchange, would give her new options.

“It took us many days, probably a couple of weeks, until we finally got on,” Kathy said. “It would just say it was overloaded, and then we finally got on and we filled out my profile. We pressed the button and it came back and said the identity was not recognized.”

Kathy said maneuvering the website is almost as confusing as the law itself.

“I think people are confused about the overall application process that it takes to complete the application and determine eligibility,” said Sondra Gardetto, manager at Health Insurance Services, LLC.

Gardetto’s office was set up to help people sign up for coverage on the health insurance exchange. But, the glitches on the website have left her mostly answering questions, instead of enrolling people.

Gardetto said plans available on the website will be open to people like Kathy despite pre-existing conditions. Plus, folks in their 60’s will likely see a price break.

“The premium prices for somebody between 60 and 64 are not going to be as much as it would have been three months ago if they paid for their own insurance,” Gardetto said.

Those who already get insurance through their employer don't need to worry about the marketplace. But, they will see some changes like no lifetime limits on benefits.

If their employer coverage premiums are too high -- they do have an alternative.

“If it is deemed to be more than 9.5 percent of their income then they can get insurance in the marketplace because it's a cost issue,” Gardetto said.

By applying through the website, people can check their eligibility for tax subsidies to help pay for their insurance coverage.

For Kathy, though, it is about getting coverage period.

“I couldn’t get insurance and I want it,” Kathy said. “Now, I can. That is a plus for me.”

The Affordable Care Act is helping Kathy get access to healthcare. But, there are some getting cancellation letters from their insurance company.

Prior to the ACA, insurance companies were allowed to offer “bare-bones” coverage for low prices. Now, these same insurance companies will be required to provide essential benefits outlined by the federal government like preventative care. So, certain companies are cancelling the very basic coverage plans since they do not meet the requirements and offering their customers other plan options that could be more expensive since they include more benefits.


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