Cover Oregon
6:20 pm
Thu November 7, 2013

Health Insurance Freak-out: Time To Take A Deep Breath?

Credit NIH
Clearing up health insurance confusion

The end of the year is approaching, government health care websites are failing and people across Oregon are anxious about how the new health  care reform law will affect them. Jefferson Public Radio’s Liam Moriarty reports there’s cause for concern, but there’s no need to panic.

It seems every day brings new stories about glitches in the new health care law. It’s complicated, people don’t understand it, and with the clock ticking on a January 1st deadline, a lot of folks are kind of freaking out. John Gridley runs an insurance agency in Roseburg, and he‘s been hearing from these people. Gridley has plenty of issues with the new law – we’ll get to that in a minute – but he also has a word of advice …

John Gridley: "I think they need to take a deep breath. We’ve got 10 agents here and we’re spending all day every day calming people down."

First off, if you’re among the roughly 30 percent of Oregonians who get their health insurance through the workplace, you don’t have to do anything; the new law doesn’t directly affect you ...That is unless you work for one of a handful of employers who plan to drop their coverage and give their workers money to buy their own policies. The grocery chain Trader Joe’s says it’ll do that for its part-timers.

Likewise, if you’re among the 35 percent of folks in Oregon covered by Medicare or other government programs, your coverage won’t be affected either. On the other hand, people without health insurance, or who want to take advantage of the subsidies now available, will want to check out the state’s new insurance exchange. It’s called Cover Oregon.

The Cover Oregon website was meant to make it easy to compare plans, calculate subsidies or tax credits you might be eligible for, and to enroll in the plan of your choice. That last part hasn’t worked out so well … Cover Oregon spokesman Michael Cox …

Michael Cox: "We know that many Oregonians have been frustrated about not being able to enroll online. And we at Cover Oregon are frustrated, too."

That glitch in the website means you can shop for insurance, compare plans and get an estimate of your out-of-pocket costs. But if you want to enroll, you’ll need to print the form, fill it out and mail it. That may be disappointingly low-tech, but Cox says it’ll do the job.

Michael Cox: "We have a system in place to enroll all Oregonians who want coverage by January 1st.  And we’re gonna make sure that every Oregonian who wants coverage at the beginning of the year gets it."

To help you navigate the intricacies of enrolling, Cover Oregon has lined up what it calls “community partners” to walk you through the process, for free.

Erin Scow works for the non-profit Community Health Center, one of those  “community partners” in the Rogue Valley. The group provides health care to low income people and the uninsured. And it’s been doing a booming business signing people up. Scow says the new coverage will make a big difference to her clients.

Erin Scow:  "A lot of them have been holding off health care for themselves because they’ve  needed to take care of their family or other things have come up. And I think this will help them get more healthy, happier. They’ve been in a rough spot for a while, and those people that it’ll help, it’s gonna be huge to them."

Meanwhile, back in Roseburg, insurance agent John Gridley is helping other people find their way through the health care maze. One major issue is clients whose individual plans are being discontinued at the end of the year because they don’t meet the new standards under the Affordable Care Act. Gridley assures those clients that they’re not being dropped cold.

John Gridley: "The companies automatically roll them over to one of the new plans that’s closest to them. So as long as they can afford the premium, they’ll still be covered January 1st."

Of course, that’s the rub. The new standards require higher levels of coverage, and that means higher premiums, sometimes a lot higher. According to the Oregon Department of Consumer and Business Services, there’s about 145,000 Oregonians in that situation.And John Gridley says the new standards don’t necessarily mean better coverage. One example?

John Gridley:  "Now we have to add pediatric dental to any plan. Doesn’t matter if the person is 60 years old and doesn’t have any teeth, they have to buy pediatric dental for about 25 dollars extra."

Gridley has chosen not to participate in the state exchange. He’s focusing on folks willing to forgo the subsidies and pay full price. He says for many of his clients, the subsidies don’t amount to a lot, anyway ...

But despite the hitches in the health care roll-out, Oregon officials say the new law will bring long-overdue relief to hundreds of thousands of state residents. Speaking at a fund-raiser for the Community Health Center in Medford this week, Dr. Bruce Goldberg – head of the Oregon Health Authority – said by 2016, the state expects to extend coverage to half a million previously-uninsured people.

Bruce Goldberg: "We’re gonna be able to go from a state where 17 percent of our population doesn’t have access to basic health care to where 4 to 5 percent don’t have access to basic health care. This is going to have a huge effect on our communities, and on people in our state."

In an interview afterward, Goldberg said it’s important to put the new health care law’s growing pains in their historical context.

Bruce Goldberg: "This is the biggest change in health care in our nation in 50 years, since Medicare and Medicaid in the early ‘60s. I think we’ve got to understand it in that perspective and work through this and I’m convinced certainly Oregon can get it right."

Bringing the goal of a fairer, more inclusive health care system to reality is the long-term challenge. In the meantime, if you’re among the folks who are looking to arrange for new health insurance, best get going. The state has hired a slew of workers to process all those paper applications, but it’s probably not wise to wait till the last minute.  

Links to health insurance resources:

Cover Oregonhttp://www.coveroregon.com/   

Community Health Center (for help applying to Cover Oregon): http://www.communityhealthcenter.org/    

First Choice Health Insurance (John Gridley's info site to calculate costs and subsidies): http://www.ehealthlink.com/individual/oregon-health-insurance-plans-2014.aspx