The Enid News and Eagle, Enid, OK

Featured Story

September 21, 2013

Seeking affordable health insurance

Hugh Meade hopes he can find a health plan that costs less than his home mortgage. Katie Bolin is looking for an insurer who won’t turn her down for pre-existing conditions. Ricardo Lopez Jr. wants coverage so he can stop going to free clinics.

Meade, Bolin and Lopez are among several hundred thousand uninsured Oklahomans whose lives could change when the next phase of the Affordable Care Act takes effect.

Starting Oct. 1, Oklahomans can begin applying for private-market policies through a new federally-operated health insurance marketplace. The policies will take effect on Jan. 1, 2014.

The marketplace is open to anyone who is not eligible for affordable employer-provided insurance or public insurance programs such as Medicare and Medicaid. People who fall within certain income ranges will qualify for federal tax credits and cost-sharing subsidies that will reduce their health-care expenses.

Many people remain confused about the rules, although the federal government is offering information and pre-registration at www.healthcare.gov and, in Spanish, at www.cuidadode salud.gov. The toll-free information line is (800) 318-2596. Licensed health insurance agents and brokers can provide assistance, too.

The Kaiser Family Foundation’s online tax credit and premium cost estimator is at http://kff.org/interactive/subsidy-calcu lator/

The coverage options available through the health-care act, widely known as Obamacare, won’t necessarily work for everyone. But for people like Meade, Bolin and Lopez, they might make sense.

Here are their stories.

Name: Hugh Meade

Age: 43

Location: Oklahoma City

Occupation: independent sign contractor

Estimated 2014 income: $28,000

Estimated silver plan premium:  $84 per month

Estimated bronze plan premium:  $26 per month

Hugh Meade has been working with saws and other power tools all of his adult life. So far, they’ve been good to him.

But he worries about what might happen.

“I don’t know a lot of guys who work with tools as long as I have who still have all their fingers,” he said. “It’s luck more than anything else. And I don’t know how long that’s going to hold up.”

Meade, 43, has gone without health insurance since moving to Oklahoma City from Atlanta 10 years ago. His wife Tammy was uninsured, too, when one of her spinal disks collapsed several years ago, requiring emergency surgery.

“She was literally unable to move. She had to crawl across the floor to get somewhere,” Meade said. “We still have massive debt from that.”

Meade is a cabinetmaker by trade. But he found that he could make better money as an independent sign contractor, so he opened Oddfab Design Lab, a small sign-fabricating shop in Oklahoma City’s Film Row district.

The firm did well last year, generating about $45,000 in income for the family. Revenues were much lower this year. He expects his income will be about $28,000 next year, when the Affordable Care Act insurance marketplace takes effect.

Meade’s 9-year-old son, Nic, is covered by a private-market health plan. The Meades purchased the policy when Nic was 11⁄2 years old and have been paying the premiums ever since. His wife now has health coverage because of her disability.

Meade continues to do without. He shopped for private-market insurance, but gave up after learning the premium would cost close to $600, more than his monthly mortgage payment.

“I’m the only income earner,” Meade said. “I’m the guy who should be insured. But we can’t afford it.”

According to the Kaiser Family Foundation, Meade should be able to get a silver-level health policy through the Affordable Health Care Act online marketplace for about $84 per month, after tax credits. Silver plans are designed to cover about 70 percent of an average person’s annual health care costs.

He should be able to get a less generous bronze plan for about $26 per month, after tax credits. Bronze plans are expected to cover 60 percent of health care expenses.

If Meade chose a silver plan, he would also qualify for federal cost-sharing subsidies that would further reduce his annual health care outlays.

Meade said he plans to check out his options when the health insurance marketplace begins taking applications on Oct. 1. He also wants to see whether he might qualify for coverage through Insure Oklahoma, an existing program operated by the state.

“I’ve done physical, hard labor almost all of my working life. I can feel it every day when I get up. My back hurts, my leg hurts, my hands,” Meade said.

“It’s very frightening. I don’t even know necessarily whether insurance is the correct answer. What I need is access to health care. I’m willing to pay for that. But I think that people who can’t afford to pay for it shouldn’t have to expect to simply become sick or become crippled or die.”

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