Stories from the health exchange

4 people profiled in August have mixed — but mostly good — results finding insurance

bshannon@theolympian.comDecember 23, 2013 

Ashley McIntosh, a college student who works two jobs, tends to business at Bonaventure Shoes in Olympia on Saturday. McIntosh is seeking health insurance for 2014, and has applied for Medicaid coverage through the state’s health exchange. Monday is the deadline to apply on the exchange for coverage in January.

LUI KIT WONG/STAFF PHOTOGRAPHER

With time running short to enroll for January coverage through the state’s health insurance marketplace, 20-year-old Ashley McIntosh recently visited the Healthplanfinder website.

She quickly ran into troubles with the site, so she printed an application for free Medicaid coverage, filled it out and dropped the paperwork in the mail.

“I’m waiting to hear back from them,” McIntosh said last week, unsure when she’ll learn that she has coverage for 2014.

The college student, who works at a downtown Olympia shoe store and also at a fast food restaurant in Centralia, said she was hospitalized briefly in early December. She wants to make sure she is covered in case something goes wrong again.

“I don’t feel like I have it made, but I feel a little bit better that I have applied and have something in the system getting processed. But I am still a bit afraid because I did just end up in the hospital and have all these new medical bills,” McIntosh said.

McIntosh was one of four South Sound residents profiled by The Olympian and News Tribune in August about their need for health care and hopes for the new options made available by the Affordable Care Act, which Congress approved in 2010.

In recent follow-up interviews all four said they have visited the state’s Healthplanfinder site to sign up for coverage. Some encountered more difficulty than others.

At least two – three, if McIntosh’s application is accepted – have joined the newly expanded ranks of Medicaid. The remaining resident purchased private insurance. That breakdown roughly follows the experience statewide for people using the state health care exchange, which in addition to offering private insurance for purchase, refers many visitors to Medicaid for enrollment.

DEADLINE MONDAY

Monday night is the deadline for starting an application for private insurance through the exchange for that coverage to begin Jan. 1. Medicaid-eligible clients have until Dec. 31 to get applications in.

Cristan Sutton of Gig Harbor was feeling more certain about coverage than McIntosh last week. Sutton went online shortly after the Healthplanfinder opened Oct. 1 and learned she could get a mid-range policy for herself, her husband Bob and youngest daughter Carolyn for about $300 a month with subsidies available through the exchange.

But then Sutton, 49, left her job with a housing outreach agency and became a mid-career college student. When she returned to Healthplanfinder to recalculate costs, she learned that the three of them qualify for free coverage through Medicaid – at least until she returns to the workforce and her husband, a carpenter, recovers from a workplace injury for which he is getting small time-loss payments.

“I’m pretty excited,” Sutton said of getting coverage. “Actually I think I would rather not do the Medicaid and find an affordable plan for us. I’m worried about the level of care for my husband. But at this point, free health care helps. ... I’m thrilled my husband has health insurance.’’

Getting Bob Sutton covered is vital, she said, because he has rheumatoid arthritis that requires medications that can run $1,900 for a month. They’ve relied on charity care to secure medications in the past, but at times “he’s had to go without. When he goes without, he can’t work. That’s where health care can make a difference. He can work,” Sutton said.

MINOR COMPLAINTS

Sutton had no big complaints about the state website. But she did say that separate coverage for her 19-year-old daughter, Sarah, seemed steep at a $100 a month for a college student still living at home. And Sarah found it “confusing” to compare plans on the site.

Michael Lee, a father of two young children and owner of two adult-family homes in the Tacoma area, said his family is set for coverage. His wife got stuck on the website as she was applying for insurance a few weeks back, he said. But she went back later, securing a tax subsidy and coverage for her and the couple’s children, ages 3 and 6.

“She was actually able to find a lower rate for them ... It’s almost half – $490 and some dollars,” Lee said. “We were paying $795.41 or something like that – just for the wife and the kids ... I’d say that’s significantly lower.”

As an individual provider to Medicaid clients, Lee is covered separately under a Group Health Cooperative plan offered to members of the union that represents home care workers. Under both plans, the Lee family expects to pay about $15 co-pays for office visits.

“From my perspective, (my wife) was able to complete (enrollment) so whatever issues they were having with the exchange and system, they were able to iron it out,” Lee said. “I – unlike all the media – was of the mind, give it time ... We are talking about a website.”

‘A BIG RELIEF’

Andy Yager, a disabled 50-year-old warehouse worker in Olympia, vowed in August to sign up as soon as he could. He tried Oct. 1, and Healthplanfinder’s first-day tech problems locked him out.

“The second day, I got in no problem and signed up the whole family. It took 15 minutes or something to do the whole thing. It was a piece of cake,” Yager said. “It only took a matter of days to get all the information in the mail.’’

The whole experience has been a big relief – “a huge weight lifted off our shoulders,” he said.

The Yagers – Andy, his wife Lisa and son Ryan – qualified for Medicaid because Andy was jobless and Lisa works part-time in child care. Their daughter Melissa, 22, applied separately as an adult college student and she qualified for Medicaid coverage through the Apple Health program, Yager said.

More recently, a favorable legal ruling ensured Andy can get federal disability benefits, putting him in a separate category of coverage through Medicare. He said his family is looking forward to Jan. 1 when his wife’s and kids’ health coverage kicks in.

“Without getting into personal information, anybody who goes 21/2 years without any kind of medical insurance, there are things on your list that need to get done,” Yager said. “My wife and I both have reason to get to a doctor. We are waiting for Jan. 1 to get here.”

Brad Shannon: 360-753-1688 bshannon@theolympian.com www.theolympian.com/politicsblog

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