While Cover Oregon continues to be a long and clunky labyrinth to navigate, local enrollees report the triumph is worth the trial.
Engaged in a lengthy and budget-breaking battle with liver cancer, Ashland musician Steve Read says monthly health insurance premiums for him and his wife dropped from $1,436 to $155 under the Affordable Care Act (Obamacare), known here as Cover Oregon.
"I'm thrilled with the fact they accept pre-existing conditions and offer a really, really nice choice of policies," says Read. "The downside is I'm still wrestling with Cover Oregon because of clerical errors, but it's not the end of the world. It's all interface problems, not problems with the program. I'm all for it."
Formerly in the Oregon Medical Insurance Pool, Read had a $5,000-per-person deductible, with a $10,000 out-of-pocket cap after deductible for the family. Under Cover Oregon, it's a deductible of $100 per person, with an out-of-pocket cap of $1,500 for the family. Read receives an annual Advanced Premium Tax Credit of $865 under Obamacare.
Retired health insurance broker Doug Holloway of Medford says he used to pay $1,200 a month for himself and his wife, both healthy and in their early 60s. Under Cover Oregon, he pays $741.
Although he calls enrollment a nightmare, Holloway says, "We're thrilled with Obamacare. ... When they get the bugs ironed out, it's going to be fantastic.
"This (ACA) had to happen. The government had to do something, like all the other developed countries, because insurers were only taking people who were excellent risks."
Holloway says the main reason he got out of the insurance business was that he foresaw the "overwhelm from the new influx" of applicants in Obamacare and, under the old system, he got tired of telling people they were uninsurable.
"Insurers would look for any excuse," he says. "I can't tell you how many people I had to look in the eye and tell them (no). My wife had cataract surgery in one eye seven years ago and they declined us. It was always difficult to get coverage for anyone over 60, even though we've always been very healthy, no-pill, no-doctor people, so we'd been going through OMIP."
As yet, applicants are unable to completely enroll online. Holloway complains about Cover Oregon "losing pages of our application, misplacing the complete application later, and finally issuing the policy without sending any billing invoice, after repeated calls by me, five in five weeks. Now we've (temporarily) been canceled. Also, we cannot get a call back, even after multiple calls and emails on our part. We're just fed up with the whole mess!"
Television music producer Bret Levick of Talent used to pay $600 a month for himself and $390 for his wife and daughter, "a huge burden." Under Cover Oregon, he pays $250 for all three. The old deductible was $1,500 a year, and now it's half that.
"It's way cheaper, a 300 percent cut," says Levick. "It makes me feel great. I worked hard for it. The Cover Oregon people are very cool and helpful, but I had to call every three days and stay on hold for hours. Like, they had me down for a $4 million tax credit. They knew it was wrong but they couldn't get it off there.
"But everything's going to be fine. I really wanted this. Once they figured it out, it was great, awesome. I can't say enough good about it. I'm still baffled why people don't get on it. I think people are misinformed and some entities are trying to keep it that way. If people knew how accessible it was, they'd do it."
Nurse Heidi Gottlieb, 55, of Ashland had only catastrophic insurance before Cover Oregon, paying $283 a month with a $7,500 deductible. Under Cover Oregon, she pays $127 for a comprehensive plan that includes dental and medication, with a $1,250 deductible.
"It's phenomenal, very positive," says Gottlieb, who did the process in two months. "It's been slow hearing back from them and knowing they received my things, but it appears it's going to get in place in a timely fashion."
The application process is free and takes 15 to 45 minutes, depending on family size, says Michelle Glass of Oregon Action in Medford, who has been helping others enroll since Cover Oregon opened Oct. 1.
Approval takes about 45 days. Applicants can download and print the application form and fill it out themselves. She doesn't advise filing online and notes that if you make an error, you have to start the entire process over.
Several local organizations offer in-person application help, including Asante Health System, Community Health Centers, the Jackson County Health Department, La Clinica and Oregon Action.
"It's a little complex online," says Glass. "Applicants (in person) have a lot of questions and a lot of anxiety, but the benefits are really tangible. Because of the depressed local economy, a lot of people are eligible and it brings a lot of peace of mind. Having a medical emergency can be very scary and expensive, so this is pretty empowering. We help people make the best choices."
Cover Oregon has access to the most comprehensive health plans, has vetted them and will assist with costs during the application process, says ACA specialist Sue Carney of Ashland. The federal government pays toward the policy monthly and provides cost-sharing assistance to cut out-of-pocket, co-pay and deductible expenses. Those below 138 percent of the federal poverty line of $15,860 for individuals or $32,499 for a family of four can obtain free coverage.
While noting "a lot of logistical problems and technical snafus nationwide," Carney says, "people are very happy with it. Very few are anything but extremely pleased, and a few are ecstatic."
Carney, who also is a certified Oregon State Exchange navigator, says Oregon was last in the nation for numbers enrolled and time taken for the process, but has now moved to the middle of the pack and "by next year will be fine."
Cover Oregon has so far enrolled 65,000, with a third going into private insurance and the rest onto the Oregon Health Plan. Another 118,000 have enrolled in Medicaid, in a process that bypasses Cover Oregon.
John Darling is a freelance writer living in Ashland. E-mail him at firstname.lastname@example.org.