NORMAN — 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 cuidadodesalud.gov. The toll-free information line is 1-800-318-2596. Licensed health insurance agents and brokers can provide assistance, too.
The Kaiser Family Foundation’s online tax credit and premium cost estimator is at kff.org/interactive/subsidy-calculator.
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.
Hugh Meade: 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 1 1/2 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 Obamacare 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.
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.
Katie Bolin: Katie Bolin works a 16-hour shift every Saturday as a home health-care nurse, helping other people deal with their aches and pains. But when she gets sick, she’s on her own.
Bolin, 35, works as a licensed practical nurse in Yukon. Because she’s part-time, she doesn’t qualify for employer insurance.
She tried to get private market insurance after her husband, Rick, was laid off from his full-time job in 2009. She was afraid she might get turned down because she had a history of sinus infections and bronchitis.
Her hunch was correct, but not for the reasons she expected.
“When I had my first son, I was diagnosed with postpartum depression. I was on Prozac for about two months. They told me I had a diagnosis of depression and was uninsurable,” Bolin said.
On Jan. 1, Bolin will be able to get insurance again. That’s the effective date of the policies being offered through a new federally-run health insurance marketplace created by the Affordable Care Act. People can begin applying for coverage on Oct. 1.
Under the terms of the act, widely known as Obamacare, participating insurance companies can’t deny coverage based on pre-existing conditions. That means Bolin is guaranteed she can get a policy.
According to the Kaiser Family Foundation, Bolin should be able to buy a “silver”-level health plan in the Affordable Care Act marketplace for $307 a month, or a less-generous “bronze” plan for $255.
Bolin estimates the family’s combined income will rise to about $65,000 next year after she receives a nursing degree from Oklahoma City Community College in May and goes to work as a registered nurse. At that income level, Bolin would not qualify for federal tax credits to reduce the cost of her insurance, if she buys it only for herself.
But if the entire family enrolls for coverage through the marketplace, the combined monthly premium would be $477 for a silver plan or $309 for a bronze plan, after tax credits, according to Kaiser.
That’s less than the Bolins are paying now for the plan that only covers her husband and the boys.