Health care website OK, cases can be complicated

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Associated Press

Posted on December 4, 2013 at 8:32 AM

AUSTIN, Texas (AP) — The federal health care website worked just fine Tuesday for Texans seeking insurance coverage, but trained helpers are finding some individual cases are not so simple and those delays have nothing to do with technology.

On the same day President Barack Obama vigorously defended his program to make sure the vast majority of Americans have health insurance, counselors across Texas dealt with an influx of applicants hoping to get insured after months of delays due of shoddy technology. The Obama administration gave itself until Nov. 30 to fix the website, and applicants began pressing the system this week.

Micheal Biggerstaff went to a store-front office in a shopping mall operated by Foundation Communities, a nonprofit agency that helps Texans with affordable housing, free tax return assistance and now free help filling out applications on healthcare.gov, the federally operated insurance exchange. Gov. Rick Perry has rejected Obama's Affordable Care Act and ordered Texas agencies to cooperate as little as possible, so Texas does not have its own website.

Curt Von Beek, a volunteer who has helped people with tax returns and now helps with insurance, talked Biggerstaff through the application process, and the 27-year-old was thrilled to see he could get insurance for less than $5 a month. In the end, though, he decided on a $29 per month plan that has lower deductibles and co-pays.

"It kind of blows my mind that it was $168 before (the subsidy); I don't know what to think about that," he said. Though he's never purchased health insurance before, he had been expecting to pay $70 a month.

Elizabeth Colvin, director of Foundation's Insure Central Texas program, said all of the offices had seen an uptick in the number of people seeking help since Sunday, when the administration said the website was working better. She said counselors still occasionally experience delays but that the system had improved steadily since Nov. 1 when they successfully enrolled their first client.

The biggest challenge, she said, is teaching people how insurance works.

"Unless you've really needed to use it, like in a medical crisis, you may not understand what your deductible means, what co-insurance means," Colvin said. "In Texas, there are 80 plans to choose from, so that in itself is a whole other process."

Application counselors also are finding that some people have complicated cases, which either slow the process or require more than a website to sort out. When 64-year-old Jeanette Garcia applied online, the system had difficulty identifying her and ultimately said she was ineligible for a subsidy, despite her low income. Dustin Kreitner helped her file an appeal by mail on Tuesday, because the premium offered cost more than half of her Social Security check.

"We had to do it two or three times, because it was kicking me out of the system. They were saying it's not me, that I'm not Jeanette Garcia," she said. Since Texas did not expand Medicaid to provide free coverage for the very poor, Garcia may fall into a coverage gap that leaves childless adults without insurance or a subsidy.

Pamela Thompson met by appointment with certified application counselor at CommUnity Care East, a health center serving low-income residents that had written to her about applying for benefits. She successfully set up an account and filled out an application in a little over two hours, but her personal circumstances made it impossible to take the next step to purchasing insurance.

Thompson lost her job last year and her unemployment benefits run out in two weeks with no new job in sight. The 55-year-old was also recently rejected when she applied for disability benefits and is in the process of appealing that decision.

There was also the question of Thompson's tax returns, since she'd always filed separately from her husband. If she doesn't file jointly, she is ineligible for a subsidy. Her counselor scheduled her for another appointment to review her options if she does not get disability benefits.

"I didn't like it," Thompson said after making another appointment to review her options. "I think it's all too complicated. Some people need insurance, and some people don't. I've got a clogged artery and cataracts. I need some help."

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Follow Chris Tomlinson on Twitter at: http://twitter.com/cltomlinson

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