Individual results may vary: a look at how the Affordable Care Act is affecting locals

Published on Wed, Jan 15, 2014 by Nathan Dalla Santa

Read More News

Last year, business partners Tammy Pearce and Dave Bucknell paid the same price for healthcare. This year, Pearce receives free healthcare while Bucknell’s price has doubled.

With the deadline for healthcare enrollment looming at the end of March, many Whatcom County residents are grappling with 
the nation’s new healthcare law, and their experiences vary from marvelous success to crushing expense.

The Patient Protection and Affordable Care Act, commonly referred to as “Obamacare,” was signed into law in 2010. Meant as an overhaul of the nation’s healthcare system, the law sets standards for care provided by health insurance companies, such as forbidding insurance companies from refusing care to customers with pre-existing conditions. Some policies did not meet the  new standards and many people have had to switch insurance plans or providers. 

The law also expands state Medicaid programs, so that participating states can provide free healthcare to citizens whose annual income is 138 percent of the poverty level or less.

Finally, in an effort to keep costs affordable, the government now requires everyone have health insurance for at least nine months out of the year or face a fine of 1 percent of the household’s income. The deadline for enrollment to avoid the fine is Monday, March 31.

In Washington state, there are around 400,000 previously uninsured people who fall into that individual mandate, said Tony Kelley, an insurance broker at Kelley Insurance Agency and Financial Services, Inc. located in Everson.

“All types of people are signing up,” Kelley said. “Attorneys, doctors, kids just out of high school, families — and we’ve been able to help them all.”

Since October, Kelley Insurance has enrolled more than 100 new clients – a tenfold increase from the company’s usual business, he said.

Though the intent of the law is to make healthcare available and affordable for everyone, a cheaper insurance rate is not guaranteed.

Pearce and Bucknell illustrate a stark difference in people’s healthcare experiences. The two are co-owners of Bay Café in Birch Bay and, being the owners of a small restaurant, neither has access to employer healthcare. Before the Affordable Care Act, each of them was paying around $300 per month for health insurance.

Preferring to invest their profits back into the business, Pearce and Bucknell don’t take salaries from their restaurant. Because of this, Pearce’s low income qualifies her for free healthcare. Bucknell, on the other hand, makes additional income from successful real estate investments, which disqualifies him from government subsidies. So, rather than getting free healthcare like Pearce, Bucknell’s cost increased to $600 per month. 

Bucknell said he has opted to pay the $700 fine for the year instead of paying $600 monthly. He plans on reevaluating the 
possibility of paying for healthcare next year.

“If I wasn’t healthy, it would be a great value for me to pay for healthcare,” Bucknell said. “But I am healthy and it’s not worth it for me right now.”

There is a wide range of results for people signing up for healthcare under the Affordable Care Act. On the positive side, there are people like Blaine resident Aimee Day, whose family hasn’t had health insurance for almost two years.

Aimee is a stay-at-home wife and mother of three, and her husband, Homero Jose, is a self-employed mechanic.

The cutoff for receiving free healthcare under Washington state’s newly expanded Medicaid program is an income of less than 138 percent of the poverty level, which for an individual is $15,856. Day and her family now receive free healthcare.

“It was scary not having healthcare and thinking, ‘OK, my home is the only real asset I have,’” Day said. “Now, if I got hit by a bus or something, I won’t have to sell my house to pay the medical bills.”

On the other end of the spectrum is Birch Bay resident Neal Cronk, who had health insurance before the mandate. Back then, he was paying $440 per month with an annual deductible of $3,000. Now, Cronk’s plan costs $770 per month and has a $10,000 annual deductible.

“For a lot of people, it’s great because it’s free,” Cronk said. “But unless something catastrophic happens, I’m never going to meet that deductible.”

In addition to the wide disparity of outcomes for people signing up for healthcare under the Affordable Care Act, many people’s attempts are being thwarted by a bogged-down system. Because all healthcare applicants in the state have to go to the Washington healthcare website and submit massive amounts of information, the website often freezes or times out, said Rod Bring of Blaine Insurance. The large volume of callers seeking help with their applications has similarly tied up phone lines.

Birch Bay resident Tamara Dwight was one of many applicants who experienced difficulties trying to sign up. After receiving a letter in early November warning her that she would need to switch her family’s plan or face a fine, she set to work immediately, but high traffic on the healthcare website forced her to call in.

“I called the office five days a week for almost two months and was only able to actually talk to someone three times,” Dwight said. “They demand that people sign up for Obamacare, but they don’t have the system in place for it yet.” 

Despite widespread difficulty making the transition into the age of the Affordable Care Act, Kelley stands by the new law and thinks that it will cause more good than harm.

“There’s been a lot of criticism,” Kelley said. “But in time, they will dial it in. 

It’s always been my feeling that an ounce of prevention is worth a pound of cure, and that’s really what the Affordable Care Act is all about – accessible and preventative care.”