For Wendy Alderson, it’s “too good to be true.” For Dan Evans, it’s life changing.
The deadline to enroll in health insurance through the Affordable Care Act is March 31, and that has prompted many Sitkans to bite the bullet and figure out what the act means for them. For some self-employed Sitkans, like Alderson and Evans, what they’ve found has been a pleasant surprise.
Back in 2012, when the Supreme Court upheld most of President Obama’s signature healthcare law, Wendy Alderson hoped the ruling would mean good things for her family.
“I know what I would hope that it would do for us, and I hope that it would basically just bring down the cost of our health insurance,” Alderson said, in an interview with KCAW in June 2012, right after the Supreme Court decision cleared the way for the Affordable Care Act to go into effect.
Alderson and her husband are commercial fishermen. They own their own boat, a combination freezer troller and longliner. And for the past decade, they have bought a very basic health insurance plan. They paid over $12,000 a year to cover themselves and their daughter. The plan had a deductible of about $2,500 per individual – meaning that’s how much they’d have to pay before the insurance kicked in.
“You know sometimes I felt like I couldn’t afford to go to the doctor because I had to pay my health insurance bills,” Alderson said.
The insurance only covered major events, like hospitalization — not preventive care or routine doctor’s appointments. In her 2012 interview, Alderson said that could be frustrating.
“It’s wondering whether you should go to the doctor or not,” she said. “It’s knowing that it’s $200 to walk into a doctor’s office, and you may or may not have a prescription that’s going to be $45 to $50.”
“You know, it’s kind of scary having a sick kid, and thinking, OK, are you sick enough to go to the doctor? Is your earache going to be gone in the morning?”
So now that the Affordable Care Act is actually going into effect, we checked in with Alderson to see if it was living up to her expectations.
And at first, Alderson actually didn’t think the act would do much for her family. In fact, she wouldn’t even have looked for a new plan, but her current insurance costs suddenly increased, from about $1100 a month to $1400 a month. All told, her family would be paying $15,000 a year just for catastrophic insurance.
“I decided I better get on the stick and look at what was available,” Alderson said.
So she logged into healthcare.gov, the new online health insurance exchange. And…
“I was astounded,” she said.
Her new plan will cost about half as much as her old one.
“Honestly, [it was] a too-good-to-be-true thing for me,” Alderson said. “It was like, wow, really?”
The new plan is actually quite similar to her old plan, but instead of paying $1400 per month, she’ll pay just $680. In total, it will cost $7,000 this year, instead of $15,000.
That’s because Alderson’s family qualifies for a tax credit. Families that make up to four times the federal poverty level can qualify for tax credits and subsidies that cover part of the cost of health insurance bought on the exchange. In Alaska, a family of three making up to about $98,000 can be eligible.
Alderson said the change is a big deal for her family.
“This is really going to help,” she said. “This last time, if we had just gone ahead and stepped it up and paid this increase, we would have been paying more for our health insurance than we would for our mortgage.”
Still, Alderson said the new system isn’t ideal. She had hoped that the act would reduce the cost of health insurance by introducing new efficiency and accountability into the world of healthcare.
“That is not the case,” she said. “The case is, the plan still costs the same, it’s [just] the government subsidizing those of us who qualify. I do understand that now, and that’s a little bit of a bummer. But I also feel that paying $700 a month for a catastrophic plan, is still a good chunk of money. I don’t feel like I’m getting anything for free. So, I’m pretty pleased.”
Sitka resident Dan Evans is also self-employed, as a photographer and home inspector. Evans hasn’t had health insurance for most of the past five or six years. For the past three years, he tried to enroll in insurance, but says he was denied because of preexisting conditions. He finally got a plan this past December. He paid $400 a month for a catastrophic plan with a $10,000 deductible.
“Really the only time you’d ever use it is if you really got hurt or sick real bad,” Evans said. “And it took me a long time to even get that.”
The issue of health insurance weighed so heavily on his mind, that he was considering giving up his photography business.
“I’ve been self-employed for 25, 30 years now,” he said. “And I actually started looking for jobs that could give me insurance, even though I don’t want them. But I just feel…I see a lot of my friends and other people when they’re getting up there. Things happen. And I just kept thinking that something might happen to me and I could have everything taken away.”
Like Alderson, Evans at first thought that the Affordable Care Act wouldn’t change anything for him. He tried navigating the health exchange website himself, and got discouraged. Then his wife heard about a program at the SouthEast Alaska Regional Health Consortium, or SEARHC, in Sitka. SEARHC outreach manager Andrea Thomas has been helping people navigate the website. She worked with Evans to find a plan that will cost him just $189 a month. The deductible is $1500 dollars.
RW: Were you surprised?
DE: Way surprised. I actually said to Andrea, I said Andrea you’ve got to stand up right now, I have to give you a hug, because this is unbelievable. [[laughs]] She knew I was really happy.
Evans said the new plan is literally life-changing.
“I was checking with the city, I was checking with the state [for jobs],” he said. “And I really don’t want to do that. The only reason I was doing it is to get medical coverage! But now, I don’t have to. I can keep doing what I’m doing, and not worry anymore.”
As for Wendy Alderson, when asked what her family will do with the money they’re no longer spending on health insurance, she said: “Pay bills! Nothing glamorous, sadly.”
“It’ll be nice to just know that I don’t have to struggle to come up with money to, you know, pay bills.”