Asbury Park Press

As Obamacare Deadline Looms, Customers Wonder What's Next

Asbury Park Press — January 30, 2017

By Michael L. Diamond

Mark Colegrove was diagnosed with congestive heart failure in 2014 when he got a potentially life-saving procedure at Deborah Heart and Lung Center in Pemberton Township.

Thanks to Obamacare, it cost him about $4,000 out of pocket for the ordeal. It was no small change for the father of a 10-year-old boy who had effectively retired from the work force. But he didn't have to foot the entire bill. And he was still alive.

"Had I not had that insurance, though, this could have been a diametrically whole different ball game," said Colegrove, 64, of Waretown.

Now Colegrove, and other advocates, worry what will happen next. The deadline to sign up for health insurance coverage for 2017 through the Affordable Car Act, also known as Obamacare, is Tuesday, bringing an end to the open enrollment period.

Colegrove and other advocates hope this enrollment isn't the last, but President Donald Trump and congressional Republicans have vowed to repeal and replace the law, and are beginning to make good on their campaign promise. In doing so, they are jumping into what continues to be a deep division point for Americans. But consumers who have coverage because of the law, relatively muted for the past four years, have begun to voice their concerns about what it will mean if they lose it.

"I think as people see more and more things threatening what they value, they wake up to what's really being lost," said Maura Collinsgru, health care program director for New Jersey Citizen Action, a consumer group that has sponsored candlelight vigils at the offices of Republican lawmakers. "I think they're frightened. I think they're very worried about what's going to be lost here."

The law, passed in 2010, requires nearly all Americans to be covered by health insurance. It targeted consumers who weren't covered by Medicare or their employer by expanding the eligibility for Medicaid and creating an exchange at HealthCare.gov, where individuals can buy policies and apply for federal subsidies.

Consumers can skip health insurance, but they will be fined 2.5 percent of their household income or as much as $2,085, whichever is more.

The law provided insurance to nearly 800,000 New Jerseyans in 2016 — about 547,000 through the Medicaid expansion and 249,000 through the exchange. And enrollment appeared to be exceeding last year; as of Jan. 14, 277,132 New Jerseyans had signed up for coverage through the exchange, according to the Obama administration.

The law itself has divided the public. A poll in December by the Kaiser Family Foundation, a research group, found 46 percent had an unfavorable opinion, and 43 percent had a favorable opinion.

Some Shore-area consumers covered by Obamacare said their networks have narrowed and their costs have increased, but it has been better than the alternative.

The Asbury Park Press met Richard Brock of Marlboro in 2013 when his attempts to get coverage were tripped up by Obamacare's numerous computer glitches. When a reporter reached him Monday, he was back online with his carrier, Horizon Blue Cross Blue Shield of New Jersey, which he said mistakenly enrolled him in a bronze plan instead of a silver plan.

He said the premium to cover himself and his three sons, ages 21, 24, and 25, had spiked from about $500 a month to more than $900 a month. But the law, which allows parents to keep their children on their policies up to age 26, has given his sons some rare financial breathing room, Brock said.

"You just can't say, 'OK, Obamacare is out,'" he said. "You have to have a plan in tact and put it in correctly. I think you have to see what Trump and his (administration) are going to come up with to determine the good and bad. I haven't heard much about it yet."

Obamacare hasn't been seamless. Sharron Greenberg, 49, of Toms River, had health insurance through Oscar in 2016. But Oscar dropped out of the New Jersey marketplace in 2017, so she switched to AmeriHealth New Jersey, and spends about $450 a month for premiums for a policy with an out-of-pocket maximum of $1,750.

To Greenberg, though, it was a small inconvenience. She needs insurance to cover about $50,000 in medication to treat a chronic condition called ulcerative colitis. And she fears losing the ACA's protections would make her policy exorbitant because of her pre-existing condition.

" A week without my medications and I'm not able to function," she said. "It's just been a life saver. I've been able to work in the jobs I've wanted to work in."

Not everyone wants to see the law stick around. Karen Kandra, a Red Bank resident, said she checked on an individual policy and saw the cost was $883 a month without subsidies. Meanwhile, insurers seemed to change their network of providers nearly every year.

Her wish: Medicare for everyone and prices that are more transparent to consumers.

"I'm hoping it goes away," Kandra said.

Colegrove, however, said he thinks Obamacare can be improved, but taking it away would be devastating. After he got divorced from his wife, a teacher, in 2014, he had two options: keep her benefits through Cobra for as much as $14,000 a month, or get Obamacare for $225 a month after subsidies.

He chose Obamacare, which he contends saved his life. There is little chance he could have paid for the $300,000 it cost for his heart procedure.

"I have a home I'm living in," he said. "I didn't lose everything."

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