Friday is the deadline for individuals to register for health insurance through the federal marketplace –– but not everyone is signing up.
Such is the case for Robin Fuller of Bradford, who –– once again –– has to forgo healthcare through the Affordable Care Act in order to make ends meet.
For her, the struggle is real –– being unable to afford triple-digit premiums and high deductibles, and this year people are being slammed by large increases.
“When I do go (to the doctor) I have to take (money) from a bill to make a payment,” Fuller said. “There were times I really could use a doctor but have to hold off until I can find something I can afford or help to pay it. I know I am not the only person in this situation. It’s sad.”
Fuller said working in the home care field doesn’t provide enough hours or money to cover expenses –– and live her life.
Therefore, she said she is forced to make payments on her medical care as a need arises. As much as she can, she said, she treats her ailments at home.
“They say I make too much money for help and I don’t make enough to get it through work. Kind of have no choice,” Fuller said.
She isn’t alone in her lack of health insurance.
According to The Center For Rural Pennsylvania, the average age of adults without insurance in rural parts of Pennsylvania is 38.9 and 37.8 in the urban part. Also, information from the 2015 American Community Survey states that the median income is $19,024 for those in rural parts of the state and $18,724 in urban sections, both uninsured.
There are also individuals who are staying with the marketplace –– despite the significant rise in premiums. Lynn Eaton Church, via The Era’s Facebook page, said she will be shelling out $200 more a month with a huge deductible. Her family switched to a UPMC bronze plan, which kicks in in January.
In a few weeks, her family will now pay $1,199 a month for insurance with a $6,950 deductible, she said.
“We just can’t get sick because the deductible is way too high. If for some reason we get sick we really can’t get treated,” Church said.
More than 161,388 Pennsylvanians selected health plans on Healthcare.gov from Nov. 1 to Dec. 2, according to the Centers for Medicare & Medicaid Services.
Meanwhile, some individuals rely on employee-offered health care plans, such as James Heckman of Foster Township.
“I’m insured through my employer (Case),” he said. “We have good coverage and it is cheap for the workers. Everyone in the country should have the kind of coverage we get. Nobody should have to choose between bankruptcy and death.”
W.R. Case & Sons offers Highmark Blue Cross, and for Heckman, he said he is on the cheapest plan: $15 every two weeks.
“I think emergency room visits are $125 but doctor visits are only $20,” he said. “Most of the doctors around here are in-network. I’ve never heard a coworker say a local doctor wasn’t in the (Health Maintenance Organization). The cheap plan is still way better than anything on the ACA marketplace.”
Across the United States, everyone must have insurance coverage –– or face a fine. Coverage can be provided from the marketplace, a job, Medicare, Medicaid, the Children’s Health Insurance Plan or other qualifying coverage that includes health cost sharing.
Acting Pennsylvania Insurance Commissioner Jessica Altman expressed caution to consumers in where they seek out health insurance.
“Some companies and agents are offering plans they say are compliant with the ACA, but they are not. The federal marketplace’s website ends in ‘.gov.’ Consumers not shopping on Healthcare.gov are not shopping on the federal marketplace,” Altman said. “In addition, consumers buying an off-exchange plan directly from a company should make sure they are on an official website for one of Pennsylvania’s five health insurers. These are Capital Blue Cross, Geisinger, Highmark, Independence Blue Cross, and UPMC Health Plan.”
Consumers can shop on the federal health care marketplace at Healthcare.gov or by calling 1-800-318-2596.
