The Reality Of The Affordable Care Act

Navigators Help Floridians Sign Up For New Health Care Marketplace

Let’s go to Kentucky, a deep red state which has nonetheless set up one of the best systems for getting health insurance for the poor. We have heard an awful lot of gripes from those with insurance on the individual market, and those with Cadillac-style plans who have been forced to adjust. But the people we haven’t yet truly seen or heard are those getting affordable insurance for the first time in their lives. Maybe I’m a squish, but this report from the NYT helped put some of the political cock-fighting into perspective:

The woman, a thin 61-year-old who refused to give her name, citing privacy concerns, had come to the public library here to sign up for health insurance through Kentucky’s new online exchange. She had a painful lump on the back of her hand and other health problems that worried her deeply, she said, but had been unable to afford insurance as a home health care worker who earns $9 an hour.

Within a minute, the system checked her information and flashed its conclusion on Ms. Cauley’s laptop: eligible for Medicaid. The woman began to weep with relief. Without insurance, she said as she left, “it’s cheaper to die.”

What price can you put on that? Or on this:

So far, [insurance agent Donald Mucci] has enrolled just a few longtime customers in exchange plans. They include Mrs. Shields, 49, a widow who had been rejected by insurance companies because she has diabetes. She is paying $745 a month for coverage through a program for people with pre-existing conditions, but the program will end in January.

Mrs. Shields, who has an annual income of about $17,000, qualified for a monthly premium subsidy of $232 a month. With Mr. Mucci’s help, she chose a silver-tier plan offered by Anthem that has a $2,450 deductible and a $4,500 out-of-pocket maximum. She will pay a monthly premium of $151 after the subsidy.Mr. Mucci said he would get a commission of $18 from the transaction. Before the health care law, he said, he would typically receive a lot more.

“Is it a win?” he said. “For Judy, it sure is.”

At the core of this technocratic edifice is something quite simple: the lifting of intense anxiety, the restoration of personal dignity, the chance to live better and longer, the opportunity to be free of physical pain. In the end, though I remain skeptical about whether the ACA is the best possible solution to the plight of those in such need, it is the only solution at hand. I want it to work. And I find the brutal attacks on it to be devoid of any true sense of what it feels to be alone and sick and terrified.

(Photo: Affordable Care Act navigator Adrian Madriz (R) speaks with Lourdes Duenas, who is looking for health insurance, during a navigation session put on by the Epilepsy Foundation Florida to help people sign up for health insurance under the Affordable Care Act on October 8, 2013 in Miami, Florida. By Joe Raedle/AFP/Getty.)