An inspector general helped save taxpayer money with the Troubled Asset Relief Program, and with the wars in Iraq and Afghanistan, according to U.S. Rep. Peter Roskam, R-Ill. So why not one to oversee the troubled rollout of the Affordable Care Act?
"If it's good for Iraq," Roskam said Wednesday on "Squawk on the Street.""If it's good for TARP and if it's good for Afghanistan, it is clearly good for $1.8 trillion of spending that takes over one-sixth of the economy."
Last week, Roskam introduced legislation that would create a special inspector general to oversee President Barack Obama's health-care overhaul, commonly known as Obamacare. As chief deputy whip in the House of Representatives, Roskam expects heated opposition from Democratic minority leader Nancy Pelosi, who accused the GOP of trying to undermine the ACA with "nuisance, unproductive" proposals.
"You have an administration that is probably the most political administration we've seen in a generation making decisions that have an impact on every single American and every single business," said Roskam, a committee member of the House's Ways and Means Committee, during an interview with CNBC. "They're clearly being political."
Almost as soon as the exchange websites opened for business on October 1, states began to be pigeonholed into categories: success, failure, cooperative, obstructive, along with some hybrids to round things out.
Many of the Affordable Care Act success stories come from solid blue states like California, Washington, and New York: Democrats in the Governor’s office and holding a majority in the legislature, and a public that is generally supportive of the ACA – for these states, setting up their own exchanges, expanding Medicaid, and actively promoting the exchange was almost a given. It’s not surprising that they’re succeeding; they were pegged as likely success stories long before open enrollment began.
But there are other states that have emerged as ACA success stories, somewhat unexpectedly. No doubt their success is not a surprise to their navigators, Medicaid enrollment coordinators, outreach teams, and in some cases, elected officials. But states like North Carolina, Kentucky, and West Virginia have been steadily getting the job done over the last few months, and their outcomes speak for themselves.
North Carolina: success in a red state
If North Carolina were pulling up the enrollment rear, it probably wouldn’t surprise anyone. The state has a Republican Governor and legislature, opted to let HHS run its exchange, refused to expand Medicaid, and passed a law in early 2013 blocking state agencies from participating in ACA implementation. And only 38 percent of the population supports the ACA (48 percent are opposed to the law).
Yet among the states where HHS is running the exchange, onlyTexas and Florida have higher private plan enrollment totals – and their populations are significantly larger.
North Carolina’s HHS-run exchange enrolled 160,161 people in private qualified health plans (QHPs) – and 48,451 people in the existing Medicaid program – in the first four months of open enrollment. For reference, Michigan (with a population slightly larger than North Carolina) enrolled 112,013 people in QHPs during the same time frame, and Virginia (with a population a little smaller than North Carolina) enrolled 74,199. North Carolina stands out as a significant leader among states where the state has not taken a role in implementing the ACA.
Blueprint for other state exchanges?
I spoke with Lee Dixon, the Managing Director of the North Carolina Navigator Consortium, about how the state has achieved such success despite the roadblocks they faced. He described a blueprint that could work in other states as well, as long as there are enough motivated individuals and organizations collaborating on the effort.
Dixon’s Navigator Consortium is comprised of 11 entities, including community care organizations, public health agencies, and legal aid offices. The Consortium received the fourth-largestnavigator grant in the country, and has 96 paid navigators and another 151 volunteer navigators. In addition to the Navigator Consortium, there are three other navigator organizations in the state, along with 31 federally qualified health centers that are working to educate and enroll local residents. All of these organizations are working together, which is a key element of the state’s success.
In February 2013, 40 stakeholders – including advocacy groups, providers, hospitals, faith-based organizations, safety net clinics, brokers and insurance carriers – came together for the first of what they dubbed the “Big Tent” meetings, to discuss ACA implementation in North Carolina. They’ve continued to meet biweekly, and attendance has ballooned to almost 300 people, including representatives from nearly 100 organizations as well as private citizens who are passionate about healthcare reform.
Some meetings are for general information sharing, while others are focused on a specific topic (eg., enrollment efforts at community colleges, or enrollment in rural areas of the state). The Big Tent meetings are now being funded by the Kate B. Reynolds Charitable Trust, further ensuring their continued success.
The Navigator Consortium established a toll-free number (855-733-3711) that anyone in NC can call to be connected with an in-person assister. Schedules for all four of the navigator organizations and the 31 health centers are available to the phone operators, so they’re able to quickly match residents with the nearest local navigator. When navigators meet with residents, they focus on building trust and making connections – and in many cases, the navigators already have widespread community ties through churches and other local organizations.
North Carolina is one of ten states where Enroll America has focused their efforts, and Dixon noted that the group’s efforts have played a key role in the state’s success.
Dixon described the ACA as “an opportunity that cannot and should not be missed” and the community-based enrollment efforts in North Carolina prove that a dedicated group of individuals and organizations working together can succeed even without the support of lawmakers and government-run organizations.
Governor boosts Kentucky exchange
Kentucky has been widely praised for its ACA success, although there are critics who point out that when it comes to QHP enrollment, Kentucky is falling short of the goal that HHS set for the state, and isn’t really outperforming its neighboring states. But the state-level goals set by CMS/HHS before the exchanges opened were little more than guesses. It makes more sense to look at how many people the exchanges have enrolled as a percentage of the total uninsured population prior to open enrollment.
In the case of Kentucky, the state had about 640,000 uninsured residents last year. By the end of February, Kynect (the state-run exchange) had enrolled 54,369 people in private plans through the exchange. But they had also enrolled 210,545 people in Medicaid. Their total enrollment was nearly 265,000, with another month left in open enrollment.
While many ACA critics scoff at Medicaid enrollment numbers, preferring to focus only on private plan numbers, insurance is insurance. And having residents enrolled in Medicaid instead of being uninsured is better for everyone. It’s better for the newly-insured individuals, it’s better for the doctors and hospitals who treat them, it’s better for the rest of the insured population who would otherwise pay higher premiums to balance out the cost of uncompensated care, and it’s better for state and local governments, as they pay about 30 percent of the cost of uncompensated care when uninsured residents seek emergency treatment.
Jill Midkiff is the Director of Communications for Kentucky’s Department of Health and Family Services about Kynect’s enrollment success. She mentioned that prior to open enrollment, nearly half of Kentucky’s uninsured population was estimated to be eligible for Medicaid under the new expanded guidelines (about 308,000 people). Although the state does not yet have data on how many of the new Medicaid enrollees were previously uninsured, Midkiff said they believe that a large number of them were previously uninsured.
Kentucky’s Governor, Democrat Steve Beshear, has been outspoken in his support for the ACA, but the state legislature is politically divided. And Kentucky is represented in the Senate by Mitch McConnell and Paul Rand, both of whom are vehemently opposed to the ACA.
And although President Obama has only a 34 percent approval rating in Kentucky, exchange enrollment has been brisk – in part because of the massive advertising campaign and outreach that Kynect has conducted, and also because Governor Beshear has made a point to separate residents’ feelings about the President from their feelings about Kynect.
Kynect success likely to grow
Although Kentucky’s QHP enrollment puts it in the middle of the pack, its Medicaid enrollment stands out: Only two states –Washington and California, both with much larger populations – had higher Medicaid enrollment totals at the beginning of February. Medicaid enrollment is a cornerstone of the ACA. One of the main goals of the legislation was to insure as many of the uninsured as possible, and Medicaid expansion is an efficient way to go about doing that.
In Kentucky, not only did the state set up its own health insurance exchange and expand Medicaid, but they’ve also got a dedicated team of navigators, known as kynectors, who have worked tirelessly for months to have as many in-person conversations as possible with residents around the state. In Eastern Kentucky, there are ten counties where more than 50 percent of the new enrollees in the first four months of open enrollment were previously uninsured – this success in reaching out to the uninsured population is largely attributed to the boots-on-the-ground efforts of local kynectors.
And as we head into the latter part of open enrollment, new enrollees across the country are expected to increasingly be people who were previously uninsured; Kynect’s success is likely to grow.
West Virginia opted for apartnership exchange, working together with HHS and relying onHealthCare.gov for enrollment. But the state also expanded Medicaid, and has been aggressive about enrollment. Using auto-enrollment and extensive outreach, they had enrolled roughly 70 percent of the state’s estimated Medicaid-eligible population (about 87,000 people, which is already 24,000 more than had been expected to enroll by the end of 2014) by mid-February.
One of West Virginia’s most successful strategies has been identifying people who were already enrolled in other government programs like Children’s Health Insurance Program (CHIP), Supplemental Nutrition Assistance Program (SNAP) and Women, Infants and Children (WIC), and auto-enrolling eligible individuals based on income information already available through those programs. Between Medicaid and the QHP enrollments in the exchange, West Virginia has reduced its uninsured rate from 13.5 percent of the population to just 4.2 percent – after only four and a half months of open enrollment.
West Virginia, Kentucky, and North Carolina are all examples of how the ACA can – and will – result in fewer uninsured Americans, even without the full support of political leaders. And although public support is low in some states – generally in areas where President Obama is unpopular – navigators and outreach groups are finding that people are eager to enroll once they understand the details of the coverage that’s available and how subsidies help to make it affordable.
A new Bloomberg poll released Thursday suggests the Affordable Care Act will be a major factor in Americans' decisions to turn out to the polls this November, especially with its opponents.
According to the poll, 73 percent of respondents who said they would repeal the health-care overhaul known as Obamacare say the law will be a "major" factor in their vote. And 73 percent said they will "definitely" vote in this year's midterm elections.
By contrast, 45 percent of respondents who support modifications and 33 percent of those who support the law as it currently stands said Obamacare will be a "major" factor in how they vote. Meanwhile, 61 percent and 54 percent of those groups' respondents, respectively, said they will "definitely" turn out to vote.
"In off-year elections, turnout is a huge factor," J. Ann Selzer, who conducted the survey, told Bloomberg. "The anti-Obamacare segment is both more likely to say they will definitely vote and more likely to say their vote will be strongly influenced by their view of Obamacare. That can be enough to sway a race."
The premier elections in 2014 will come in the battle for Senate control — if Republicans swing six Senate seats currently in Democratic hands, they will take back the Senate.
There are seven seats up for grabs in traditionally red-leaning states this November — West Virginia, North Carolina, Louisiana, South Dakota, Alaska, Montana, and Arkansas.
"Many vulnerable Senate Democrats are competing on more Republican turf and carrying more direct Obamacare baggage than Alex Sink was," Tim Miller, the executive director at the GOP research outfit America Rising, told Business Insider in an email on Wednesday.
Overall, more Americans are in favor of either keeping the law as is or making adjustments to it than fully repealing it — 51 percent want to keep it with "small modifications," 34 percent want full repeal, and 13 percent want to keep it as is.
Individual provisions of the law are more politically popular. For example, 65 percent support a ban on insurance companies denying customers coverage based on pre-existing conditions, and 73 percent support letting children stay on parents' plans until the age of 26. But by a 51-47 margin, respondents opposed the provision mandating Americans buy health insurance.
Daily Show correspondent Samantha Bee has uncovered a small double standard: While Obamacare critics object to its covering contraception for women, no lawmakers have attacked $172 million in Medicare spending on penis pumps.
Penis pumps, which are vacuum tubes that help men attain erections, cost the government $360 each, according to Ilyse Hogue, president of the National Abortion and Reproductive Rights Action League. Medicare spent $172 million on penis pump claims from 2006 to 2011, NBC News reported.
Bee was stunned to learn of the costs.
“So for less than a dollar a day, a man can restore the glory of his erection?” she said on “The Daily Show” Wednesday. “That's amazing!”
She also said Hogue's criticism of the situation seems misplaced.
“She just didn't understand that women's selfish desire for sexual health and gynecological exams pales in comparison to men's need to deal with erectile disfunction,” Bee said.
“These are hardworking American penises,” she added. “Should we really be abandoning them at the end of their careers?”
Bee and Hogue also speculated about why lawmakers haven't declared war on penis pump spending.
“Statistics show that probably some members of our Congress have a vested interested in having penis pumps covered,” Hogue gently suggested.
WASHINGTON (Reuters) - The U.S. administration said on Monday that more than 5 million people have now enrolled in private health insurance under the program known as Obamacare, since open enrollment began on October 1.
The tally is an increase of at least 800,000 enrollees since March 1, with volume rising as the six-month enrollment period approaches its deadline on March 31. The nonpartisan Congressional Budget Office estimates that enrollment could total 6 million, but private estimates have suggested a lower turnout.
The announcement, in a government blog posted by Centers for Medicare and Medicaid Services Administrator Marilyn Tavenner, did not say how many new enrollees are the younger adults that President Barack Obamaneeds to make his new health insurance marketplaces a success.
But Tavenner said the pace of enrollment has been at its highest since late December, when there was a rush of interest from people who wanted coverage beginning January 1.
She said the federal website HealthCare.gov had 1 million online visitors over the weekend and more than 4 million visitors last week. A federal call center set up to take applications over the telephone had more than 198,000 calls last Thursday.
(Reporting by David Morgan; Editing by Chris Reese)
This Sunday is the the Affordable Care Act's fourth anniversary and, in what is something of a tradition, Republican National Committee Chairman Reince Priebus wrote a scathing op-ed in USA Today on Friday to remind readers of all that the GOP believes is wrong with the law.
But it's also a reminder that there is one piece of the law that even the GOP really, really loves and would never roll back: letting kids stay on their parents' health plan until age 26.
"Believe it not, we can actually find some common ground. For example, I think we can agree on allowing young people to stay on their parents' insurance plans until age 26," Priebus wrote. The Republicans could take the Senate -- even the presidency -- but that piece of Obamacare is here to stay.
It's no surprise that the GOP has embraced what is likely the most popular provision in the 900-plus-page law. A Bloomberg News poll released earlier this month found that 73 percent of Americans support the policy. According to the Obama administration, more than 3 million young adults are insured because of it.
To their credit, Republicans have always been rather fond of the age-26 rule. Sen. Marco Rubio (R-FL) -- then a candidate -- said just a few months after Obamacare was signed into law in 2010 that it was one of the few good ideas in a law that should otherwise be "scraped and replaced with better ideas."
"The idea that people up to the age of 26 should be allowed to stay on their parents' insurance plan, has widespread support," Rubio said. House Majority Leader Eric Cantor (R-VA) said something similar a few months later.
The Republican alternatives, which Priebus was talking up in his Friday column, would also maintain the age-26 rule. The Senate GOP proposal released in January kept it in place, even as it claimed to "repeal" Obamacare. If the elusive House alternative ever corporealizes, it could include it as well.
It's further evidence that, though the hard-line conservatives still profess that they can repeal "every word" of the law, that's not going to happen. The line that the GOP must walk now is opposing Obamacare, because that's what their base demands, while acknowledging that, four years in, millions have benefitted from the law that has served as their ideological foil for so long.
In this new reality, as Priebus's op-ed implicitly admits, there are some things that simply can't be undone.
The last day to sign up for 2014 coverage under the Affordable Care Act is Monday, March 31.
But a Mar. 24 study in PNAS found that many of the people who would benefit most from healthcare reform may not know enough to actually buy coverage.
In August and September 2013, researchers surveyed a nationally representative sample of 6,000 Americans, who answered questions about both the ACA and health insurance in general. Here's what they found:
When the survey was conducted, half of Americans hadn’t even heard of the health exchanges, where people can sign up for coverage, or of the subsidies that help people pay for insurance — and those numbers are even worse for the uninsured.
Only a quarter of survey respondents said they knew "a fair amount" about the Affordable Care Act, suggesting that educated decision-making about coverage will be difficult for the majority of Americans.
Why this is a big problem
According to the authors, one of the most important ways to evaluate the success of the exchanges will be to see if they promote competition that results in cheaper, better coverage for individuals. But it will be hard for that to happen if uninsured people don’t use the exchanges, or if they can't figure out how to buy the right coverage for themselves in the first place.
Part of the problem is the complexity of the insurance system itself. The relationships between deductibles and premiums can difficult for buyers to understand, and different plans cover different things. The authors say that this complexity may deter people from making a choice at all.
Overall, 42% of respondents and 58% of uninsured respondents did not know that a deductible was what they would have to pay before their insurance started paying for coverage.
Even worse, more than half of people eligible for subsidies had not heard of the insurance exchanges or the subsidies designed to make their options more affordable.
While it's likely that more Americans have learned about their coverage options since the time of the survey — people without insurance are signing up now at higher rates than they were when exchanges first opened — the results show that just one month before the exchanges opened for business, many of the most important beneficiaries were still in the dark.
You've probably read plenty of confusing stories about people's health insurance premiums going up, going down, or going to zero. So which is it?
It depends. Fortunately, the Kaiser Family Foundation has developed the handy calculator below to determine what the answer is for you, based on your income, smoking habits, and other relevant factors.
To actually buy a plan, you'll need to visit HealthCare.gov, but this tool will give you a sense of the cost. It only takes a few seconds. Give it a try:
Your deadline to sign up for a 2014 plan under the Affordable Care Act is this Monday, March 31.
The court's conservative justices were sharply critical of the provision in the law. The women justices, meanwhile — liberals Elena Kagan, Sonia Sotomayor, and Ruth Bader Ginsburg — defended the law, according to the Times.
Justice Anthony Kennedy, a swing voter with a libertarian bent, told U.S. Solicitor General Donald Verrilli, who defended the mandate, that his reasoning "would permit requiring profit-making corporations to pay for abortions."
The rule at stake under the health-care overhaul is a provision in the ACA that requires all new health insurance plans to pay for contraceptives. The issue is whether for-profit corporations — in this case, the lead plaintiff Hobby Lobby Inc. — can refuse to provide all or some contraceptive services.
Verrilli argued that for-profit corporations should not have a right to religious liberty that supersedes federal law. He told Chief Justice John Roberts it would potentially open the floodgates for for-profit corporations to claim exemptions.
But Roberts said Congress passed the 1993 Religious Freedom Act for that reason, and he hinted at a possible narrower ruling that focuses on more closely held companies, according to The Wall Street Journal:
Chief Justice Roberts appeared to tip his hand when he told Mr. Verrilli that the parade of horribles — all kinds of religious exemptions being claimed by all sorts of employers, punching holes in the uniform application of the laws — could be avoided by a ruling limited to closely held enterprises, like S corporations that pass their earnings through to their shareholders. That would leave the issue of, say, an Exxon claiming religious freedom rights to another day. Later, Justice [Stephen] Breyer suggested he might be open to that type of resolution.
In somewhat typical fashion, Kennedy seems to be the key swing vote. According to the Journal, he asked skeptical questions of both sides. Both Verrilli and Paul Clement, the lawyer representing Hobby Lobby, reportedly aimed at him in their closing arguments.
This is the most significant Obamacare-related case argued before the Supreme Court since the high court upheld the law's individual insurance mandate two years ago, in the heat of the 2012 presidential election. A ruling is expected to come in June.
The Obama administration is extending the deadline to sign up for health insurance past March 31 for some individuals who have trouble completing enrollment before the deadline.
An administration official said "individuals with special circumstances and complex cases" who have already started enrollment will have until mid-April to apply for an extension under the new plan. In a statement, Department of Health and Human Services spokeswoman Joanne Peters said the extension was due to a surge in demand, as the administration mounts a furious push to get as many people as possible to sign up for health insurance before the deadline.
"Open enrollment ends March 31. We are experiencing a surge in demand and are making sure that we will be ready to help consumers who may be in line by the deadline to complete enrollment — either online or over the phone," Peters said.
According to The Washington Post, the new deadline will rely on an "honor system"— HHS will not determine whether a person is telling the truth when he or she says she started enrollment before the March 31 deadline.
"Another day, another Obamacare delay from the same Obama administration that won’t work with Republicans to help Americans suffering from the unintended consequences of the Democrats’ failed healthcare law," RNC Chair Reince Priebus said in a statement.
Administration officials offered a comparison in the extension to allowing voters already in line when the polls close to go to the polls:
Many administration officials had been firm on the March 31 deadline. They stressed that this move was not another delay or a change in plans — simply an accommodation for people in line. The administration made a similar move in December, when a surge of people signed up for coverage starting Jan. 1.
Late Tuesday night, the administration announced it would offer extensions to prospective enrollees who begin the sign-up process before the March 31 deadline. People will have until mid-April to apply for extensions, many of which will be granted on the basis of an "honor system" for those who claim they tried to enroll ahead of the initial deadline.
Boehner didn't mince words when he was asked about it Wednesday.
"What the hell is this? A joke?" he said. "Another deadline made meaningless. If he hasn't put enough loopholes in the law already, the administration is now resorting to an honor system to enforce it."
Boehner wondered why the administration wouldn't move the deadline to April 15. The administration stressed in its announcement that it was not delaying the law but simply providing more time to an expected surge in interest ahead of the deadline. An official emphasized, however, that it was not an extension in the open enrollment period.
Boehner's comments led to more partisan bickering. White House senior adviser Dan Pfeiffer tweeted that Boehner and other Republicans opposed the change out of spite. At a press conference Wednesday afternoon, Senate Majority Leader Harry Reid retorted the "real joke" is House Republicans continuing to vote to repeal or alter Obamacare.
"There are some people who are not like my grandchildren who can handle everything so easily on the Internet," Reid said. "And these people need a little extra time." Some people, he added, are "not educated on how to use the Internet."
10. Services to help overcome long-term disabilities and chronic conditions
11. Screening to determine if your drinking is unhealthy
All of these benefits fall under the 10 essential benefits that the Affordable Care Act provides:
1. Outpatient care—the kind you get without being admitted to a hospital
2. Trips to the emergency room
3. Treatment in the hospital for inpatient care
4. Care before and after your baby is born
5. Mental health and substance use disorder services: This includes behavioral health treatment, counseling, and psychotherapy
6. Your prescription drugs
7. Services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
8. Your lab tests
9. Preventive services including counseling, screenings, and vaccines to keep you healthy and care for managing a chronic disease.
10. Pediatric services: This includes dental care and vision care for kids
So-called "grandfathered" plans, which have existed since before March 23, 2010, may not provide all of these benefits.
Enrollment in health insurance exchanges under the Affordable Care Act has surpassed 6 million, President Barack Obama said Thursday on a conference call with health care navigators and volunteers.
That means enrollment in the exchanges has surpassed its target number, which was revised down from an original goal of 7 million after the federal health care website's disastrous rollout in October.
The deadline for people to sign up for coverage this year is March 31.
"This afternoon, while traveling in Italy, President Obama convened a conference call with health care navigators and volunteers helping with enrollment efforts and announced that more than 6 million Americans have signed up for private health insurance plans through the federal and state Marketplaces since October 1," the White House said in a readout of Obama's conference call.
"The President was joined on the call by several thousand grassroots volunteers, navigators and in-person assistors who are leading the effort to enroll millions of Americans in quality, affordable health insurance plans."
The White House said demand continues to surge ahead of the deadline — there were 1.5 million visits to HealthCare.gov on Wednesday, and more than 430,000 calls into call centers. There are still four days to go before the initial deadline. And on Tuesday, the Obama administration said it would grant extensions to people who start applications ahead of the deadline but are unable to complete them for various reasons.
After the website's disastrous launch, only 106,000 people picked plans in October, the first month people could sign up. But by December, once many of the problems with HealthCare.gov had been fixed, more than 2 million people had signed up.
The Congressional Budget Office's most recent estimate projected 6 million people would sign up for coverage during the law's initial, six-month enrollment period. The CBO projects that 7 million people will join in 2015 and 9 million more will join in 2016.
While the ACA won't make it possible for everyone who is uninsured to find affordable health insurance, there are many people who will be able to find good coverage for the first time.
I'm just one of them.
Why I Was Uninsured
For many years, I didn't have health insurance primarily because I couldn't afford it. (I'm not on staff at Business Insider, so I don't get coverage through the company.)
My wife and I did pay for health insurance for about a year, from late 2010 to late 2011. During that time I went to the doctor for basic preventative care, and I got a broken toe splinted back into place — the kind of things you can do with health insurance.
Visiting a doctor also cost me nothing when I was living in Spain and South America. In Ecuador, I visited a hospital to get rid of a stomach parasite acquired in the Amazon. When I asked how to pay, the doctors laughed.
But when my wife and I moved to New York in 2011, the cheapest market coverage we found cost more than $700 a month, with a $10,000 deductible.
Back in 2010, when a car hit my bike and bounced me off the windshield, I refused treatment and a ride to the hospital. I was too worried I could end up with an ambulance bill that could be thousands of dollars.
And two summers ago, when something snapped or popped inside my knee during a soccer game, I didn't want to get it checked out. I knew I couldn't afford surgery and didn't want it to count as a pre-existing condition if the ACA was repealed. I still feel it when I run.
Accurate numbers are hard to come by, but studies estimate that somewhere between 18,000 and 45,000 Americansdie each year because they go without coverage.
I fit in the category of "young and invincible," and I've been lucky. But if something serious were to happen, I didn't know what I'd do.
I wanted health insurance.
The Individual Market
I've been a freelancer, contractor, paid intern, full-time temporary employee, and worked for small bars and restaurants. In none of those positions has an employer ever paid for health insurance — and that situation is not unique, with aroundone-third of the U.S. workforce participating in the "freelance" or "gig" economy.
Instead of getting coverage from an employer, freelancers who want insurance have to buy it on the individual market, and the ACA has improved things in a few ways.
First, it's now easier to compare plans. Back when I bought coverage in 2010, I searched the web for insurers but didn't really know how to compare one against another, even after reading long coverage documents. They all were described differently.
The deadline to sign up for health insurance through the Affordable Care Act is Monday, March 31. (Extensions will be granted in a few cases.)
I first tried to look at my options on the health insurance exchanges on Oct. 1, 2013, even though, at the time, I didn't think I would sign up. But like millions of other people, I couldn't even log in.
During last night's cold open, Obama, with the help of a new social media manager, did ridiculous stunts to appeal to a younger generation of potential Obamacare users. Like wearing a "Pharrell hat" while smoking an e-cigarette.
He took a selfie with social media stars Kim Kardashian, Harry Styles, and Batkid.
The president danced for a vine video with Pope Francis.
And even went so far as to kiss Justin Bieber. All in the name of Obamacare.
HealthCare.gov was down early Monday morning — on deadline day for enrollment in health-insurance plans under the Affordable Care Act.
The federal site became unavailable shortly after 3 a.m. ET. A representative for the Department of Health and Human Services said the site's tech team had found a software bug as part of routine overnight maintenance, but the issues spilled into the early hours of the morning on the East Coast.
About 8:30 a.m. ET, the representative said, the site was "coming back up."
"HealthCare.gov marketplace application and enrollment system is coming online now," the representative said in an email. "The tech team extended regular maintenance window this morning and is bringing the system online gradually to best meet consumer demand."
Visitors who experienced problems were asked to leave their email address so that they could be notified when the site was back up.
Officially, Monday is the final day for people to enroll in health-care plans under the law colloquially known as Obamacare. The Obama administration has said, though, that some people who began signing up by the deadline and had problems that prevented them from completing the process would have extra time to do so.
While the March 31 deadline applies to the whole country, people who started to sign up but have been unable to finish the process due to technical difficulties will be able to get an extension in some states.
You can check and see how much coverage might cost you beforehand. All plans cover basic health services, including preventative care, mental health, emergency room visits, maternity care, lab testing, and more.
If You Miss The Deadline
Residents of the 36 states that use the federal government exchange will have until mid-April to apply for an extension, which will grant them a special enrollment period of approximately 60 days to choose a plan. In order to get the extension, people will have to check a box that says they tried to enroll before the deadline.
Some other states that have had technical issues — including Maryland, Minnesota, Nevada, and Oregon — have offered similar extensions, though in some cases, their requirements for showing an earlier attempt to enroll could be different.
After mid-April, some people will still be eligible for extensions that allow them to sign up for health coverage that will start this year. These exceptions will be granted to those who couldn't enroll because they were sick, in a natural disaster, or experiencing ongoing site errors.
Additionally, people who experience a major life change can apply for an enrollment period to obtain insurance after the deadline. Some of these life events include getting married, having or adopting a child, losing a job that provided health insurance, or moving to a new area with different coverage options.
If none of these exemptions apply to you and you are uninsured after the March 31 deadline, you may have to pay a penalty.
Who Doesn't Have To Pay The Penalty
If the cheapest insurance plan available to you would cost you more than 8% of your income, then you don't have to pay the fine.
People also don't have to buy coverage and won't pay a fine if they don't earn enough money to file a tax return or are part of a religious sect that objects to insurance. There are a few other people that are exempt, listed here, along with 14 factors that qualify people for "hardship exemptions" from paying a fine.
Some of those hardship exemptions are very specific, such as receiving a shut-off notice from a utility company or having had medical expenses you had trouble paying in the last two years.
The final exemption is fairly broad however, and states "you experienced another hardship in obtaining health insurance." David Howard, a professor at Emory University's Rollins School of Public Health, told Modern Healthcare that this most likely means that "basically anyone who wants to be able to claim a hardship exemption will probably be able to."
Anyone who is uninsured in 2014 and doesn't qualify for an exemption will have to pay either $95 or 1% of their income, whichever is greater, when they file taxes next year.
The next chance to sign up for health insurance will be Nov. 15, 2014 — and that coverage won't start until 2015.
WASHINGTON (Reuters) - The White House said on Monday that it expects final enrollment numbers for private health care insurance under Obamacare in 2014 to be "substantially larger" than 6 million after a busy final weekend of in-person and online signups.
"Here on the last day of enrollment, we're looking at a number substantially larger than 6 million people enrolled,"White House spokesman Jay Carney told reporters, noting he was not sure when the government would be able to release its final enrollment figures.
(Reporting by Roberta Rampton and Jeff Mason; Editing by Doina Chiacu)