Healthcare.gov Navigators See Surge As Deadline Looms

Mar 29, 2014

Credit Rebecca Huntington

With the deadline looming to sign up for health insurance under the Affordable Care Act, healthcare-dot-gov navigators are seeing a surge in people seeking help. Wyoming Public Radio's Rebecca Huntington has more.

"Thanks for your patience, you'll have our undivided attention shortly. Your access to quality, affordable coverage is just a few minutes away."

That's the hold message for the healthcare.gov helpline. It's on speakerphone in the computer lab at the Teton County Library. In the lab, six trained navigators are helping individuals access the new federal marketplace for health insurance. With the March 31st sign-up deadline approaching, the library is having an all-day marathon with back-to-back appointments.

"Is that per person?" Craig Spankie asks.

"That would be the family premium," Morlock.

Librarian and navigator Suzanne Morlock is helping Craig Spankie who works as a carpenter. She called the healthcare.gov helpline after hitting a roadblock. Spankie is anxious to get back to work. But he's also anxious to get insurance.

"OK, can you log me out and then show me how to get back to here so I can do that at home?" Spankie asks.

As a carpenter, Spankie doesn't get insurance through his employer and this will be the first-time he's been covered in seven years. His three kids get insurance through the state's children’s health insurance program. But he's pleased to have access to an affordable plan for the entire family. His story is not unique. Teton County has the highest rate of uninsured individuals in the state.

But not everyone in the computer lab is having luck finding an affordable plan. Librarian and navigator Kurt Plagge says the first two individuals that he helped made less than $11,500 a year. And that's too little to qualify for a subsidy.

In other states, they would qualify for Medicaid, health insurance for low-income individuals. But so far, Wyoming has decided not to expand its Medicaid program.

"So they didn't qualify for Medicaid. They were allowed to buy health insurance if they wanted to through the marketplace, but it would be pretty expensive. It was definitely unaffordable."

Plagge says they are exempt from having to pay the penalty for not having insurance. Even so, he says they were disappointed to not get health insurance. And they weren't the only ones who left disappointed.

"The couple I worked with had the opposite problem," Plagge says. "They made just slightly too much money to qualify for a subsidy."

He says buying insurance would have cost them 20 percent of their total annual income.

"With their current income, the way they estimated it, it would have cost them $1,333 a month for the two of them for insurance. If they made $4,000 a year less it would cost them about $240 a month for the two of them. It's quite a big difference."

And that puts them in a tough spot.

"In their case, at first they thought, 'Wow, we should work less, maybe we'll get insurance,'" Plagge says.

But Plagge says it's not quite that simple.

"One of them had the opportunity next year to qualify for a good insurance program through work as long as that person maintained their current level of work. So they're caught in a conundrum," he says.

Like the individuals that made too little to get subsidies, they will be exempt from paying a penalty for going without insurance. That's because the Affordable Care Act exempts people who don't have access to affordable insurance.

Overall, Plagge says that people, who fall in what navigators are calling the "sweet spot," like carpenter Craig Spankie's family, are finding affordable plans and getting insurance for the first time in years.

But in Wyoming, for those who make just a little too much or not quite enough, the plans are anything but affordable. And those groups are likely to continue living without insurance. For Wyoming Public Radio, I'm Rebecca Huntington in Jackson.