by Jordan Green

Around Feb. 25, the number of people who had enrolled in a healthcare plan through the Health Insurance Marketplace set up by the federal government crossed the 4 million mark. Last week, I joined their ranks during the final sprint before open enrollment ends on March 31. Considering that the Affordable Care Act continues to be the most superheated, toxic political issue in the land, my experience was — sorry for the anticlimax — smooth, painless and, well, affordable. To be sure, my first attempt to navigate the website was a blind stumble through a confusing digital warren thwarted by frozen screens and failed passwords. The task was complicated by indecision about whether I should sign up on my own, or with my wife and infant daughter. In mid-December, about the time the website reached full functionality, I decided to stick with my employer plan to avoid unnecessary complication. But recently, I was forced to look for a new plan when I changed jobs. After some initial difficulty navigating the site, I dialed the publicly listed 800 number, and a pleasant customer service representative volunteered to sign me up over the phone. I had been bracing myself to pay a higher premium than I had through my old employer plan, administered by Womack Publishing, a media company that operates a chain of 15 newspapers in Virginia and North Carolina. The young woman at the other end of the line informed me that based on my family income I wouldn’t qualify for a subsidy. “Without a tax credit, it will typically be on the high side,” she warned. She clearly explained the options, and I chose the second cheapest Bronze plan for $219.50 per month with a $5,500 deductible and $15 copays for primary care visits. Under my previous plan, I paid a monthly premium of $288. By using the exchange to shop for a plan, I’ll save my family more than $800 a year. I can’t find anything to complain about there. It’s difficult for me to understand why Republican politicians are willing to paralyze the country in their zeal to kill the Affordable Care Act. As a constituent in North Carolina’s Republican-leaning 6th Congressional District, I’m faced with a GOP field in which Phil Berger Jr. says, “Obamacare? No way,” Jeff Phillips supports full repeal and Don Webb wants to fight his party leadership because they crafted a budget that funds this law of the land. I’m unaffiliated, and my vote is up for grabs to the candidate that embraces the most sensible policy. I’m not insensitive to the prospect of hundreds of thousands of North Carolinians being dropped from their previous plans. (Incidentally, the government is now allowing people whose plans don’t meet federal standards to keep them for three years.) I don’t particularly care how it’s done, but any candidate who wants my attention will have to propose a plan to expand coverage to more people and bring costs down for consumers. Republicans are going to have to emphasize solutions over obstruction to reach voters like me. The biggest hurdle in reform remains the fact that people who were previously uninsured are the most reluctant to sign up under the exchange. A recent survey by McKinsey & Company found that only 27 percent of respondents who had signed up for plans under the exchange were previously uninsured, up from 11 percent. More than 80 percent cited affordability as their reason for not enrolling, but the survey found that 66 percent of respondents were not aware that they qualified for a subsidy. Mary Haglund, owner of Mary’s Gourmet Diner in Winston-Salem, is one of the previously uninsured. “I used to be covered by Blue Cross Blue Shield,” she told me. “I was paying $3- to $400 a month; I had a preexisting condition. I got really sick of paying it. I got really mad and canceled it. I’m 60, and I haven’t had health insurance in years. My husband is 45. He was uninsured too. He was a punk rocker who became a restaurant rat. Then the Affordable Care Act came along, and I said, ‘That might be my chance.’” She was prepared for disappointment. But Haglund and her husband found a plan that covered both of them for $240 a month with $25 doctor copays. “I’m thrilled about it,” Haglund said. “Quite frankly, I didn’t know what was going to happen.” Scrape away the rhetoric, and the political situation looks a lot more dire than the public-health reality.

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