August 24, 2013

Obamacare questions hit home

Americans have more questions than answers about how the impending change will affect them.

By CHAD TERHUNE Los Angeles Times

Like many others, Scott and Danielle Nelson are anxious about what President Obama's health care law will mean for them.

click image to enlarge

Danielle and Scott Nelson pose with their children, Taylor, 7, back right, and Dane, 3, at their Aliso Viejo, Calif., home on July 3. They are relieved to find Danielle’s pre-existing cancer will be covered, but they have many more questions.

Allen J. Schaben/Los Angeles Times/MCT


Part-time government work is becoming even more so under the health-care law championed by President Obama.

Many cash-strapped cities and counties, facing the prospect of shelling out hundreds of thousands of dollars in new health-care costs under the Affordable Care Act, are opting instead to reduce the number of hours their part-time employees work.

Cutting the number of hours part-time employees are permitted to work will save some county and local governments from having to provide health-care coverage for employees. The Affordable Care Act requires employers to cover employees who work at least 30 hours a week or to pay a penalty.

Critics of the law have pointed to Bureau of Labor Statistics reports that show many of the new jobs the economy is adding are part-time positions. And many private-sector companies are cutting hours or health benefits, citing new costs associated with the Affordable Care Act. On Tuesday, United Parcel Service said that, beginning in 2014, it would exclude working spouses currently covered from the company's health-care plan if those spouses are eligible for coverage through their own companies.

Even 3 1/2 years after Obama signed the measure, both private- and public-sector employers say uncertainty over the law's implications are driving their caution, which means shifting full-time jobs to part-time status.

The decisions to cut employee hours come 16 months before employers -- including state and local governments -- will be required to offer health-care coverage to employees who work at least 30 hours a week. Some local officials said the cuts are happening now either because of labor contracts that must be negotiated in advance or because the local governments worry that employees who work at least 30 hours in the months leading up to the January 2015 implementation date would need to be included in their health-care plans.

On Tuesday, Middletown Township in New Jersey said it would reduce the hours of 25 part-time workers to avoid up to $775,000 in increased annual health-care costs.

"It's not something we prefer to do, but the cost of health insurance is significant and would really impact municipal budgets," said Anthony Mercantante, Middletown's township administrator.

-- The Washington Post

While government officials tout the broad benefits of the Affordable Care Act to drum up enrollment, many consumers are eager to know how the overhaul will affect them personally, from pocketbook concerns to worries about whether their local doctor and hospital will be included.

And so far, there have been considerably more questions than answers, as officials and insurers scramble to get ready and clarify many of the details that people care about the most.

The issue hit home for the Nelsons several weeks ago when their current health insurer, Aetna Inc., said they were among thousands of customers in California whose coverage will be canceled at year end. As a result, they will need to buy a new policy just as the federal law reshapes the market.

The surprising news came at a rough time for the Aliso Viejo, Calif., couple and their two young children. Danielle Nelson, 42, was diagnosed with cancer in March. She began sobbing as she shared the insurance company's letter with her husband. Her 7-year-old daughter, Taylor, saw something was wrong and handed her parents a pink purse where she had saved up $27.

"All of this has turned our lives upside down," said Scott Nelson, 49. "The uncertainty in health insurance really has us scratching our heads."

The Nelsons aren't alone in searching for answers as the biggest change to health care in nearly half a century prepares to kick in Jan. 1. About half the public says they don't have enough information about the health law to understand how it will affect their own family, according to a recent poll by the Kaiser Family Foundation.

Huntington Beach, Calif., resident Brad Miller said he and his wife pay about $1,200 a month now for their health insurance. The 60-year-old says he's concerned that comparable coverage will be expensive next year and federal subsidies won't be available to help.

Steven Aispuro, a 50-year-old father of three in Whittier, Calif., is uninsured and eager to find out how much family coverage will cost, and whether his family qualifies for government aid. "You hear a lot of negative things about Obamacare on TV. I don't really know what's true about the law," he said.

The federal health law requires most Americans to have health insurance starting next year, and many consumers will qualify for free or subsidized coverage based on their income.

While subsidies may make insurance more affordable for some, state officials have already warned that premiums could rise an average of 30 percent for many middle-income residents who don't get their insurance through their employers.

How individuals and families fare will vary based on their age, household size, income and where they live. Explaining the nuances of a complex law and various insurance options is a daunting task.

The Nelson family said they feared the worst after the Aetna cancellation notice, particularly as they incurred medical bills related to the cancer diagnosis.

"Are we going to lose our house? That was really where my mind went," Danielle Nelson said.

In the days and weeks that followed, they learned they stood to benefit from certain provisions of the health law, while other questions surrounding cost and choice of doctors were harder to pin down.

Scott is a philanthropy and communications consultant who left a corporate job with health benefits about 18 months ago. Danielle Nelson previously worked as an assistant vice president for financial firm Lehman Bros. in Southern California.

Under the health care overhaul, insurers must accept all applicants regardless of pre-existing medical conditions. That was a huge relief for the Nelsons after her diagnosis of non-Hodgkin's lymphoma, a blood cancer.

Danielle Nelson had a tumor in her jaw removed. But thus far, she doesn't require further treatment beyond regular testing. She still worried her premiums would be higher next year because of the cancer, but the health law forbids that as well.

The Nelsons pay $667 a month now for their health policy. But a mid-level "Silver" policy from California's new insurance exchange -- along with the federal subsidy for which they are eligible -- would cost them $593, or 11 percent less.

Starting next year, health insurance premiums are based on a person's age and location. Separately, premium subsidies hinge on household income and size. Individuals earning less than $46,000 a year and families below $94,000 annually may qualify for subsidies.


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