On Nov. 8, I began my quest to purchase health insurance. As a 63-year-old, self-employed woman, the least expensive – and the worst – health plan available to me will cost $778 a month, or 17 percent of my adjusted gross income. To be considered affordable under the Affordable Care Act, health insurance should cost no more than 8.16 percent of AGI. Therefore, I qualify for a shared responsibility payment financial hardship exemption, which, in turn, qualifies me to purchase catastrophic health coverage. Herein lies the problem: In order to purchase catastrophic coverage at my age, I must have an exemption certificate number.

I have talked to Mercy Hospital financial counselors and health care navigators at Opportunity Alliance and to people at the Healthcare Marketplace, the Internal Revenue Service, Consumers for Affordable Health Care and Maine Community Health Options, and the Maine Bureau of Insurance recently confirmed that my efforts are futile. The exemption certificate number, necessary to purchase catastrophic coverage, cannot be obtained until the enrollment period has ended, and obtaining an exemption certificate number is not considered a qualifying event to purchase coverage outside of the enrollment period.

I am perplexed. If I cannot get an exemption certificate number until the enrollment period has ended, why isn’t getting an exemption certificate number a qualifying event?

One person suggested I reduce my income to qualify for the subsidy. That’s the American Dream? Make less money so you qualify for government subsidies?

I have also been told to purchase the $778 coverage and, when I get an exemption certificate number, change to catastrophic coverage; $778 is not affordable. We are not allowed to change our coverage after Dec. 15 unless we have a qualifying event. Receiving an exemption certificate number is not a qualifying event.

I’ve written to our senators.

Pamela Larsen

Portland


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