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Health insurance exchanges start in New York

October 6, 2013
By JASON?SUBIK , The Leader Herald

Dave Gibson was doing some work near his home in Bleecker and a tree fell on his head and broke his neck.

"I can laugh about it now, because I'm not dead," Gibson said.

Gibson damaged the vertebra in his neck and, because he did not have health insurance at the time of the accident, he racked up $26,000 in medical bills that he could not pay. He said he last had health insurance while he was working in Connecticut, but his employer dropped his coverage after he turned 60 and the premiums rose to over $1,000 a month for the employer's contribution. After that Gibson, who once owned Fulton Computer Co. in downtown Gloversville, tried in vain to find a health insurance carrier that would cover him despite his age and high blood pressure. He couldn't find one.

Article Photos

At top, Dave Gibson works on his laptop trying to get into the HealthCare.gov site at his home in Bleecker on Thursday.
(The Leader-Herald/Bill Trojan)

The roll-out of the provisions of the Affordable Care Act, often called "Obamacare" by critics and supporters of the law, offered hope for Gibson in the form of health insurance marketplaces, also known as health exchanges. The exchanges are online marketplaces where many health insurance plans that meet the standards of the Affordable Care Act are offered up to individuals. In theory, the marketplaces will offer more options to individuals and help them comply with the law's mandate requiring everyone to obtain health insurance or pay a fine of either $95 or 1 percent of their income, whichever is greater. The marketplaces will also expand the options available to people who already have health insurance through their employers.

"I was looking forward to getting on the health exchanges. Effective Jan. 1, the health insurance carriers can no longer deny me based on my having a preexisting condition," Gibson said. "I just wish it had happened a year ago,"

Last week, Gibson was responsible for at least several of the 30 million hits received at the nystateofhealth.ny.gov website, the place where the health insurance marketplace was supposed to begin offering health insurance policies aimed primarily at New York state's 2.7 million uninsured residents.

The sheer number of hits was surprising, more than 10 times the number of uninsured. State officials are trying to figure out why their website has attracted more hits than in any other state.

State Department of Health Executive Director Donna Frescatore said the agency doubled the website's capacity after users experienced delays and other difficulties entering.

New York is constantly monitoring the website for "robots" which could inundate the system as a protest or as a way to disrupt the health care program. But no evidence has been found. The department said evidence of an attack or protest could be seen immediately.

Although more than 30 million hits were recorded by Wednesday evening, just 12,000 have entered the system and supplied information that is expected to lead to purchasing insurance, Frescatore said.

Many of the 30 million hits may reflect several visits by the same person over two days. Many may also simply be gleaning general information and may apply later. Still others could be from another state, but employed by a company based in New York. The state is looking to streamline the process so people can shop faster and not be "timed out" by the site.

That was the problem Gibson experienced.

"I've been trying to get on, but I keep on getting timed out," he said Thursday. "I tried all day yesterday and several times today."

Frescatore urged New Yorkers not to be discouraged if they are blocked or slowed in their use of the website. She noted applicants have six months to enroll and applications as late as December can result in insurance coverage on Jan. 1, the earliest date for coverage.

The state's customer service center operators have provided information to and answered questions from more than 9,000 New Yorkers," she said. "Today, like all other states, New York's website is experiencing significant levels of activity, which is causing some users to experience difficulty entering the site and delays in application processing."

Fulton Montgomery Regional Chamber of Commerce President Mark Kilmer said many of his chamber members continue to have questions about how the Affordable Care Act will effect them. He said he's not sure how the law will effect the chamber continuing to offer its members health insurance options through Amsterdam-based health insurance broker Bouchey and Clarke Benefits Inc.

"It's going to have an effect, because the members now based on the law can go straight to the exchange, they no longer need to be a part of a group," he said.

Tim Salls, a broker at Bouchey and Clarke, said the health exchanges will give chamber members more options than they had before, but not necessarily better prices. He said it's always been a misperception that the chamber received some kind of discounted health insurance through buying policies together as a group. He said insurance costs are determined by community rates for businesses in the two to 50 employee range and "the rates are the rates." He said his company provides advice to five chambers of commerce in the greater Capital Region and he suspects the health exchanges will increase the value of that advice. Bouchey and Clarke has ramped up its operations hiring three new full-time employees in anticipation of the many questions created by the health exchanges,

"Small businesses don't really have the resources they need to do the research they need to make informed decisions, even more so today than before. We used to show clients four or five benefit offerings, which was itself confusing to them, but now to tell them to go navigate through the state's website, where they're going to look at 64 different health plans, that's a lot of information," he said.

The Fulton Montgomery Regional Chamber of Commerce will host an information session for its members regarding the health insurance exchanges on Oct. 23 at the Winners Circle in Fonda at 8 a.m.

The Associated Press contributed to this article.

 
 

 

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