The wheels on the health care bus continue to go round and round, but confusion over the website, insurance rates, government tax credits and cancelled plans are leaving many people with more questions than answers.

That’s exactly how 54-year-old Mike Wilkins felt Thursday night when he showed up for a health care information forum, sponsored by Virginia Organizing. Wilkins said he’s been without health insurance for 10 years, ever since he left his job at Food Lion and became self-employed.

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Wilkins said he delivers bread and runs a small flower shop out of his home, and estimates he makes between $25,000 and $30,000 a year. But since his insurance costs will come out of his own pocket, the premiums for good coverage have been too high for him to afford, he said.

“I’ve just gone without it because I have so many other expenses, I just never could have afforded it,” he said. “I’m thankful the Lord has blessed me with such good health, because otherwise I just don’t know what I would have done.”

According to Virginia Performs, an initiative of the Council on Virginia’s Future, about 18 percent of Southside Virginia residents were uninsured in 2010. Most of these cases were simply because of their inability to afford good coverage, which can range between hundreds to thousands of dollars a month for a family without employer-based coverage.

Wilkins said he’d considered looking into health insurance in the past, but decided to get serious about finding a plan when he heard that everyone had to get insurance by next year or face a fine.

The requirement is part of the Affordable Care Act, which mandates that most individuals have health insurance by March 2014. Those who don’t get coverage will face a fine of $95 or 1 percent of their taxable income in the first year.

Wilkins decided he had to find coverage somewhere. There was just one problem — like many Americans, he had no idea where to start.

“I don’t have any clue how to begin with this,” he said. “I know I have to have health insurance, but I don’t know much about it.”

To get more information about the new health care system, Wilkins attended one of two sessions put together by Virginia Organizing, a nonpartisan group that seeks to educate people on important issues and help them make informed decisions.

The crash-course in health care and the Affordable Care Act was led by Amber Porón, a certified health care navigator for Enroll Virginia. Her job is to assist residents in answering questions about health care and helping them sign up in the new health insurance marketplace.

At the meeting, residents learned the basics of the marketplace and who could qualify for government-subsidized health care plans. They also learned about changes being made to existing plans that could affect those who already have health insurance.

According to Porón, the website, which experienced major glitches for weeks after its initial Oct. 1 rollout, is now “working much better.” She explained users can now log on to the website and find out if they qualify for a government-subsidized plan, even if they already have employer-provided insurance.

Rebecca Warren, 36, said she signed up on the website last week without any problems. She said she already had health insurance through her employer, Averett University, but wanted to see if she qualified for a better plan under the Affordable Care Act.

While she was able to sign up on the website by herself, Warren said she thinks most people are still confused about where to go and what to do concerning their insurance plans.

“I think there are a lot of negative opinions right now about health care,” she said. “A lot of it is because of things people are hearing, and they just don’t understand.”

Throughout the forum, Porón explained the breakdown of insurance plans, which range between bronze, silver, gold and platinum, and the amount of coverage each plan offered. She also explained that all insurance plans must now offer what are called “essential services,” and no one can be turned away because of a pre-existing condition.

Exact figures on the cost of the plans, as well as deductibles and co-pays, will differ from person to person depending on their situation, Porón said.

While the majority of her presentation targeted people who don’t have insurance, Porón stumbled over a question raised by several currently-insured attendees about their ability to keep their current doctor if they were to switch to a different plan.

Porón said that not all plans will be accepted by all doctors, so residents should check to see if their current doctor will take the new plan before they sign up.

“So the comment by our president saying that we could keep our doctor if we liked them, that was false?” one attendee asked.

“Yeah, you would have to check with each plan, so yes,” Porón said.

For those uninsured, Porón said help is available for anyone having trouble understanding the new system or enrolling in a new plan in the marketplace.


(Posted: December 8, 2013 at / Story by: Brittany Hughes)