It's been a rough & rocky road for the Obama Administration as it rolled out the Affordable Care Act's online application for the uninsured.
House Majority Leader Rep. Eric Cantor said, "The rollout of Obamacare is nothing short of a debacle"
Kentucky Governor Steve Beshear said, "You know, this is working in Kentucky."
Designed to help the 50 plus million people who don't have health insurance - get it - there are those who like it...
BCBS of Alabama President & CEO, Terry Kellog said, "Despite what maybe even some of my colleagues would say, I think the exchange is great public policy."
…And those who don't.
Even Alabama's governor, Robert Bentley, has choice words for what the U.S. Supreme Court calls a law.
Governor Robert Bentley said, "Everybody makes a big deal about the technology and how terrible it is. And they've spent billions of dollars on it and it should have been working. And they only tested it for two weeks and all that, but you get past that, it's still a terrible piece of legislation. What I'd like to see, is a block grant. Let me manage it. I can do better than the federal government can."
So three years after it was enacted, signing up for health insurance is finally here.
Agee Baldwin is one of Alabama's navigators, a guide if you will, for those who need help signing up for the Affordable Care Act or the ACA.
Enroll Alabama Navigator Agee Baldwin said, "We've talked to people who've just bawled in tears, because they have these huge pre-existing conditions that would negate them from being insured. It's just not going to be an issue, thanks to the Act."
Navigators like Baldwin go into the community and meet one on one, talk to groups and/or set up appointments for anyone interested in the ACA.
On this day he spoke to these folks at the Greater Birmingham Ministries on food distribution day.
One woman, 40-year-old Victoria Evans who is disabled, with a young child, getting $750 a month from Social Security Disability, learned she qualified for ACA.
Qualified for ACA, Victoria Evans said, "One of the plans that I discovered and learned today that I'm eligible for, I would have to pay zero out of pocket expenses. Linda: Obviously that's good news for you. Victoria: That is excellent news for me."
But the news wasn't as good for 62-year-old Brenda Lollar who lives on Social Security widow benefits of $685 a month.
Lollar fell into the medicaid gap. That means, if the state had expanded Medicaid benefits she would have qualified, but right now she doesn't. And she would have to use almost $600 of her entire monthly check to pay for ACA benefits. Something she's unable to do. Even now, without cash, she skips some visits to the doctor and doesn't fill prescriptions.
Didn't qualify for ACA, Brenda Lollar said, "That's the way I have to do it, I mean, I'd like to went into a stroke. I was scared to go to the doctor because I could lose my house if I get medical bills against me."
I showed Lollar's interview to Governor Bentley. This was his response.
Governor Bentley said, "Bless her heart, she needs more than health insurance. I don't know enough about her income. I don't know enough about her situation to really comment on that."
Governor Bentley stands by his decision to not expand Medicaid, his staff calling it a broken system.
Governor Bentley said, "We have no plans at the present time to expand Medicaid. Linda asks: Will Alabamians suffer because Medicaid hasn't been expanded? Uhh... will some of them suffer? Will some of them suffer? you know, they will still be seen."
But the state should have expanded Medicaid at least that's what one economist here at UAB's School of Public Health told me. According to his data more than 300,000 Alabamians would have been helped by the Medicaid expansion. Another study indicates more than 30,000 jobs would have been created."
Director & Professor, UAB Lister Hill Center for Health Policy, Michael Morrisey, PhD said, "The net cash revenue that comes into the state across all of its taxing authorities is about $935 million. That's after paying for the Medicaid expansion. So I think you can make a sort of good business case for wanting the expansion."
On the flip side, Morrisey also believes the state made the right decision in not operating its own exchange.
In some counties, Alabamians only have one insurance choice - Blue Cross Blue Shield. Humana is the only other health insurance operating within the exchange, in our state, run by the federal government.
Is it possible there would have been more health insurance choices if the state ran its own exchange? Morrisey says no. The governor confirms that.
Still many are experiencing sticker shock. That's because the ACA requires a list of ten essential health benefit categories like pediatric eye, dental and preventative care; maternity care; and the care associated with chronic conditions, to name a few.
The ACA is designed to reduce the number of uninsured from 50 million to 20 million which Morrisey says is a good thing. Another benefit, reducing the falling federal deficit - that's the gap between what the government spends and what it takes in - now at 680 billion.
Dr. Morrisey said, "Yes from the CBO's point of view, it does reduce the deficit, but it doesn't mean that we're not spending more. You can't cover 30 million people and not spend more."
But at least for now, for some, it appears the ACA's troubles outweigh the benefits.
According to Morrisey, other states like Washington, Kentucky and Minnesota that run their own exchanges aren't seeing the glitches that the federal government is seeing. Due to the glitches, the deadline to avoid penalties has been extended six weeks until March 31st, 2014.
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