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Health Care Reform:

Health Insurance & Affordable Care Act

More Than 110,000 Signed Up For Coverage Through In November


Patrick Kelly, a navigator with the Legal Aid Society of Roanoke Valley in southwest Virginia, said his appointment calendar is booked for the next two weeks, though he will try to squeeze in more because he doesn’t want to turn anyone away.

‘I’m going to have a hard time breathing through Dec. 23,” he said.

Now that is working, Kelly said a big part of his job is helping consumers understand what they’re buying by explaining insurance terms like “deductibles,” “co-insurance” and “HMOs.” He credits with providing a summary of benefits for each plan, which makes it easy for consumers to understand what’s covered and how much benefits cost. With one click, they can find out which doctors are in a plan (although experts say that consumers eager to stay with their doctors should double-check with them) and which prescription drugs are covered.

The site also allows people to almost instantaneously determine if they are eligible for Medicaid, the state-federal health insurance program for the poor, or federal subsidies to buy private health plans. So far, only about 40 percent of the 2.3 million people found eligible to shop in the exchanges have qualified for subsidies -- far lower than the 90 percent projected in the first year by the Congressional Budget Office. Federal officials said Tuesday night they could not explain the discrepancy.

Kelly said most people have not complained about the high deductibles in many cheaper plans because they are relieved simply to have coverage or are already accustomed to seeing them.

“Nine times out of ten, people come away pretty satisfied,” he said.

He said he is worried, though, about reports that insurers may be getting incomplete or inaccurate enrollment information from As a result, he is telling clients to call insurers to confirm their enrollment.

That situation is improving, but more work is still needed, said Karen Ignagni, CEO of the trade group, America’s Health Insurance Plans.

Language Barriers

In El Paso, Texas, with one of the nation’s highest rates of uninsured, navigators said is working much better, but they still periodically hit glitches such as frozen screens. Delays in the launch of a Spanish-language web portal have also been a problem.

Tue, Dec 10 2013

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