Obamacare success stories keep coming, with a rosy forecast for 2015


Karen is just one of 272,500 Michiganders who signed up for coverage through Healthcare.gov, where a strong finish to 2014 enrollment bodes well for next year.

So much good news, it’s hard to know where to begin.

On Thursday, Obama administration officials predicted health insurance premiums would be stable in 2015, thanks to a large and varied pool of insured Americans. This is according to the Kaiser Family Foundation, which reported that about 28 percent of the 8 million Americans who enrolled in private health insurance through Healthcare.gov were in the 18-34-year-old age range needed to help keep the risk pool balanced and keep premiums down — the demographic naysayers predicted would not sign up. Yet another “horror story” debunked.

In Michigan, 272,539 people signed up for coverage through Healthcare.gov, in addition to thousands more who have enrolled in the Healthy Michigan Plan, the state’s Medicaid expansion program that launched April 1.

From Erin Knott, Get Covered America Michigan State Director:

The first open enrollment period was historic and consumers proved to be hungry for the new coverage options. … We’re overjoyed that our work helped so many Michigan individuals and families obtain peace of mind and financial security through the new coverage options.

Numbers don’t lie, but even more compelling are the stories of people like Karen Marshall of Oak Park, Mich. Until about four years ago, she’d always had health insurance through work. But when she lost her job, she couldn’t get even the most expensive private insurance because the insurance company claimed she had a pre-existing condition.

Actually, she didn’t. Marshall was prescribed an anti-depressant to treat symptoms of menopause, but the existence of the prescription alone disqualified her for coverage. Under the Affordable Care Act (ACA), people can’t be turned away for any pre-existing condition — real or perceived.

Marshall has always considered herself fortunate to be healthy, but she never felt luckier than she did after getting health insurance that kicked in on January 1, 2014. On a trip the week before, she slipped on the ice and fell, breaking her wrist in three places.

She saw an orthopedic surgeon on January 3 and had surgery the following week. Everything was covered by her insurance, leaving her only having to pay her deductible and her $6,000 out-of-pocket maximum for the year. She’s now had two surgeries, one hospitalization, and has physical therapy and follow-up visits ahead.

The first surgery alone, which required an overnight hospital stay, would have cost me $20,000. The medical bills have been astronomical. Without health insurance, I would have been bankrupt. I don’t know what I would have done. I can manage the $6,000 by paying it off over time. But if I didn’t have insurance I don’t know what I’d do. It’s scary to consider.

Marshall’s income as an independent contractor qualified her for tax credits. Her Silver plan now has a premium of $245/month. She admits that’s a stretch for her budget, but she wanted to get as much as she could for her money.

Most everything is covered at 80%, and my plan includes dental and preventive services. I’m all about prevention because I’ve seen what it can do. I’ve never needed health insurance like this before – but when I needed it, it was there. I’m so grateful.

Open enrollment for 2015 begins November 15, 2014 — but if you have a significant life change, such as losing your job or your current coverage, you can sign up within 60 days, even outside the enrollment period. Visit Healthcare.gov for details.

[Photo credit: Top, Will O’Neill | via Flickr; Bottom, courtesy of Karen Marshall]