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]

  • Stein-Erik Dahle

    But… but…. eh… BENGHAZI!!!!

    • You have a good point. Also the Fast and Internally Furious Revenue Service.

    • JustinBailey

      Let’s not point fingers here. Clearly this development is Obama’s fault.

  • judyms9

    This accidental injury could have bankrupted Marshall in the past. Those who think they can beat the odds and fail to get covered are rolling the dice against Fate and may lose. As accounts like these roll out more and more people will become closet Obamacare enrollees even as they continue to criticize it when in the presence of their rightwing friends. I strongly suspect many have already.

  • kiptw

    Evolution at work. Intelligent people will get coverage and more of them will live to reproduce. Those who are stupid or doctrinally deluded will aid the process in their own way.

    • Cat Marcuri

      Oh, my, I hadn’t thought of that! Could this possibly be Darwinian adaption to a changing society?

      • dmcrane

        I had the same thought…survival of the fittest always pre-supposes the fittest are the most intelligent at deciding when it is time to adapt to changes.

  • jamesbeaz

    This is a huge improvement for America. But, you know what? Imagine if we implemented negotiating for drugs, universal budgets for hospitals, and close-to-free medical training for doctors (which would allow them to take cuts in their bloated salaries), then this woman wouldn’t need to spend years paying off the — still outrageous — sum of $6,000, because we would have first-dollar care for everyone. Let’s celebrate progress, but let’s also be honest and admit that anyone having to pay off a debt of $6,000 just because they had the misfortune of slipping on ice is a uniquely American perversion of the way a good society should work.

    • Amy Lynn Smith

      I agree: We should definitely celebrate progress while continuing to work for reform that makes quality healthcare less expensive.

      • Cat Marcuri

        When we lived in Italy, I discovered that actual medical doctors go out on every ambulance call. Italy of course has universal health care, part of the reason living there is expensive, but their health care is pretty damn good. We military types had no hospital of our own, so we went through the Italian system. My son had a surgery for a hernia there, and they took very good care of him. He had tons of specialists coming by to make sure he was doing okay, and several of them reassured me that it was no charge for them to check on him several times a day. Not nurses, who were also on top of everything, but DOCTORS and SPECIALISTS! We need that here. Badly.

        • Marc K

          You liberals are hysterical. Must be the same people that believe Cuba gives the same medical treatment to the tourists that pay as to the peasants. You think maybe they knew you were military and gave you a tad better treatment?

    • Marc K

      Thanks for the advice Dr Beaz. For 8 years you studied and completed residency, taking years out of you social life in order to save peoples lives. Wait you didn’t? Oh you were f’ing around in HS and now are jealous of people making more than you – got it. What do you suggest a doctor is worth? A iron worker can make 200K + a year. Is that worth more or less? Yes please drive to eliminate any drug company spending 3 billion dollars on a new specialty drug. We have too many life saving drugs at this point.

      • jamesbeaz

        I’m a European-US dual citizen — if you want to be robbed by the medical-industrial complex of the US until the day you die, have fun. I wish everyone in the US had the option to enjoy high-quality socialized medicine in Europe, like I can if I wish.

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