insurance

Have Obamacare exchanges improved? 5 answers

In October, Bankrate asked five writers around the country to go for an opening-day test drive on the Obamacare exchanges, the online health insurance marketplaces that are supposed to allow consumers to shop for plans and learn whether they're eligible for federal tax credits to cut monthly premiums. Most members of our panel had a rough ride, and it wasn't long before the federal exchange website HealthCare.gov would become infamous for its glitches.

President Barack Obama recently said the site is now "working well for the vast majority of users," and many of the state-operated exchanges are signing people up at a faster clip than the federal marketplace. So, we asked our writers to revisit the exchanges they had sampled in October to see if things really have improved. The results were mixed.

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Jay MacDonaldSunnier days in Florida

By Jay MacDonald

THEN: Your shopping experience on the opening day of the new Florida health insurance marketplace can be summed up in four words: "Please wait" and "System down." -- Jay MacDonald, on Oct. 1, 2013.

NOW: What a difference two months makes.

Compared with the opening-day frustrations of trying in vain to see my Florida health insurance options via the federal HealthCare.gov website, a return visit in December went smooth as eggnog.

The portal's new "See Plans Before I Apply" feature enabled me to do exactly what I'd been prevented from doing in October, when the website could neither complete my application nor grant me a peek at policies without a sign-up.

Once inside this time, I was greeted by 102 plan options from five health insurance companies spread over four metallic -- "bronze," "silver," "gold" and "platinum" -- coverage levels. After 20 minutes of Amazon-easy research, I had what I needed to make comparisons against the high-deductible health savings account I've used for more than a decade.

Since I don't qualify for one of the health care law's price-cutting subsidies, annual plan premiums on the exchange for my age group range from $5,400 for a bronze plan, with 60 percent coverage, to $10,500 for a platinum plan, with 90 percent coverage. Deductibles run from $6,300 in bronze to between $0 and $1,000 in platinum.

Was I temped? No. As a self-employed business owner, health insurance for me has always been about two questions: What will it cost me to have a cut finger? And what will it cost me to have a heart attack? With my HSA, my annual premium is $3,100, and although my deductible is $11,500, I'm covered 100 percent after that.

Sure, there's a bit of risk my way. But considering I spend less than $200 a year on medical services and have accrued enough in my HSA over the years to cover my deductible, it remains my least expensive way to afford a cut finger and a heart attack.

Sheryl Nance-NashNew York premiums get a Bronx cheer

By Sheryl Nance-Nash

THEN: I logged on several times Tuesday morning and got an error message. I tried again later and nothing, period. Will I keep trying? No, thanks. --Sheryl Nance-Nash, on Oct. 1, 2013.

NOW: Sometimes, things are sweeter the second time around. At least that's what I was hoping as I went back on the website for the New York State of Health, the Empire State's Obamacare marketplace.

New York State of Health
New York State of Health website

My husband is over 65 and could retire with Medicare, but I am a freelancer and depend on his current coverage through his employer. So does our young-adult daughter. The first time I ventured into the marketplace I was vastly disappointed. Most plans for my daughter and me cost around $800 per month. My husband was even more disappointed, because he was left facing the onerous prospect of another four years on the job before he could retire with full medical benefits for the family.

His unhappiness made me unhappy. I decided that if I had a full-time job, that would settle the health insurance issue. He could retire now. A second look at the exchange was my last best hope at maintaining the freelance life.

So, I plugged in our potential household income if I stayed freelancing and my husband retired and started receiving his pension. I went for one of the higher coverage levels ("gold") because we need comprehensive care. To my shock, I came up with different, even steeper premiums than I'd seen previously: $1,100-$2,100 per month. My heart sank.

I immediately reached out to Elisabeth Benjamin, a vice president of the Community Service Society of New York, which is serving as a statewide Obamacare "navigator," or helper.

She asked if my daughter had had a birthday. Yep, she turned 20 in October. Then came the bad news: "She goes from children's coverage, which is around $150 per month, to adult coverage, ranging from $300 to $800 per person," Benjamin explained. "That must be the big pricing variance."

My face grew a couple of inches right then. We can't afford an exchange plan, so I'm going to have to go back to work full-time so my husband can retire.

David McMillinIn Indiana, smoother site brings rate shock

By David McMillin

THEN: The law's success hinges on people like my parents and me getting answers that ultimately motivate them to get coverage. On opening day, those answers seemed to be very elusive. -- David McMillin, on Oct. 1, 2013.

NOW: After unsuccessfully trying to research new Indiana insurance options for my parents when HealthCare.gov launched on Oct. 1, I returned to the federal health insurance exchange to see if the reports of a better website were true.

The online user experience is indeed much smoother. Rather than forcing every visitor to create an account, it's easy to browse insurance plans after inputting very basic information: where you live and your age. For each plan, you see easy-to-digest details of monthly premiums, deductibles, out-of-pocket maximums and copayments/coinsurance expenses.

However, I can't give a completely rosy portrait. While time has dramatically improved the website's functionality, it hasn't altered the reality that "affordable" is a relative term when it comes to health insurance.

My parents' income doesn't qualify them for subsidies. While I did find a plan with a monthly premium that's approximately $120 less than what they currently pay, there's much more to insurance than the recurring payment. The most affordable plan for my 64-year-old father and soon-to-be-64-year-old mother comes with a whopping $10,000 deductible. Even after meeting the deductible, patients on this plan have a 40 percent coinsurance payment every time they go to the doctor or buy prescription drugs.

I called my dad to run through some of the options, highlighting premiums, deductibles and copays, but he made a great point: that that information tells only part of the story.

"You can read the general descriptions of plans, but it's nearly impossible to understand what procedures and prescriptions are covered or which doctors you can see," he told me.

My parents are paying a lot for their current insurance, but there is comfort in familiarity. Rather than dedicate hours of time to researching the pros and cons of new options on HealthCare.gov, they'll be sticking with their current plan.

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