Have Obamacare exchanges improved? 5 answers

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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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Sunnier 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.

New 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 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.

In 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.

Health care hopes dashed in California

By Marcie Geffner

THEN Good. Bad. Surprising. Confusing. That sums up my first encounter with Covered California, the health insurance exchange now open in the Golden State, where I live. — Marcie Geffner, on Oct. 1, 2013.

NOW: Two months ago, I thought choosing a new health insurance plan to replace my canceled individual policy would be simple. Now I know better.

At that time, the Covered California exchange seemed to work. It was easy to access, and I was able to find out which plans were available, how much the monthly premiums were and what coverage was provided. But now, some of the new plans that I could see then are no longer displayed, and there’s no clue as to why they’re gone.

The president announced in November that insurance companies could let people like me keep our plans that had been canceled, but California decided not to go along. I’m peeved and disappointed.

Meanwhile, the exchange admitted to the Los Angeles Times that it gave some users’ names, email addresses and telephone numbers to insurance agents without permission. That might be legal, but it’s wrong, especially in a state where privacy is prized. I no longer trust the exchange.

The new policies have lower deductibles, but higher premiums and maximum out-of-pockets. It’s maddeningly difficult to find out which doctors and hospitals are in which networks because the search functions are slow and cumbersome, and no one seems to know whether they’re accurate.

On Dec. 9, I received a letter from a prestigious local hospital, saying it accepts the new plans of only three insurers. After two and a half hours of research, I realized it’s impossible to compare those plans with my existing one. There are too many moving parts: premiums, deductibles, copays, out-of-pockets, provider networks, drug formularies — the list goes on.

My biggest frustration is that I can’t compare providers’ negotiated rates. One insurer told me I had to find out the billing codes for medical procedures to compare how much I’d actually pay. That’s laughable.

Lesson learned: Don’t get sick.

For 20-something, chat falls flat

By Stacy Lipson

THEN After spending over an hour on the website, I logged off, and moved onto the next project on my to-do list. I can only hope that the bugs and glitches will be fixed the next time I attempt to log on.

— Stacy Lipson, on Oct. 1, 2013.

NOW: Back in October, I started researching rates for an Illinois bronze plan for myself. I ended up finding a plan with high out-of-pocket costs, including the deductible, which is typical of bronze plans. They offer the lowest level of coverage, typically picking up about 60 percent of health care costs. At the other end of the spectrum, a platinum plan covers 90 percent, on average.

Chat with someone who can help
Healthcare.gov chat

But I had struggled with HealthCare.gov in October and expected that by December most of the problems would be resolved. I may have been too optimistic.

I decided to use the site’s live chat feature this time. I explained to the live chat operator about my initial difficult attempts to fill out an application, and asked him to advise me on choosing a plan based on the information I had already submitted.

Operator: You will need to fill out an application.

Me: I have filled out an application.

While in the live chat, I found I was unable to log in to my account, and asked the operator for assistance. He asked when I had been able to log in previously.

Me: On Oct. 1, the day the exchange opened.

Operator: This is what you will need to do, then. You will need to create a new account with a NEW user name you haven’t used before.

Start all over and create a new account? I realized that there was no quick fix in order to obtain access to the Affordable Care Act online marketplace. And I wondered about the old account that I created, and whether the personal information that I had provided was secure.

I’m not sure if I’ll keep trying. Since I am currently under 30, I will be examining other options such as a high-deductible “catastrophic” plan available to people in my age group under the health care law, or health insurance that I could purchase from a trade association.