Obamacare and working poor

Published 12:00 am Tuesday, October 8, 2013

Confusion, skepticism as sign-up period begins
Attempts to decipher the Affordable Care Act have consumed gallons of newspaper ink and hours of airtime.
But one day last week, at a health-care center that serves the uninsured, the working poor distilled the complex health-care law known as “Obamacare” to three words: I don’t know.
They don’t know how poor you must be to qualify. They’re not sure who gets subsidies or how much the penalty is if they defy the federal mandate.
Two days after enrollment began for President Barack Obama’s ambitious and unfairly maligned effort to extend health insurance to some of America’s 48 million uninsured people, many of those who need it most remained skeptical about it.
At the Church Health Center in Memphis, Tenn., exam rooms were filled with patients, who mostly must work part time and without insurance to qualify for care.
With its annual out-of-pocket limits and guaranteed coverage regardless of pre-existing conditions, Obamacare was designed for people like Rea Geyer, a hairdresser who came to see her endocrinologist. She lost her coverage when she divorced. An estimate for private insurance was $2,000 per month, but her application was denied coverage because she is significantly overweight. Her mother is a breast cancer survivor, and doctors have been monitoring lumps in her breasts.

Geyer, 44, is paying the last $200 on a three-year-old $5,600 medical bill. Still, she’s one of the lucky ones: She was able to access the federal website, healthcare.gov, on Monday, the insurance exchanges’ opening day.
The least generous plan, bronze, covers 60 percent of health care expenses and the most generous, platinum, 90 percent. Geyer priced a plan in the middle — silver, which covers 70 percent. The premiums would be $241 per month. “There’s just no way,” she said. She left with a prescription for diabetes medicine, driving off in a 14-yearold Grand Marquis sedan with 216,000 miles.
Obamacare is no competition for the nonprofit Church Health Center; it’s estimated that only 20 percent of the center’s 16,000-plus patients would qualify.
In another exam room sat Mark Tate with a corn that’s been pestering him for a year. The 35-year-old barber didn’t seek care until his mother Phyllis found out the toe had turned black.
“If I hadn’t drug him out of the shop, we wouldn’t be here,” she said.

Before coming to the center, Phyllis Tate, insured through her job at FedEx, hurriedly tried to look at healthcare.gov but the site wasn’t working. She thinks her son’s income is in the sweet spot — not too low and not too high to qualify — but she’s not sure.
For now, she’s withholding judgment about Obamacare.
“I don’t know if I have an opinion,” she said. “I feel like everyone should have insurance.”
Down the hall, Cynthia Robertson, 52, fixed her eyes on the ceiling as a medical assistant slid a needle into her arm to draw blood. Robertson, who described herself as healthy aside from her diabetes and congestive heart failure, is the only one in her family of seven without health insurance. Her $10-per-hour job as an attendant at the FedExForum, home to the NBA’s Grizzlies, gives her a schedule loose enough to home school her youngest child, who is hearing-impaired and struggled in public schools. But the schedule remains unpredictable enough to keep her financially strapped.
Robertson once had insurance through a job with the Internal Revenue Service. She bristled to think the government could force her to buy coverage and said she doubted Obamacare as a fix.
Her novel idea?

“Give the extremely good jobs with good insurance to the really sick,” Robertson joked. “Or let them all work for Congress.”
Geyer’s suggestion, equally implausible, spoke to the dismal options for people like her.
“This time, I’m not getting married for love,” Geyer said. “I’m getting married for insurance.”
Wendi C. Thomas is a columnist for the Memphis Commercial Appeal. Email: thomasw@commercialappeal.com.