CONCORD, N.H. (AP) — After months of preparation mixed with political wrangling, a six-month enrollment period starts Tuesday in New Hampshire for the new insurance plans under the Affordable Care Act.
The law will require nearly everyone in the country to have health insurance or face fines. Insurance markets will offer subsidized private coverage to people who do not have health insurance on the job, including the uninsured and those who buy their own policies.
New Hampshire opted not to run its own online markets, but Gov. Maggie Hassan’s administration has tried to have the state partner with the federal government to manage health plans and provide consumer assistance. Anthem Blue Cross and Blue Shield will be the only company offering plans through the new markets.
Here are the stories of a few individuals who spoke recently to The Associated Press:
THE HEALTH CARE PROVIDER:
Dr. Sarah Young-Xu, who works at the Ammonoosuc Community Health Services clinic in Haverhill, wishes that information about the new insurance plans had been available earlier.
“I think most people are a bit in the dark,” she said. “So far, there’s more anxiety on our part, trying to figure out what we’re going to tell people.”
Young-Xu said she is concerned that her local hospital — Cottage Hospital — is not included in the narrower provider network Anthem will use for its individual plans. While that affects only a small percentage of her patients, she worries about those who will have to travel farther for care, including pregnant woman who will have to deliver their babies at another hospital.
“That presents a barrier to patients,” she said. “The reality is, for folks who don’t have reliable transportation, this is isolated.”
But overall, Young-Xu is optimistic, particularly if the state decides to expand its Medicaid program.
“If it comes to pass that a majority of people gain access to health insurance, that will be tremendous,” she said.
Jen Pennington, an uninsured paralegal from Manchester, was optimistic months ago, but that feeling has waned.
“When the dust sort of settled, it became very clear that this was not affordable,” said Pennington, 33.
Pennington has been without health insurance since 2011 after deciding that it made more financial sense to pay out of pocket than purchase a high deductible plan.
She makes too much money to qualify for a subsidy and says she’ll likely decide to forgo insurance and pay the penalty instead. The penalty in 2014 is $95, or 1 percent of taxable income. By 2016, it’s $695 or 2.5 percent of taxable income, whichever is greater.
“The people who require assistance, who are underprivileged and don’t make enough, they should be taken care of,” she said. “The problem is, The people in the middle are sliding further down the slope.”
According to government estimates, monthly premiums for someone Pennington’s age in New Hampshire would range from $212 for a high deductible bronze plan to $320 for a gold plan with less cost sharing.
Mary Jo Cannarella, a retired nurse from Nashua, remembers treating many patients who ended up far sicker because they put off preventive and primary care. So she jumped at the chance to volunteer with the AARP to help educate the public about the health overhaul law.
“There are many people who need the education and outreach in order to access the marketplace options, and there’s a lot of confusion and misinformation out there,” said Cannarella, a former nurse educator.
Cannarella expects to be on the road several times a week, traveling to public libraries and other locations, including the annual Pumpkin Festival in nearby Milford. At a presentation she attended, audience members included people who had lost their jobs and had no insurance and those who had questions about how the law would affect them.
“You don’t feel you’re introducing them to a concept that’s completely foreign to them, but they want to know, ‘How do I do this or that?’” she said. “They did know a lot about what was going on, but as far as the nitty-gritty of the details, they had questions.”