Residents say insurance access net positive

By Kevin Wilson

kwilson@cnjonline.com

Ask Geni Flores what’s changed for her under the Affordable Care Act, and she’s got a follow-up question.

“Do you want to start,” Flores said, “with my son, my daughter or my brother?”

While they acknowledge that education about the ACA and the program rollout could have been better, a few residents contacted said the increased access to insurance and health care is a positive on balance.

Katha Burke, an agent at Western States Insurance in Clovis, said negative connotations about the ACA are upsetting to her. She said there are many benefits for clients she saw just last year that couldn’t get coverage and can now do so.

“They had to jump through hoops to get insurance,” Burke said. “With the ACA, there is none of that. There are no hoops to jump through; there are no health questions.”

Burke has heard stories of people who had plans canceled, and hates knowing that anybody might be inconvenienced. she said many of those plans had coverage that didn’t justify the premiums.

The premiums do have a high sticker price, when considering it’s a completely new expense for many who didn’t carry insurance.

“When you’re going from not paying anything, going from $100 to $200 is a lot,” Burke said. “We’re just trying to educate people on the reason you need health insurance.”

Flores, who teaches bilingual education at Eastern New Mexico University, said she was covered prior to the ACA, but others in her family were not:

• “My son had a pre-existing condition,” Flores said. “He was diagnosed when he was 15 (with precancerous polyps). Because of that diagnosis — he’s 32 now — he wasn’t able to get health care. He had no health care, even though he’s married and has kids and the kids are covered on her health plan.”

Her son, who lives in North Carolina, is now signed up for coverage. Very early in January he had a preventative test — something he may have needed to serve a six-month wait time to receive under previous insurance coverage. Without insurance, Flores said, the tests were expensive, but she paid for one anyway a few years ago just to have peace of mind.

• Flores has a brother who lives in Taos that does seasonal work. He didn’t qualify for health coverage with employers and couldn’t afford individual coverage. Also, he was paying off a pair of hospital bills for accidents. With the ACA, he received a premium he could handle.

• Flores’ daughter, a single parent, had a son who qualified for Medicaid. However, she didn’t qualify for anything and stayed on her mother’s plan until she was 26.

Now 28 and in California, Flores’ daughter has found a policy that included dental coverage.

Flores hated the problems with the website rollout, but said anger about the purpose of the act escapes many.

“People don’t understand it at all,” Flores said. “Mostly people who are comfortable with their own health care accounts are quick to blame other people. People who have the comforts of life are often quick to blame those who don’t, and blame them for being poor.”

Pilar Moreno of Portales, who opened a small business and got covered through the exchanges, said the misconception is that everybody gets free health coverage, and she knows that’s not the case.

One of Moreno’s issues is that she has found many Texas doctors don’t work with the exchange plans, and she has to go to Albuquerque instead of the shorter drives to Amarillo or Lubbock.

Moreno didn’t disclose her premium, but said paying $100 to $200 a month seems like a lot until you have to visit the emergency room, or when you find out spending one day at the hospital can easily run $4,000 if you’re not insured.