Tale of two health exchanges: How are consumers in Ohio and Kentucky faring?

The Affordable Care Act (ACA)  was conceived and born in controversy. Many blame supporters of the law for the recent government shutdown and consider all it a bad idea all around. Others herald the ACA as the unalienable right of every American. More than a month has passed since the official launch registration on Oct. 1, so how are Kentucky and Ohio faring in their efforts sign up residents?

“It was crazy that first week, but the craziest thing was the overwhelming interest in applying," said Carrie Banahan, executive director of the Office of the Kentucky Health Benefit Exchange. “We had no idea that so many folks would sign up.”

The Health Insurance Marketplace or "exchange" allows individuals to compare plans and select coverage. Many states have set up support exchanges with telephone and in-person assistance to help residents navigate the system.

The Kentucky side

According to Banahan, Kentucky’s exchange, known as kynect, experienced some initial problems with registration, but resolved glitches after increasing its number of servers.

She reported that by mid-October:

  • 35,000 applications had been filed
  • Of those, 12,000 people had already been determined to be Medicaid eligible
  • About 6,000 people were found to be eligible for premium assistance.

She found it surprising that people bought plans on the exchange who weren’t eligible for subsidies, because they got better deals on the exchange.

Another surprise came when more than 300 small businesses filed applications in Kentucky by mid-October. Banahan said she expected the number to be miniscule, around 10 by year's end.

While initial numbers look encouraging, she explained there’s still a major push to get the word out to eligible residents in the State.

“We never doubted for a minute that our exchange wouldn’t be operational and functional and doing a good job as it’s doing right now,” she said. “Plus, there’s the governor’s support. He has been behind us from day one and very supportive of a state-based exchange. That’s really been a key that has resulted in our success.”

Kentucky Gov. Steve Beshear has been a vocal kynect cheerleader. Both he and the system have attracted national attention for what could go right. Beshear sees kynect as a model for exchanges across the country, enrolling an average of 1,000 Kentuckians a day in health care coverage.

“People who say the Affordable Care Act doesn’t work need look no further than Kentucky,” Beshear said. “Not only is it working here, Kentuckians are still stampeding to the website and call center to find affordable health coverage. The fact that so many Kentuckians are actively seeking health coverage for themselves, their families and their employees tells us that kynect is meeting a gaping need in our state. At long last, every Kentuckian can finally find affordable health insurance.”

Kentucky's numbers

  • 40,572 enrolled in new health coverage, including Medicaid and private insurance
  • 33,561 enrolled in Medicaid
  • 7,011 enrolled in a qualified health plan
  • 16,425 eligible for a subsidy to purchase a qualified health plan
  • 843 small businesses applications for health insurance for employees
  • 41 percent of registrants are under 35 years old
  • 23 percent of registratnts are 25 years old or younger
  • 59 percent women

McConnell: "Problems run deep"

Not everyone in Kentucky is rallying around the numbers. Kentucky Sen. Mitch McConnell argues that ACA, or Obamacare, fails on its promises to the American people.

“Obamacare’s problems run so deep and the broken promises are so pervasive that it is impossible to identify an ‘easy fix,’” the Republican Senate Minority Leader said. “It truly ought to be repealed or delayed. But if the President is truly sorry for breaking his promise to the American people, there is a natural place to start: He could support legislation that would help restore these plans to folks who want them back.”

McConnell spokesman Robert Steurer reinforced the senator’s arguments, stating ACA drives up costs and limits choice.

“Only 6 percent of Kentucky’s uninsured have signed up for a program that was ostensibly built to help them,” said Steurer. “And 83 percent of those uninsured who are signing up are enrolling in Medicaid, not a private health plan.”

The Ohio side

On the other side of the river, Trey Daly, director of Enroll America in Ohio said business is booming. He stated the non-profit agency continues to experience an "incredible" response, which indicates significant pent-up demand for coverage.

Daly said unfortunately the issue has become a political hot button, but people who really need health care rarely care about party lines.

“Through the politics of all of this, we’ve forgotten that the Affordable Care Act was intended to help solve a very serious problem,” he said. “Beyond the clatter of the

last month or so, there is a desperate need. People desperately want access to affordable health coverage.”

Similar to Kentucky, Daly explained Enroll America in Ohio got off to a rocky start with online registration at healthcare.gov. He said things seem to be running more smoothly now, with few glitches to report as of late. He explained people need to ignore "intimidation" from negative media reports and, if necessary, seek help to get registered.

“We keep emphasizing with people, you have time,” he said. “The earliest coverage would begin is Jan. 1, and if you’re enrolled by Dec. 15, you’ll be covered.”

While Kentucky’s governor heralds the ACA, the Ohio governor’s office has a different take altogether. Lt. Gov. and Department of Insurance director Mary Taylor said she finds initial Ohio numbers via its registration site  very disappointing and blames inequities in the ACA to be the cause.

“The federal government’s rollout of Obamacare has been embarrassing and chaotic, but not surprising,” she said. “While the problems with Healthcare.gov have made it difficult and in some cases impossible for Ohioans to review coverage options, the website's failures are most likely temporary. What is more concerning are the long term impacts of the law – higher premiums for consumers and job creators, less consumer choice and more mandates. All of these factors explain why just 1,150 Ohioans selected an Obamacare plan in October.”

The people’s side

One of those 1,150 Ohioans is Maineville resident Sally Gasior. As a retiree from Procter & Gamble, she has coverage. However, her 28-year-old son Edward, who has cystic fibrosis, aged out of coverage under her policy. Because of his condition he must receive regular care and expensive prescription drugs in order to remain healthy. Under new healthcare laws, he can’t be turned down for insurance because of his pre-existing condition.

Gasior said she watched last month’s government showdown over the ACA with a sense of horror.

“I just think that shutting down the government if you don’t get your way is irresponsible,” she said. “It costs everybody money. The idea that there’s so much opposition to improving the whole health insurance system for everyone is just pretty frustrating to me.”

Even though both are computer savvy, Gasior said she and her son hit the wall when trying to sign up online and finally surrendered by calling the 800 number.

“We were excited about just sitting down at the computer and doing it at home, but we ended up turning to the phones, and we got great help there,” she said.

  • Figures released Nov. 13, by the Department of Health and Human Services, revealed that during the first month: 106,185 Americans selected a Marketplace plan as part of the ACA
  • Of those enrolled: approximately 27,000 registered online using Healthcare.gov
  • Approximately 79,000 registered using healthcare exchanges operated by individual states 

As a kynector, a health care exchange navigator, Donna Womack works with Kentucky residents who need help with registration. She explained while determining people’s eligibility was simple, she initially ran into technical difficulties when it came to selecting health care plans.

As with other users, she said she’s seen a vast improvement in the system after the first week. Following a relatively slow start, Womack now has appointments scheduled every day. As many of her clients are low income or elderly, she explained many have been without vital medical care for some time.

“People who have been needing medications, like diabetics who need insulin and people who are supposed to be on psychiatric medicine haven’t been able to get them. These people are so happy to know that they’re going to have access to this now. They’re just so excited,” she said.

After hearing about kynect on a television ad featuring Beshear, Edgewood resident Patricia Friend said called the number listed right away. Friend explained she quit her job to take care of her ailing sister who has since died, leaving her herself without insurance. While she has yet to select her Medicaid plan, Friend said the process is about 97 percent complete. She encourages anyone who has concerns about signing up to call in as she found the experience extremely simple.

“I would just call and sign up because people my age, and I’m in my 60s, are not necessarily computer literate and they might have fears about it,” she said. “So just having the people on the phone basically talking them through it is so helpful. I think for them, the telephone is going to be the best answer.”

Jessica Noll contributed to this story.

Have you tried to register, either via kynect or Healthcare.gov? Please share your experience with the system.

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