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Sun., Jan. 12, 2014

Jamie Tobias Neely: Health care’s sleepy start

Despite all the fireworks leading up to it, the launch date for the Affordable Care Act’s new health insurance, New Year’s Day, dawned sleepily enough around here.

While we’ve heard much political outrage over virtually every single aspect of the new system, many previously uninsured Americans have discovered they finally can afford coverage.

Samantha Russell, a 46-year-old real estate agent in Spangle, says she’s very happy with her new health insurance. Last year, she paid a monthly rate to her physician’s office to cover her appointments, but she lacked insurance coverage for prescriptions, X-rays or hospital care.

With a new bronze Molina plan, she estimates she’ll pay half again as much this year for triple or quadruple the coverage. She expects to pay approximately $140 each month. She believes similar coverage before the Affordable Care Act would have cost her between $500 and $600.

The process of applying, which included advice from her doctor’s office, took less than two hours.

“I think it depends on whether you choose to be crabby about it or happy about it,” Russell says. And as she listens to friends and colleagues debate the new insurance plans, she’s observed another phenomenon. People’s reactions to the Affordable Care Act all depend on where they turn for news and information. “Are you watching Fox News or ABC?” she asks.

Those complaining loudest neglect to mention the sheer number of uninsured Americans. The Washington state Office of the Insurance Commissioner estimates the number of uninsured residents at 990,000, according to spokeswoman Stephanie Marquis. That’s a significant chunk of the state’s population.

The insurance commissioner’s office estimates that uncompensated care in Washington, including all those unbillable emergency room visits, costs more than $1 billion annually. Those costs are often shifted to insured residents in the form of higher premiums, an average of $1,017 per insured family each year. Continuing to allow nearly 16 percent of state residents to live without health insurance isn’t a financially sound option. And denying coverage to consumers based on their medical histories has always been wrong.

Critics rightly point out that the enrollment process, particularly in exchanges run by the federal government in other states, should have been considerably smoother. But returning to our previous system isn’t a viable alternative.

A single-payer system, however, one day may be. Surely, had that been the model for the Affordable Care Act, fewer technology glitches would have ensued.

By including multiple private plans in these exchanges, the entire system has become enormously complicated. When I checked out my own hypothetical options for coverage on the Washington website,, 38 possible plans popped up.

Marquis points out that shopping for Affordable Care Act insurance isn’t exactly like going to Travelocity. That’s because a health insurance plan is a vastly more complicated product than a round-trip airline ticket.

But the federal government, which has been successfully enrolling millions of Americans in programs such as Medicare for years, certainly has demonstrated the capability to register people in single-payer plans.

Last week Washington Healthplanfinder announced that 248,270 Washington residents are newly enrolled in either private health care plans or the state’s cheerfully named Washington Apple Health, our euphemism for Medicaid.

Between Dec. 23 and Jan 2 alone, 35,000 residents signed up.

Some, like 20-year-old Geoff Gaffaney of Spokane, are still trying to figure out the process. Between website glitches and his own busy schedule dashing between two downtown retail jobs, Gaffaney hasn’t enrolled yet in the free Washington Apple Health plan he qualifies for.

His previous coverage ran out on Dec. 31. Three days before the end of the year, Gaffaney came down with a fever and tonsillitis. He was able to squeeze in one last doctor’s appointment, and a round of antibiotics, on New Year’s Eve.

Gaffaney’s goal: to get his new health insurance figured out as quickly as possible. Even a 20-year-old, perched right in the middle of the immortal years, is wise enough to know he needs it.

Jamie Tobias Neely, a former member of The Spokesman-Review’s editorial board, is an associate professor of journalism at Eastern Washington University. Her email address is

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