UTICA — Some area residents are jumping up and down with joy.
Some are cursing President Obama.
And some are just scratching their heads.
But they’re all reacting to the same thing — the Affordable Care Act, the state health plan exchange it created and the act’s individual mandate for health coverage, which kicks in Jan. 1.
“Sometimes it’s good and sometimes it’s not so good,” said Peter Carchedi, a Utica-based insurance broker who sees clients across Central New York. “It depends on the person’s circumstances.”
For example, people who bought their own insurance now have more and often cheaper options, Carchedi said. But sole proprietors, who no longer might purchase commercial plans, sometimes wind up paying more now if they don’t qualify for premium subsidies on the exchange.
That issue just brought a 20 percent rate increase for a couple who run a snowplowing business in Cicero, Carchedi said.
Gloria Vescera of Utica wasn’t happy when she received a Dear Jane letter from her insurer. Her Healthy New York policy didn’t meet the minimum coverage requirements of the Affordable Care Act. So, her insurer cancelled her policy and offered her a new one – for more than twice as much a month plus higher out-of-pocket costs, she said.
“I went crazy,” she said. “I was really upset about it.”
What her letter didn’t clearly explain was that Vescera, whose husband is on Medicare, can go on the exchange and apply for a tax subsidy that could lower the cost of her premiums. Reports indicate that some Healthy New York members have made out better and some worse when buying plans on the exchange.
Shelly Callahan, executive director of the Mohawk Valley Center for Refugees, said she isn’t certain how things are working out for the refugee population she serves.
“I don’t feel like we’re really going to know until January,” she said.
It’s a big relief to everyone that the Children’s Health Insurance Program will remain in place, she said.
“Everybody’s interested and concerned and just wants to make sure their kids are covered, which in most cases, they seem to be,” Callahan said.
Local navigators, who are paid by the state to help people sign up for coverage on the state health plan exchange, said they’ve seen a lot of people without coverage qualify for free care through the expanded Medicaid program or for large premium subsidies to purchase exchange coverage.
But most of the small business people Carchedi works with don’t feel like winners, he said. He has two business-owner clients in Syracuse who are just generally upset with the Affordable Care Act, he said.
Page 2 of 2 - “The business owners were swearing at Obama and calling him certain names that I would not want to say,” Carchedi said.
Carchedi said he’s also seen a lot of families lose out through a new requirement that employers with 50 or fewer eligible employees offer four types of coverage: employee only, employee and spouse, employee and dependents, and family. In companies that used to only offer employee or family coverage, that change has driven up the cost of the family option, he said.
One benefit of the exchange, though, has been more choices for individuals buying coverage. Individuals used to have to pay $1,300 a month for a direct pay plan, something only 16 to 17 percent of the population did because of the price tag, he said. Now, that has become cheaper.
Carchedi has lost out in one sense. A nonprofit client that didn’t qualify for small business tax credits on the exchange decided to stop purchasing an employee health plan. Instead, it gave employees money to purchase their own exchange plans.
“So, I just lost $5,000,” Carchedi said.