Theresa DuBose is no fan of the Affordable Care Act but on Wednesday morning it helped her get health insurance for the first time in years.
“I don’t agree with Obamacare at all,” said DuBose, 53, but “it does benefit me.”
She was one of the first to enroll through navigator Monica Baldwin at Christ Community Health Services on the first day of Open Enrollment under the law. Experts are expecting a lot of confusion surrounding the law, which President Trump and Congress tried to repeal earlier this year but failed. The Trump administration cut the advertising budget to encourage people to enroll by 90 percent and slashed the amount for in-person assistance in Georgia by more than 60 percent. Insure Georgia took an even bigger hit than that when its funding for assistance was reduced from $2.3 million to a little more than $300,000, an 85 percent cut, said Fred Ammons, the CEO of parent company Community Health Works.
“If you talk about a gut punch, that is the definition,” he said. Even though it forced them to cut staff and a lot of other things, the group has been “working our behinds off” on grassroots efforts with community partners to get the word out. While Ammons expected the turnout to be low, which typically happens on the first day, there was a “moderate” amount of calls and in-person assistance instead.
“I wouldn’t say that we’re overwhelmed by any stretch of the imagination but it could be worse and it is a little better than it has been in years past on day one,” he said. “I’ll say I’m happy where we are today for it being day one. Now we just have to keep that up.”
At Christ Community, it took a while to figure out the email password for DuBose but once Baldwin entered it and created the account, DuBose qualified for a $778 per month subsidy to help her pay for premiums. DuBose, who works in a dental office, said she gets by on her income because “I know how to manage my money. As long as I have my family and my kids, I don’t need all of that high-dollar stuff.”
“Amen to that,” Baldwin said.
Soon, the screen was filled with the first of a a slew of health plans from Blue Cross Blue Shield of Georgia, the only provider for the Augusta area and 85 counties throughout Georgia. The range of premiums start at 76 cents a month but that also comes with a $5,500 deductible and high co-pays for things like Emergency Room visits, a plan DuBose ultimately rejects.
“Go to the one with the lowest deductible,” she said as Baldwin begins to scroll down through plans and the premiums rise.
Baldwin said her role at this point is akin to that of a dressmaker.
“We’re going to find the right one to fit you,” she told DuBose. Generally speaking, the more you pay in premiums, the less the other costs, Baldwin said as she scrolled down through more options. At $25.17 a month, the deductible drops to $200 but it is still a $250 charge per ER visit and co-pays for specialty visits are higher. DuBose doesn’t think that will be a problem.
“I don’t ever go to the Emergency Room,” she said. At $111.31 a month, the deductible is $250 but the co-pay is just 10 percent after that and a visit to a specialty doctor will cost DuBose just $30. While she sees her primary care doctor at Christ Community about once every three months, she has had ear surgery and she believes she will need surgery on her nose as well.
“You’re a healthy woman,” Baldwin said. “But we don’t know what to expect from Nov. 1 to next year.”
Baldwin figures out the premium on this plan will come out to about $27.82 per week.
“Can you afford to do this?” she asked DuBose.
“I’m going to do that,” DuBose replied.
“Then this is the right plan for you.” Baldwin said, before enrolling her in the Blue Cross Blue Shield Silver Pathway X HMO. Without her subsidy, DuBose would be paying more than $889 a month.
“That’s price gouging, big time,” she said. Even though it is helping her get health insurance, she isn’t happy with the current system or with President Obama for bringing it about.
“It’s supposed to be affordable for everyone but it’s not,” she said. Her hope lies in Trump, whom she helped vote into office a year ago.
“He’s trying to push to get something different done,” DuBose said. And she believes Trump will “if they allow him to.”
Reach Tom Corwin at (706) 823-3213