After two months of trying to purchase health insurance on the Maryland Health Connection—a new state-run health insurance exchange that opened Oct. 1—I finally lined up coverage for my family, trading in a long-held policy purchased in the individual insurance market for a so-called Obamacare policy. Our new policy, which starts on Jan. 1, comes with many more protections than our current plan and will cost us $2,250 less in 2014, but comes with some tradeoffs.
When starting the process early this fall, I figured shopping online for a standardized health insurance policy on the newly created exchange would be a breeze. After all, I'm a freelance health care and insurance writer and have a good grasp on the Affordable Care Act (ACA). At the very least, I thought it would be easier than shopping for coverage nearly a decade ago when we entered the individual insurance market after my wife also became self-employed. That shopping experience led to a 30-hour odyssey, one I chronicled for The Washington Post.
But buying an ACA policy also was an exercise in patience. I encountered numerous hassles with Maryland's online exchange—confronting error messages, completing applications repeatedly and dealing with overall sluggish performance and problems comparing plans and buying insurance—and unacceptable 2014 premium notice delays from CareFirst BlueCross BlueShield on the cost increase of our current plan. Even if the exchange worked properly, I still would have had to wait nearly two months for CareFirst's premium notice so that I could truly compare my options and decide whether to keep our existing policy.
On Jan. 1, those in the individual market are among the millions of Americans who can purchase insurance on the new health insurance exchanges. Those who make less than $46,000, (or $94,000 per family) a year will be eligible for financial assistance to lower their monthly premiums. Others, like me, will continue to pay full freight. But everyone will get protections from a cut-throat system.
Those protections—including banning insurers from denying people insurance or jacking up rates on those with medical issues—are why I've been looking forward to buying ACA coverage. My state, Maryland, is one of 14 that set up its own exchange; the federal government initially is running the online health insurance marketplaces for 36 other states. According to the Kaiser Family Foundation, Maryland also enjoys some of the lowest premiums rates on the new exchanges.
The problems with the federal exchange are well documented, and overshadowed positive reports on state exchanges working in California, Kentucky and elsewhere. Even though Maryland embraced the ACA and quickly moved to set up an exchange in the weeks after the March 20, 2010 passage of Obamacare, Marylanders faced similar, possibly even worse, snafus as those shopping on the federal exchange. Here's my story of shopping for coverage on Maryland's exchange.
The Individual Market
Thanks to the attention Obamacare has received, people are learning more about the individual health insurance market. It's the place where 19 million people like me have to shop for insurance—the self-employed or those without access to employer-based coverage and who do not qualify for government programs, like Medicare or Medicaid.
The individual market is volatile and can be a particularly costly place to buy insurance, especially for the middle-aged and older set or anyone who has even minor health issues. As a result, most people who buy such coverage don't last long in this market. Some just stop buying health insurance, but most are priced out of it, kicked out of it or leave after securing more stable coverage in the group market or in government programs. That's assuming you can even get coverage to begin with, as insurers can reject you based on your health or price a policy so high that it's unaffordable.