More Illinoisans share their experience with the Affordable Care Act

SHARE More Illinoisans share their experience with the Affordable Care Act

Different Illinois residents had different takes on President Obama’s health plan. Read their stories here:

No longer uninsured after finding a plan that worked for them

Kirby and Cindy Pringle counted down the days until Oct. 1, 2013 when new options became available through the Affordable Care Act, in hopes they would be able to afford health insurance again.

The Tuscola couple have been without it for two years, when their insurance premiums “got too expensive” after Kirby Pringle turned 55. He is now 56, his wife is 55.

“It was the choice between either making the health insurance payments or having a vehicle,” Kirby Pringle said. “We had to go with the vehicle and so we just dropped our health insurance two years ago.”

The couple are artists and made about $23,000 together last year.

On the online marketplace, they found a silver plan that will cost them $48/a month after you factor in the tax credit, with a deductible of $1,500. They used to pay $530 per month with a deductible of $5,000, Pringle said.

“That is a big, big chunk of money for us [in savings],” Pringle said. “Like any health insurance, you hope you never have to use it. But thank goodness we have something like this to cover.”

Disappointed with the Affordable Care Act options

Judith Reed had assumed she would benefit from the Affordable Care Act, being uninsured and “truly low-income.”

But instead, Reed said she wound up being either confused or disappointed by the law.

Reed, 64, of Mount Prospect, gets a combination of $15,864 yearly from Social Security and from her retired pension from the United Airlines. That’s too much for her to qualify for Medicaid, she was told.

Yet, buying a plan on the “Obamacare” online marketplace also isn’t a solution, she said, even when a tax credit is factored in.

Reed’s issue is the high deductible she would have to pay before her insurance plan kicked in. She was told on the phone that the cheapest bronze insurance plan, which Reed said is all she could afford, would cost her $7.39 a month once a tax credit was factored in, but insurance wouldn’t kick in until she paid $5,400 in out-of-pocket deductibles each year. The Sun-Times did not find such a plan on HealthCare.gov, but did find a similar one of $0 premium with a deductible of $6,000.

“That is not affordable to me,” she said.

Instead, she said she would rather pay a $95 penalty for not having insurance next year before she joins Medicare at age 65 and stick to what she’s already doing: paying out-of-pocket to her doctor and dentist without having insurance. “I guess I’m playing Russian Roulette by not having it, but I see no other choice.”

End of pre-existing restrictions gave more options for health insurance

Choosing to leave her job in 2007 also meant giving up relatively affordable health insurance.

Dr. Rebecca Quigg, of Riverside, left her job as a cardiologist at Northwestern Memorial Hospital to become a stay-at-home mom to her two sons. She does consulting now.

After the insurance plan she got through Cobra ran out 18 months later, she said she had tried to find cheaper insurance, but “found that I was uninsurable,” because Quigg had what were considered “pre-existing conditions.”

In 2010, she eventually found a catastrophic plan that had a premium of $903/ a month, with a deductible of $2,500.

Though she considered that plan to have a high premium, high deductible and one that covered little, “I didn’t want to cancel it, because I was afraid to not have insurance,” Quigg said. “I used the policy as catastrophic coverage only.”

She got new options when the Affordable Care Act forbid insurers to exclude coverage because of pre-existing conditions after 2014.

On Dec. 11, Quigg bought a gold insurance plan through the Affordable Care Act’s online marketplace that had a premium of $600 and a deductible of $500. She wouldn’t say if she got a tax credit for her plan or how much she made.

But she said, “Not one medical question was asked, and that’s the most important thing about this law.”

The federal government released statistics last week saying that 47 percent of Americans were denied health insurance coverage or charged more because of pre-existing conditions when they tried to purchase insurance on the individual market.

If you want to share your own story, e-mail me at mjthomas@suntimes.com.

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