Stop pointing fingers; let’s get the ACA to work

Herbert Egert couldn’t wait for the fixes to the health exchange website in his home state of Maryland. The managing partner of Affinity Dental Associates renewed with his current health care provider at a significant increase in rates.

Egert’s practice provides health insurance to employees who work at least 24 hours a week. The insurer covering his employees offered to renew the contract, which ends in March, by the end of December at a 32 percent increase. Egert wanted to wait to see what the exchanges had to offer. But he was concerned that if he waited, his premium would be even higher when he had to renew next year. He also wasn’t completely sure he might find lower-cost coverage through the marketplaces. He gave up trying to get access to the exchange website despite feeling that his renewal hike is too high and not justified.

I’ve been writing a series of columns explaining various aspects of the new health care exchanges. As part of the series, I’ve been following Egert’s efforts to get coverage. As an employer with 50 or fewer full-time workers, Egert was also interested in the Small Business Health Options Program Marketplace, commonly known as SHOP. In that exchange, his business could receive a health care tax credit worth up to 50 percent of premium costs.

But even this option doesn’t work for the practice right now.

The Maryland SHOP exchange will not be ready until April to allow for more testing, the state announced recently. It was a second delay. Officials first said the exchange would be ready in January, a postponement from the original start date of Oct. 1.

That was too many delays and uncertainties for Egert. Unsure of what coverage he could get and at what cost, he felt he had no choice but to renew with his current provider. But even so, Egert hasn’t soured on the Affordable Caret Act.

“The ACA will insure tens of millions of people that couldn’t get coverage before,” he said. “I am still supportive of the law. I will look at the new small-group plans when they become available.”

Although anecdotal, Egert’s story represents the feelings of a lot of people across the country who needed things to go smoothly. The momentum that President Barack Obama had going into the launch has been lost. Fault is now the front-page story. Pundits and politicians are one-upping each other to see who can come up with the best zingers. None of the taunting helps people.

But if you’re interested, the marketplaces are still open. True, they are still having trouble. But they are open nonetheless. If you’re having difficulty navigating through HealthCare.gov or your state’s exchange website, the Kaiser Family Foundation has updated a tool, also available in Spanish, that calculates health insurance premiums and subsidies in all 50 states plus the District of Columbia. You can find it at kff.org/interactive/subsidy-calculator.

I hope the Obama administration is right when it pledges that by Saturday, many more website users will be able to move faster through the system, see fewer error messages and be able to complete their applications and enroll in one sitting. The administration says it has trained more than 68,000 brokers and agents, more than 10,000 call-center representatives, more than 17,000 certified application counselors, and more than 2,900 navigators. It also is working to set up direct enrollment through insurance companies.

Officials say processing times are likely to vary, based on the complexity of a household, the number of household members applying for coverage, and the completeness of the application and supporting documents that are submitted. If needed, marketplace personnel may follow up during processing to request additional information or documentation.

I don’t want to join the chorus of chastisers about all the problems with Obamacare and HealthCare.gov. Push the administration to do better, but let’s not forget who this is about. It’s about the many people who are still not sure whether and when they might get access to affordable health care. I’ve worked with many people who are struggling to pay medical bills because they didn’t have health insurance. I counsel people who have had to forgo getting insurance because they lost a job and now their most pressing need is food and a roof over their head. They worry about getting sick. Or they worry about their kids getting sick. They need the new system to work.

I’m rooting for the fixes not because of any political affiliation but because I can see the need. Perhaps there’s a better solution to the ACA. But right now, it’s all we’ve got.

Michelle Singletary: michelle.singletary@washpost.com.

Washington Post Writers Group