Countdown to Obamacare

Forty million Americans without health insurance. That was the great-shame talking point, the rhetorical fuse for health reform. Harry Truman pushed for universal coverage in the 1940s, LBJ floated it in the 1960s, Bill Clinton elbowed and failed in the 1990s.

The snapshot of uninsured families crowding emergency rooms was more than a political image to galvanize health-reform activists. It played out daily in Snohomish County, notwithstanding the rise of walk-in clinics. An untenable status quo is as resource-draining as it is inhumane.

On Oct. 1, history becomes whole. The Affordable Care Act or Obamacare becomes relevant for the uninsured and underinsured with the launch of the state’s comparison-shopping health-benefit exchange. Behind the curtain sits the leviathan — the find-your-best-deal for coverage that starts Jan. 1.

If navigating the online thicket or quizzing a benefit-exchange hotliner is the biggest obstacle, it pales relative to the menace of racing around uninsured.

As The Herald’s Sharon Salyer reports, 15 percent of county residents or 113,000 adults and children are minus health insurance. In less than a month, families will be able to pick from the state’s “Health Plan Finder.”

“It will allow you to make an honest comparison between the plans, which we’ve never had before,” said Stephanie Marquis, of the state Insurance Commissioner’s office.

The benefit-exchange website is atypically user-friendly (www.wahbexchange.org). The hotline for questions (or the online-challenged, and they are legion) opened Tuesday. The number is 1-855-923-4633.

The exchange website includes a feature to calculate individual and family costs. As Salyer reports, some outcomes are surprising. A family of four earning up to $94,200 a year, for example, still qualifies for tax credits.

The mission is to tailor coverage to individual needs and price restrictions. Despite pushback on Obamacare — whether legitimate or partisan — this isn’t the UK’s National Health Service. The poor and working poor are covered through expanded Medicaid. Those squeezed in between will pick from gold, silver or bronze plans (quick guess which costs the most.) Determining criteria revolve around the three C’s of cost, convenience and coverage. Does a family member have a chronic disease like diabetes? What is an acceptable co-pay or deductible?

There is a stick for those who drift and remain uninsured. The fine is $95 per adult, half that per child, and up to $285 per family.

Ostrich behavior isn’t an option. The mission of the health-benefit exchange is “to radically improve how Washingtonians secure health insurance.” An ambitious aim we hope it fulfills.

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