Wayne Clegg spent Christmas Eve clicking through www.healthcare.gov with his sister in Rock Hill. Three hours and a phone call later, he successfully enrolled in a silver-level health insurance plan, which will cover 70 percent of his medical costs.
“I finally got through,” said Clegg, 44, who will gain coverage for the first time in nearly a decade. “I’m excited.”
Clegg is one of more than 24,000 state residents who signed up for insurance on the federal health exchange website from Oct. 1 to Dec. 28, according to statistics released recently by the U.S. Department of Health and Human Services. He said he was finally able to enroll after making several attempts following the website’s launch in October. He received his new insurance card on Jan. 3 from Blue Cross Blue Shield of South Carolina, one of three insurers offering health care exchange plans in the state.
He stopped by the Blue Cross Blue Shield information van parked on Cherry Road Monday morning for clarification of his premiums and coverage. The company kicked off its series of health care stops with its blue recreational vehicle in Rock Hill. The RV will make its way to other metro areas in the coming weeks.
Three licensed agents were available to answer questions and sign up people for coverage through the federal website, according to Blue Cross Blue Shield spokesperson Adam Myrick. The van opened at 8 a.m. Monday, and by noon agents had met with 10 people. It’s unclear how many signed up for plans.
According to the Department of Health and Human Services, national enrollment figures remained low until December, when the website was retooled after problems with long delays and frequent crashing. Uninsured residents have until March 31 to enroll in a plan or face penalties in 2015.
The other companies offering plans in South Carolina are Consumer’s Choice Health Plan and Coventry Health Care of the Carolinas Inc. Together, South Carolinians have 52 options for individual or family insurance plans. Small businesses with less than 50 employees have 12 options, according to the state Department of Insurance.
While the federal website is easier to navigate since improvements were made last month, Myrick said it takes roughly an hour to sign up someone for a plan because agents spend time going over different coverage options and financial circumstances.
The plans make it possible for those with existing conditions to get insurance, but premium costs offered through the marketplace are typically higher than premiums offered through employer-funded systems. Tax credits that lower monthly premiums are available to those whose income is between $11,500 to $46,000 annually.
Ricky Steele, 59, of Lancaster County, said the costs were “prohibitive” for himself and his 62-year-old diabetic wife, who is out-of-work and drawing Social Security benefits.
His wife has been uninsured for years, and her income falls short of the minimum threshold for the tax credits, Steele said. He signed up to talk with agents on Monday in the hopes of finding more affordable plans, but was dismayed to learn that his wife doesn’t qualify for Medicaid or for a reduced premium plan.
“There’s nothing affordable about affordable health care,” said Steele, adding that the governor’s decision to opt out of Medicaid expansion was a “rip-off.”
South Carolina was one of several states that opted out of expanding Medicaid, which the federal government had offered to fund for the first three years. Gov. Nikki Haley and state legislators rejected the expansion on fiscal grounds, saying the increase would be unsustainable long term because the program is jointly-funded by the federal and state governments.
State residents who would have been eligible for insurance through Medicaid expansion, or who make less than $14,500 annually, are exempt from penalties. Other exempt groups include Native Americans, those who decline medical care for religious reasons and prison inmates.
Ricky Steele is covered under the federal Consolidated Omnibus Budget Reconciliation Act, or COBRA, which temporarily extends employer health plans after an unexpected job loss. Wheelchair-bound from an accident that severed his left leg in 1989, Steele worked for several years at an industrial site as a service manager until his health worsened recently.
His COBRA coverage ends later this year, and there will be a gap of several months until his Medicare benefits kick in. Steele said he’s afraid he’ll be unable to cover medical costs in the interim.
For Clegg, whose coverage starts next month, the new plan means not having to pay full out-of-pocket costs for his type II diabetes and health follow-ups for pancreatitis and other conditions.
Clegg’s month-long hospital stay at Carolinas Medical Center in North Carolina in 2011 was covered by the hospital’s indigent care fund because he was uninsured at the time and couldn’t afford to pay.
“This health insurance is the best thing for a long time,” said Clegg, who plans to return to work as a barber at the end of January so he can cover his premium costs of about $324 a month. Clegg is also applying for disability.
Jie Jenny Zou • 803-329-4062