Trying, Failing On HealthCare.gov

Nov 4, 2015

For much of this year, Sara Goodrich of Lakeland has gone without health insurance -- despite trying over and over again to complete enrollment on HealthCare.gov.

“For the last six months, all of the agents have been telling me something else is the issue. Resubmit here, there's an address error, it's your birthday, for some reason, that would affect my application, and I just said, I am trying to follow the rules here, and you guys aren't helping,’” she said. 

“And I can't do it. I don't know what to do."

The former teacher is now a stay-at-home mom with two children, and she helps her husband with his small, exterior cleaning business. When she logged onto HealthCare.gov -- which people in Florida and 36 other states use to shop for health insurance if they don't get insurance through an employer or another source -- she found out her income qualifies her for tax credits that lower monthly premiums to about $45 a month.

"We did get approved for that, and signed up for two months, but within those two months they could never verify our documents of income, and they couldn't tell me where the error was,” Goodrich said.

Enrolling through the marketplace is the only way for Goodrich -- or other Floridians -- to qualify for tax credits.  She said dozens of hours spent on the HealthCare.gov website, on the phone and help in-person with navigators still couldn't fix the issue.

"If I could afford $650 to pay Humana for insurance, I wouldn't need the marketplace," she said.

In 2015, Florida saw more people sign up on the federal health insurance marketplace than any other state, with close to 1.6 million enrolled. Yet as the third year of open enrollment gets under way, some are still struggling to get coverage.

Goodrich said she's not as worried about getting sick -- it's breaking the law that goes against her nature. She said she had her identity stolen a few years ago, and wonders if that may be part of the problem.

"In the end, it wasn't ever resolved, it wasn't ever fixed, I had to cancel my insurance,” she said, adding that the never had an issue with Humana, but couldn’t get answers from HealthCare.gov.

Goodrich wonders if now, as the 2016 enrollment is under way, that she'll be fined for going without health coverage under the Affordable Care Act.

"I would love to know who to speak to about this," she said. "And if there's a way to not get fined, that would be wonderful, but if there was a way to get health insurance easily, that would be even better." 

Many people learned about the penalty when filing their federal income tax. In 2016, the fee for going without health coverage is increasing to $695 per person, or 2.5 percent of yearly household income, whichever is greater.

In some cases, people can apply for an exemption, said Jodi Ray, director of Florida Covering Kids and Families at the University of South Florida in Tampa.

"And a navigator can help with that, and determine whether they think an exemption is likely, and also help a consumer fill out the application for an exemption,” she said.

According to the Kaiser Family Foundation, about 2.8 million Floridians today are uninsured.  About 800,000 of them qualify for tax subsidies to lower the cost of monthly premiums, but haven't signed up.

"We want to make sure that those individuals that we still haven't enrolled that are eligible for financial assistance, that we are reaching them,” said Ray, who oversees navigators across the state.

Two years ago, when HealthCare.gov was launched, it plagued by technical glitches and crashes. With the third open enrollment period now under way, the site has gotten some long-awaited technology upgrades, including easier window-shopping and out-of-pocket cost estimators.

"Is our system going to be perfect? Absolutely not,” said HealthCare.gov CEO Kevin Counihan.  "Our system is faster, with 40 percent fewer servers, than we had a year ago. So every year, we believe that our system is going to become better, faster, cheaper and more stable."

Despite their efforts, Sara Goodrich of Lakeland said she's given up hope that she'll have health coverage when 2016 starts.

"I still have this inside me, where I have to do it, it's the law. But I'm not going to do it before the holidays,” she said.

“I will wait until next year. I just can't take this task on. It's not as simple as making a phone call and getting insurance like they say it is.”

Enrollment this year runs through Jan. 31, 2016.

Lottie Watts is a reporter with WUSF in Tampa. Health News Florida receives support from the Corporation for Public Broadcasting.