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Health Care Law Is 'An Answer To A Prayer' For Some Older Americans

Company Enrolls People In Obama's Affordable Health Care Plan

CHICAGO (AP) - For many older Americans who lost jobs during the recession, the quest for health care has been one obstacle after another. They're unwanted by employers, rejected by insurers, struggling to cover rising medical costs and praying to reach Medicare age before a health crisis.

These luckless people, most in their 50s and 60s, have emerged this month as early winners under the nation's new health insurance system. Along with their peers who are self-employed or whose jobs do not offer insurance, they have been signing up for coverage in large numbers, submitting new-patient forms at doctor's offices and filling prescriptions at pharmacies.

"I just cried I was so relieved," said Maureen Grey, a 58-year-old Chicagoan who finally saw a doctor this month after a fall in September left her in constant pain. Laid off twice from full-time jobs in the past five years, she saw her income drop from $60,000 to $17,800 a year. Now doing temp work, she was uninsured for 18 months before she chose a marketplace plan for $68 a month.

Americans ages 55 to 64 make up 31 percent of new enrollees in the new health insurance marketplaces, the largest segment by age group, according to the federal government's latest figures. They represent a glimmer of success for President Barack Obama's beleaguered law.

The Great Recession hit them hard and for some its impact has lingered.

Aging boomers are more likely to be in debt as they enter retirement than were previous generations, with many having purchased more expensive homes with smaller down payments, said economist Olivia Mitchell of University of Pennsylvania's Wharton School. One in five has unpaid medical bills and 17 percent are underwater with their home values. Fourteen percent are uninsured.

As of December, 46 percent of older jobseekers were among the long-term unemployed compared with less than 25 percent before the recession.

And those financial setbacks happened just as their health care needs became more acute. Americans in their mid-50s to mid-60s are more likely to be diagnosed with diabetes than other age groups, younger or older, accounting for 3 in 10 of the adult diabetes diagnoses in the United States each year. And every year after age 50, the rate of cancer diagnosis climbs.

The affordable coverage is "an answer to a prayer really," said Laura Ingle, a 57-year-old Houston attorney who had been denied coverage repeatedly because she has sarcoidosis, an autoimmune disease. She recently had back surgery for a painful condition that's been bothering her for months.

One night in September, 64-year-old Glenn Nishimura woke up with wrenching pain that sent him to the emergency room. It was his gallbladder. A doctor recommended surgery.

Instead, Nishimura went home. A consultant to nonprofit groups, he was self-employed and uninsured.

"I checked myself out because I had no idea what this was going to cost," the Little Rock, Ark., man said. "They didn't want me to go, but they didn't stop me."

Nishimura lost his coverage after leaving a full-time position with benefits in 2007, thinking he could land another good job. The recession ruined that plan. After COBRA coverage expired, he was denied coverage because of high blood pressure and other conditions.

He made it until September without a major illness. A second night of gallbladder pain and a chat with a doctor persuaded him to have the surgery. After getting the bills, he negotiated the fees down to $12,000, which he considered "a big hit, but it could have been worse." The average cost of a gallbladder removal in Arkansas was listed at three times that. Nishimura dipped into his savings to cover the bill.

In December, he chose a bronze plan on the new insurance marketplace that costs him $285 a month after a tax credit. The deductible is $6,300, so he hopes he doesn't have to use his coverage. He can get on Medicare in April, just in time for his annual checkup.

"Now there's the peace of mind of knowing the limits of my obligation if I have catastrophic health needs," he said.

Dr. Bernd Wollschlaeger said he's noticed a recent increase in patients in this age group at his family practice in Miami. Lots of them have untreated chronic conditions that have progressed to an advanced stage.

"Many have delayed necessary treatments due to costs and expect a total and quick workup on their first visit," he said, adding they want referrals to specialists and tests including colonoscopies and mammograms.

The abundance of older patients signing up is no surprise to the Obama administration, which conducted internal research last year that showed the "sick, active and worried" would be the most responsive to messages urging them to seek coverage.

Signing up younger, healthier enrollees is seen as more difficult, but crucial to keeping future insurance rates from increasing. The administration said those age groups may put off enrolling until closer to the March 31 deadline.

"We have always anticipated that those with more health needs would sign up early on, and that young and healthy people would wait until the end," administration spokeswoman Joanne Peters said.

Some of the aging boomers were determined to get coverage in the marketplace, despite repeated problems and frustration with the federal website.

The hours spent online and over the phone paid off for real estate agent Greg Burke and his beautician wife, Pat. The empty-nesters qualified for a tax credit that will lower their monthly health insurance premiums by nearly half.

The Burkes, from Akron, Ohio, are among the 38 percent of marketplace enrollees in the state between 55 and 64 years old. He's 61 and had a knee replaced six years ago.

They will now spend $250 a month for health insurance, "a huge savings," Greg Burke said. Their deductibles also dropped from $2,500 each to $750 each, meaning they will pay less out of pocket.

In Miami, licensed practical nurse Marie Cadet, who is 54, often works double shifts to make ends meet for herself and her 12-year-old daughter. She had been paying more than $150 a month for health insurance, with a $3,000 deductible. In effect, she paid most medical costs out of her own pocket, including about $80 a month for blood pressure medicine.

After choosing a plan from the marketplace, Cadet's monthly payment dropped to $86 a month, with the government kicking in $300. Her deductible fell to a more affordable $900.

"Now," Cadet said, "I'm not scared anymore."

Join the discussion

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wstarhopper February 18 2014 at 5:17 PM

I find it interesting that according to a new poll 75% who voted for Obama now say that they would change their vote. I would also like to know how this is a good thing for seniors. I am a senior and I find it nothing but bad news. The Oregon part of Obama care is so badly messed up that the website has still not been able to sign up one person. Meanwhile or state people are still pouring more money into the thing.

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Jerry wstarhopper February 18 2014 at 6:14 PM


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rfbel1104 February 18 2014 at 7:21 AM

With or without insurance. Good luck paying off a hospital bill if you or yours has a serious illness.
If the "average" American income is around 45k my mothers bills were 128k in 1978 with cancer. That was the part insurance covered. She was bedridden at home for 9 months before she died. So you can multiply that 127k by at least 6 or 7 to get today's expense for a cancer victim. Like I said good luck with that if you aren't older and on Medicare at least. Oh I forgot if you have a disease like cancer or heart disease and are looking for insurance good luck. The only mistake that was made was everyone should be on a single payer system. Screw the insurance companies!! Nothing has changed for any of the states that refuse the take the federal money. If you go out to look say in Georgia. From what I can see I have a group rate and the same plan would cost me the same less what my employer pays. I make too much money. So the insurance companies didn't lose out from what I can see. The little guy gets it again!

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daxcess2 February 18 2014 at 10:04 AM

My insurance sales person was in my office recently to discuss alternatives to the new rates which will be in effect in 6 weeks. The rates have gone up 44% in one year, in three years almost 100%. So while this article may tout the ACA as a boon for the population of this country, the vast majority of citizens who are now paying exhorbitant fees to cover the minority.

In order to provide healthcare for my employees, I have to spend twice what I was spending just a few years ago, and their portion has gone up even further. The quality of their care is in danger since fewer and fewer doctors and hospitals locally are participating. One entire practice has switched to concierge medicine.

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carolberg February 18 2014 at 10:03 AM

"The danger to America is not Barack Obama, but a citizenry capable of entrusting a man like him with the Presidency. It will be far easier to limit and undo the follies of an Obama presidency than to restore the necessary common sense and good judgment to a depraved electorate willing to have such a man for their president. The problem is much deeper and far more serious than Mr. Obama, who is a mere symptom of what ails America . Blaming the prince of the fools should not blind anyone to the vast confederacy of fools that made him their prince. The Republic can survive a Barack Obama, who is, after all, merely a fool. It is less likely to survive a multitude of fools, such as those who made him their president."

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Linda Counts February 18 2014 at 10:03 AM

I'm going to be 62 next month. Quit my great-benefits job to move back to our hometown. Not working and have no insurance for me (hubby is a Veteran, so he's covered). With hubby's meager income this past winter, there's no way we can even afford Obamacare. I am fairly healthy and meds are at a minimum. So, do I somehow scratch together the $200 or so for insurance premiums (even with Obamacare), or hope I don't get sick (or hurt) before Medicare age and pay the penalty in the meantime?

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lsieminski Linda Counts February 18 2014 at 10:10 AM

felling lucky? sorry it is a no brainer..get insurance!

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dremawolfe February 18 2014 at 4:31 PM

I believe this story accounts for at least six people that are happy with Obamacare. How will they carry the rest of us??

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rbprph February 18 2014 at 12:27 PM

Those same people would get sick whether they have insurance or not. And we ( the insured ) would ultimately pay for the expensive emergency room care. I' m glad they can contribute to the healthcare pie, however much or little. What you should worry about is why a brand drug cost 50 percent less in canada or Mexico. That is an industry the the American consumer subsidizes directly!

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Sundog February 18 2014 at 1:40 PM

These are the people who will hit the health-care system the hardest.

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rwjonespe February 18 2014 at 4:26 PM

Two facts seem to escape many people. 1- a representative may vote against a bill, or an amendment to a bill, even though he/she supports the concept behind the bill/amendment simply because they believe it needs more work. 2 - Just because some program provides some good for some people, it does not mean it is a good program or even a salvagable program; and definately doesn't mean it is the only solution. The first case noted in the article is a just cause. The second I have problems with- he quit his job, SAYS he couldn't get insurance due to pre-existing conditions. I was fired, started my own business and got Blue Cross when I was 53 even though I was Type II Diabetic and over-weight. Had two 20% markups and a $2,500 deductible - not bad in light of Obama Bronze plan - but was insurable.

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Brian Workman February 18 2014 at 4:25 PM

If I could get FREE Health Care of Good Quality, I would give ObamaCare a thumbs up!? I can't get it for free, because I have to pay for someone else's ObamCare Coverage, it's NOT FREE!! There is NO FREE in ObamaCare!! Nothing is FREE comming from our Government!! You've already paid for it!!

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Jerry Brian Workman February 18 2014 at 6:17 PM


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