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Obamacare's big divide

Petaluma Health Center Certified Enrollment Counselor Flor Serrano talks with Lourdes Baron about her health insurance application.

Scott Manchester/Argus-Courier Staff
Published: Monday, October 28, 2013 at 9:20 a.m.
Last Modified: Monday, October 28, 2013 at 9:20 a.m.

As Califiornia's health insurance exchange debuts and local healthcare providers busily guide the public through the intricacies, and glitches, of the federal health care overhaul commonly called Obamacare, local residents' experiences reveal the ups and downs of the new system.

For Lourdes Baron, a Sonoma resident who has been bringing her six children to the Petaluma Health Center for the past seven years, the changes are a major improvement.

“My children were always covered under the Petaluma Health Center's sliding payment scale,” she said in Spanish, as a health center employee translated. “But because my husband and I made too much money to qualify for (financial) help to pay for insurance, we just had to stay healthy.”

Baron and her husband are both self-employed — she as a janitorial worker and her husband as a landscaper — and the couple have gone without health insurance their entire lives, feeling that they could not afford it. So when Baron's husband was recently diagnosed with high blood pressure, Baron struggled to cover his medical expenses.

“We've been paying for his medicine and doctor's visits out of our pocket and it's been getting very expense,” she said wearily.

But now, because of subsidies offered through the national Patient Protection and Affordable Care Act, or Obamacare, along with the state's new health insurance exchange, Covered California, the Barons can afford and have signed up for health coverage. It took them about an hour.

“We're just so relieved and happy that we won't have to pay so much anymore,” she said, leaning back into a chair at the Petaluma Health Center Tuesday afternoon. “It's been difficult.”

Baron and her husband have joined thousands of people across the state applying for health insurance through the state's new exchange. And while many people are excited about the new health insurance option, others are already experiencing difficulties.

Petaluma resident and mother of two Kathleen Dal Porto is a stay-at-home mom. Her husband, Anthony, is a food processing equipment salesman. He's self-employed and his income fluctuates each year. The Dal Portos used to have health insurance through Blue Shield, until the insurer informed them their current policy would no longer be available due to changes resulting from the Affordable Care Act. Blue Shield told the Dal Portos that their premiums would increase by at least $300 per month.

“Our premiums were ridiculous before. Now it's outrageous,” Kathleen Dal Porto said Tuesday, declining to say how much they currently pay. “We'll probably have to register through the exchange, but that will be tough since we never know our annual income until the end of the year.”

Dal Porto said that her husband's income can fluctuate by as much as $100,000 per year. Because insurance costs are income-based in the new system, Dal Porto said she feels lost.

“It makes it tough for us to know how much we're actually going to be paying each year in medical costs,” she said. “Right now, we're just trying to figure out what is going to work best for us. It's been really stressful.”

Petaluma Health Center Practice Manager Cathy Woodcock agreed that navigating through the available insurance options can be confusing for people. “We know that it isn't always easy to understand,” she said. “That's why we have trained people available to talk to anyone who has questions.”

The Petaluma Health Center has been answering questions and signing people up for the state's program using paper applications, since they currently cannot do so online due to glitches in the system. Woodcock could not estimate when the online systems would be running smoothly.

But website problems have not slowed enrollment in the state's health insurance program for the Petaluma Health Center. Certified enrollment specialist Flor Serrano has signed up five people in the last week by having them fill out paper applications in her office.

Since the state's health insurance program opened on Oct. 1, thousands of people have visited the website and local health centers to apply for coverage. The applications will be reviewed and coverage will begin on Jan.1.

For more information on Covered California, visit www.coveredca.com. For additional questions, call the Petaluma Health Center hotline at 559-7850 or make an appointment to speak with a counselor at 559-7500.

(Contact Janelle Wetzstein at janelle.wetzstein@arguscourier.com)

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