More than 7 million people have signed up for private health insurance under the system introduced last year for those who were uninsured or had policies considered substandard.
What happened to them since has varied greatly.
Many have been happy with their new insurance, according to polls. Others are encountering a variety of snags — high premiums, telephone runarounds or difficulty getting care. Together their experiences provide a glimpse of how the largest social program launched since Medicare has worked out for the people involved.
With lessons learned, the program enters its second year with enrollment beginning Saturday.
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NICK OF TIME
Shawn Turner didn't realize it when the health insurance program debuted last year, but she would become a dramatic example of its purpose.
A 54-year-old medical transcriptionist in the tiny Illinois village of Cisco, Turner had gotten health benefits through her job for 15 years. "The main reason I worked was to get the health insurance," she says.
Then, last year, she lost coverage when her employer outsourced her work to an Internet-based transcription service. Her husband, Lloyd, who owns an auto body shop, had been on her policy so he lost his insurance, too.
In December, the Turners signed up for a "silver," or medium grade, plan on the new government website listing policies available. They would pay $236 a month and the government would pay the insurance company $830 a month, a subsidy based on their estimated $22,000 income. Their deductible was $750.
A few weeks after her coverage started, she was suddenly doubled over with abdominal pain that sent her to the emergency room. It was uterine cancer.
"I was in shock, just kind of numb," she says.
From late January through July she endured two surgeries and chemotherapy. Blue Cross Blue Shield covered more than $265,000 in medical bills, a sum that otherwise "could have wiped us out I would imagine," she says.
Today, Shawn Turner says, her doctors believe she's cancer free. Her once-lustrous brown hair is beginning to grow back after chemotherapy. She's preparing to look for a part-time job as her strength returns. The Turners were able to keep their small house on the edge of town surrounded by corn and soybean fields.
"We got to keep our livelihood and we didn't become a detriment to society and our hospitals got paid," says Lloyd Turner.
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MORE FOR MORE
For 10 years, Steve Duchesne, 49, carefully purchased health insurance that covered what he believed his family of five needed — catastrophic illness and injury — and that omitted what it didn't, such as full vision care services and treatment for drug abuse.
Now, under the new system, he has more insurance than he's ever had, but at a higher cost, and he's not happy about it.
The public relations consultant's old plan was canceled because it didn't include all the minimum services required under the new law. His monthly health insurance costs have risen from $645 a month to $1,033 a month for the new policy.
"We're a middle-class family with what I consider a middle-class income for our area," says Duchesne, who lives in Redondo Beach, California. No subsidies were available for a family of five with a household income of more than $110,000.
Duchesne says he's had to drop his adult dental coverage, reduce his contribution to his individual retirement account and cut other household expenses to make up the cost difference.
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