Health & Science
1:00 am
Tue March 18, 2014

Critical Deadline Approaching for Wisconsin Uninsured

The Affordable Care Act requires people to be enrolled in a qualified health insurance plan by March 31 or face a penalty.

Lauren Koegler, left, works with a "navigator" at an Affordable Care Act enrollment fair in Milwaukee

In Wisconsin, the deadline is critical for about 77,000 residents who will lose Medicaid coverage on April 1.

The ACA mandate also includes all young adults who reach age 26 and can no longer be included on their parents’ plan.

Lauren Koegler is exactly the type of person President Obama needs for his Affordable Care Act to succeed. The White House says health plans are affordable, when a lot of healthy, low-cost young adults enroll.

Koegler is 31 years old.

“I’m prone to more sinus infections and things like that that tend to pass on their own. And other than that, I’m really healthy,” she says.

Koegler works as an occupational therapist at a nursing home. The job offers health insurance, but she feels it’s too expensive.

“I think it was like $265 a month just for me. Which, I never go to the doctor. I haven’t been to the doctor once in the last three years. So it just seems like a waste of money for me,” Koegler says.

But she says living without insurance has been a gamble, and one not worth continuing.

“I don’t want to pay a fine, and I should have insurance just in case because God forbid, something happens, they would go after my parents or go after my family of some sort. They’re gonna get their money. They always get their money,” Koegler says.

Koegler says even though she deals with other peoples’ insurance at her job, she’s been lost trying to understand and pick a policy for herself. So she attended an enrollment fair the Wisconsin Alliance for Women’s Health sponsored last week in Milwaukee.

Executive Director Sara Finger says the fair offered so-called navigators, to help people create accounts on healthcare.gov and review insurance options.

“I think there’s a lot of anxiety and confusion about health care reform and the Affordable Care Act. And I’m seeing people leave with a little bit of relief, shoulders a little bit less tense and a little bit of a smile on their face,” Finger says.

Another person who attended the enrollment fair was Jamal Summerville. The 26 year old is single and unemployed with no health insurance. He says he’s looking forward to getting coverage so he can have a doctor check out a pinched nerve in his shoulder.

After talking with a navigator here, Summerville found out he’s actually eligible for Medicaid under the state’s new guidelines. He plans to go home and enroll.

“Most likely since they’ll penalize you once you don’t meet the deadline, I will be going home to sign up,” Summerville says.

Last year, Gov. Walker rejected federal money to expand Medicaid in Wisconsin and instead, reconfigured the state program. He’s adding about 83,000 extremely poor adults, and eliminating coverage for 77,000 others who earn just over the poverty line. The state tells them to purchase policies on the federal exchange.

“We actually just signed up through the marketplace yesterday,” says Samantha Radovanovic. She held her 2-month-old baby girl as she spoke on the phone from Kenosha.

The baby is able to stay on Medicaid, but not the parents because they don’t fit the state’s new income guidelines. Radovanovic says her husband works for a small company that does not provide insurance. She says the cheapest policy they could find on healthcare.gov costs more than $400 a month, with an annual deductible of $12,000.

“It’s not a good thing for us at all. We just bought a house last year and we’re on a strict budget and didn’t foresee having to have this extra payment,” she says.

Radovanovic says she resents being forced to buy something her family cannot afford.

“We’ve thought about selling one of our cars so we could use that money to pay for insurance every month and because I’m a stay-at-home-mom it would be feasible, but it’s still not easy at all,” she says.

Radovanovic says one bit of good news is that the insurance plan the couple found, would let her keep her current doctors.