Affordable Care Act changing health care in Nebraska

Health care is changing in Nebraska in the wake of the Affordable Care Act – or, as some call it “Obamacare.” More than 40,000 people got insurance this year through the exchange, or marketplace, created by the Act. NET News looks at how the Act affected two Nebraska women, and what changes may be in store for the rest of us, in today’s Signature Story.

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Sara Tangdall lives in Omaha, where she teaches college English part-time, and works part-time for a nonprofit. The 26-year old has asthma, which requires medication. Under her old policy, she said, that could be a problem. “Because of the medications I was on, I had to pay four to five hundred dollars a month out of my own paycheck, and then wait to be reimbursed for that. And that’s really hard when you’re living paycheck to paycheck,” Tangdall explained.

Tangdall said she likes her new policy. “I pay $240 a month and I get really, really good prescription coverage. And that’s what I need. I’m really happy with my plan that I got through the marketplace. I find it to be affordable for my income level. And so far I’ve been really pleased with the experience,” she said.

Tangdall is one of 43,000 Nebraskans who got insurance this year through the marketplace set up by the Affordable Care Act. She personally had insurance before. But the Kaiser Family Foundation estimates that nationally, 57 percent of those getting insurance through the Act were previously uninsured.

No one knows the precise percentage for Nebraska. But if the state matched the national estimate, about 25,000 previously uninsured Nebraskans are now covered.

However, if people like Tangdall like the changes brought about by the Affordable Care Act, others, like Andrea Kodad of Omaha, do not. Kodad, 39 with two children, works two jobs, as a physical therapist and helping with her husband’s construction business. She also gets insurance on her own -- not through work. And she liked her existing policy.

So Kodad didn’t appreciate the letter she got last year from her insurance company, describing the policy she’d have to change to, to meet the requirements of the Act. “The premium was going to go up, from about $450 a month to $726 a month. Our coinsurance – what we are responsible for beyond that – was going up from 15% to 50%, and our out of pocket maximum was also going up by several thousand dollars a year,” she recalled.

“I cried at our kitchen table,” Kodad said. “I knew that … long term, our nest egg was either going to be gone within a year or two, that we would be using our savings to make up that difference, or I was going to have to take, potentially, a third job.”

Since the Obama administration delayed that part of the law, the Kodads have been able to keep their old policy, for now.

In the future, more Nebraskans are likely to be affected directly by the Affordable Care Act. Sen. Kathy Campbell, who’s led the so-far unsuccessful fight to expand Medicaid in the state, says she expects more people to sign up next year.

“I think we have a number of people in Nebraska who may be eligible for a subsidy and may not realize it and may have not signed up. We also have people who might have thought about signing up for insurance but who have just waited and said well, you know, “I’m going to see what happens to the employers, I’m going to see what happens to the exchange,” Campbell said.

Bruce Ramge, the director of Nebraska’s Department of Insurance, says tax penalties people without insurance will pay starting next April will probably lead more people to sign up. Campbell likes more people getting insurance. “I feel pretty good about where we’re at as a number. I’d certainly like it to be better,” she said.

But Sen. Jim Smith of Papillion, who has resisted Campbell’s attempts to expand Medicaid, citing concern over costs, has similar reservations about more Nebraskans getting insurance through the Affordable Care Act’s exchange. “While we certainly want to see the uninsured provided the coverage that they need, I think there’s some concern and uncertainty yet as to what the impact is on other families that were previously insured,” Smith said.

Nebraskans will see that impact, and other effects of the Affordable Care Act, as more parts of it are scheduled to take effect in the years to come.