How Obamacare is affecting New Yorkers

The rollout of Obamacare has been marked by embarrassing technical glitches, finger-pointing and a stream of apologies.

But a look at how the new health care law is impacting New Yorkers reveals an even more complicated picture.

The Daily News spoke to four people whose lives are affected by the Affordable Care Act in radically different ways.

***

Beverly McClain, a 58-year-old Manhattan woman suffering from stage IV breast cancer, was hopeful about the law.

No more.

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McClain, who owns a graphic design firm with her husband, had been thrilled with the group policy she had through her business.

It cost about $ 600 a month and had a $ 1,250 annual deductible, but her doctors at NYU Medical Center and Memorial Sloan Kettering were in-network.

President Barack Obama with Health and Human Services Secretary Kathleen Sebelius. The two have had to answer to criticism of the botched rollout of Obamacare.

Miller Elisa

President Barack Obama with Health and Human Services Secretary Kathleen Sebelius. The two have had to answer to criticism of the botched rollout of Obamacare.

That was key.

For the past two years, she has undergone numerous rounds of chemotherapy and radiation.

“Who knows what that stuff would have cost me?” McClain said. “It was all taken care of through that plan.

“I was so happy with it,” said McClain, who has been receiving support from the nonprofit CancerCare. “For cancer patients to be happy with their plans is very unusual.”

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But McClain received a letter from her insurance company three weeks ago, saying she was going to have to find a new policy.

The reason: Her insurance company was canceling its policy for businesses that contained only a husband and wife.

Carriers “across the board” are canceling plans like the one long enjoyed by McClain, said Brian Bodner, president of the New York metro chapter of the Association of Health Underwriters.

“The administration, by putting these requirements on carriers, is forcing them to make certain business decisions, and as a result of these decisions, certain clients are going to be underserved,” Bodner added.

Marilyn Stern, who has found a better and cheaper policy through the New York health exchange, in her West Islip, Long Island, home.

Christie M Farriella/for New York Daily News

Marilyn Stern, who has found a better and cheaper policy through the New York health exchange, in her West Islip, Long Island, home.

Reading the letter, McClain grew incensed.

“Why should we be penalized because we’re married?” she said.

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McClain spent the next week researching plans on the New York exchange, the state’s online marketplace for health insurance that was created under Obamacare.

Those new policies were all more expensive than her current policy, they offered fewer benefits and — most importantly — none included her doctors, McClain said.

“When you have so much uncertainty in your life, the last thing you want to do is walk away from your doctors,” McClain said.

She has found a plan not on the exchange that includes her doctors, but the monthly premium is $ 200 more and she has no idea how much she’ll have to pay for her medications.

“What I’ve had to do is find an insurance company that’s not involved in the exchange because the exchange is poison for me,” McClain said.

“I believed Obama when he said you can keep your insurance, but that’s not the case with me,” she said. “I’m having benefits taken away. I’m being charged more. And there are no policies on the exchange that include my doctors.”

The rollout of the Affordable Care Act has been marred by embarassing technical glitches.

MIKE SEGAR/REUTERS

The rollout of the Affordable Care Act has been marred by embarassing technical glitches.

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She said she and her husband have considered drastic measures. “We were looking into getting divorced so we can keep our plans,” McClain said. “When you have cancer, it’s not a joke.”

***

For Marilyn Stern, the new law has been a godsend.

Stern, a 62-year-old retired financial manager from Long Island, suffers from recurring bronchitis after being exposed to the toxic fumes at Ground Zero after the 9/11 terror attacks.

She quit her job as a JPMorgan managing director 18 months ago after her daughter, a mother of three, passed away. Stern has been helping to take care of her three grandkids ever since.

After her COBRA policy expired, she enrolled in a plan designed to cover catastrophic events only. It afforded her just one annual doctor’s appointment.

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Stern, who suffers from high cholesterol, said she shelled out $ 620 for a blood test this summer and then $ 520 for a three-month supply of Vitorin, an anti-cholesterol drug.

Sheldon (left) and Barbara Selin hold a copy of their Obamacare research. They had to purchase a more expensive health insurance policy with the New York Health Insurance Exchange in order to keep both their doctors and hospitals.

Barry Williams/for New York Daily News

Sheldon (left) and Barbara Selin hold a copy of their Obamacare research. They had to purchase a more expensive health insurance policy with the New York Health Insurance Exchange in order to keep both their doctors and hospitals.

She has held off on getting other basic tests — like a mammogram — because of the high cost.

But she found a policy on the New York exchange through Empire Blue Cross Blue Shield that suits her perfectly: Premiums are $ 160 cheaper than what she was paying, and doctor visits, lab tests and specialists will cost her $ 30 max.

And signing up was a breeze, she said.

“For me, the New York health exchange was really a welcome relief,” said Stern, a widow who lives in West Islip. “With my health care plan now, I’m afraid to go to the doctor and I’m going to have to pay a lot of money for medications. With this new insurance, I’m not going to have to worry about that.”

***

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The new law has no effect on Sheldon Selin’s health care situation. The 80-year-old retired human resources manager has Medicare.

But his wife, Barbara, is a different story.

Barbara Selin, 63, recently left her job as a receptionist at a Manhattan pilates studio.

Barbara Selin has mixed feelings about Obamacare: 'You have so many options, but it's so hard to get clear information about each of them.' Here, the Selins insurance research.

Barry Williams/for New York Daily News

Barbara Selin has mixed feelings about Obamacare: ‘You have so many options, but it’s so hard to get clear information about each of them.’ Here, the Selins insurance research.

She’s been on a COBRA policy that costs her $ 566 a month and expires at the end of the year.

The Selins looked into two Empire Blue Cross Blue Shield policies, but neither was right for her. One was a chintzy plan that just provided for doctor’s care. The other was a Cadillac plan that was far too expensive.

So the Manhattan couple took their search to the New York exchange where they found a policy through Oscar that seemed just right. It was $ 80 a month cheaper than her COBRA plan and even offered $ 400 a year for a gym membership.

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The plan had one drawback: Her gynecologist was not in-network. Still, Barbara Selin was willing to accept that and pay for those visits out of pocket.

But after seeing her gynecologist last week, she reconsidered.

Her doctor at Lenox Hill Hospital told her that she needed a procedure. If it isn’t successful, she was told, she might have to go under the knife.

Concerned about the potential costs of an extended hospital stay at an out-of-network medical center, the Selins went back to the drawing board.

The experience was mind-numbing for Barbara Selin.

Fortunately, her husband, who was well-versed in the byzantine world of health insurance thanks to his years in human resources, helped her understand the myriad policies.

The best plan they found that includes her gynecologist and hospital costs $ 200 more a month — but she’s likely going to go for it anyway.

“Even a three-day hospital stay could cost $ 30,000 out of pocket,” Sheldon Selin said.

Barbara Selin said she has mixed feelings about Obamacare.

“It’s a good and a bad thing,” said Selin. “You have so many more options but it’s so hard to get clear information about each of them.”

rschapiro@nydailynews.com


Health – NY Daily News

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