News10NBC's Special Report: Affordable Care Act

Posted at: 03/27/2014 10:38 AM
Updated at: 03/27/2014 6:21 PM
By: Rebecca Leclair

People are choosing between groceries and health insurance. People are worried about going bankrupt if they get sick. News10NBC is hearing dilemma after dilemma from New Yorkers signing up for coverage under the Affordable Care Act. 

The federal government announced this week it was extending the latest deadline. News10NBC has learned that the March 31 cutoff stands and if you miss it, you could be fined.

A lot of people have been complaining on News10NBC’s Facebook page about facing a fine if they don’t sign-up for health insurance. Many say they can’t afford the premiums or the deductibles and it would be cheaper to stay uninsured and pay the penalty.

The free clinic at St. Joseph’s Neighborhood Center always has a steady stream of patients. The director says the Affordable Care Act will never put them out of business, even though everyone is supposed to have insurance and their own doctor. There will always be people who need care but can’t afford it.

Close to half of the 1,100 patients who come to the clinic don’t qualify for public assistance, but don’t have the money for premiums or deductibles either.

Sr. Christine Wagner, St. Joseph’s Neighborhood Center, said, “And our population is those who are above Medicaid eligibility, are working and just don't have the income to be able to afford employer based insurance and now can't afford the exchange insurance. We will keep them here.”

Marian Schrader is a navigator, paid by the state to help people through the sign-up progress. She says when some people hear how much the plans cost, they decide not to enroll.

Marian Schrader said, “I'm letting them know there is a fine, but I also understand if you can't afford to buy insurance, I mean, are you going to buy insurance or buy food? You’re going to buy food.”

If you are not enrolled in a plan by the deadline, you could be fined.  When you file your income taxes next year, the penalty will be taken out of your tax return or assessed separately.

Fines are calculated two ways and you would pay the higher amount. There's a flat fee of $95 per adult and $47.50 per child. For a family, the maximum is $285 dollars or based on your income. The fine is one percent of the total over the tax filing threshold. For example, a married couple with two kids, making $70, 000, would be fined $497 for the first year. Fines go up in each successive year.

Krista Brown, from Clifton Springs, is a self-employed day care provider. She followed the rules. She signed up for a new plan because the federal government cancelled her old one. Now she is worried she can't make the payments because they doubled. She could face a penalty if she doesn't pay.

Krista Brown said, “We are living paycheck to paycheck just to pay the bills and have to worry about being sick. My husband is like, ‘what do we do’. I want an answer, I want a good answer.

News10NBC took her frustration right to the state agency running the health care exchange. News10NBC called and explained her situation. Now, a state official wants to re-do her paperwork because it appears, her income was incorrectly calculated and she could qualify for free health care.

News10NBC should find out Friday if she is eligible for that. If you don't get insurance and have to go to a doctor or a hospital, you pay 100% of the costs.

If you need help signing up for health insurance, you should start by going to the New York State of Health website.   

You can sign up online. There is also a list of navigators you can go to for one-on-one consultations.

There is a walk-in enrollment session Friday, March 28 at 1099 Jay Street, Bldg J 2nd floor from 8:30am until 7pm.  

There is a call center with operators who can talk you through the process.  They are available 8:00 a.m. to 8:00 p.m. weekdays, with special hours on Saturday, March 29 from 9:00 a.m. to 1:00 p.m. The phone number is 1-855-355-5777.