POSTVILLE, Iowa -- For Candy Seibert, a self-employed property manager from northeast Iowa, getting by without health insurance is just a way of life.
Her experience isn't unusual in Allamakee County, where the 44-year-old Seibert lives. According to 2010 Census data, the bucolic county has the highest percentage of people without insurance in Iowa. A total of 18.2 percent of the population here lacks insurance, compared with a statewide average of 10.7 percent, based on the Small Area Health Insurance Estimates survey.
The onset of President Barack Obama's health care overhaul could bring down the number of uninsured in this region, with an expansion of state-run low income health coverage and new insurance marketplaces where people can buy plans. But there is both confusion and skepticism about the program in this area. Seibert, who has never had health insurance as an adult, said she didn't know much about the new law and wasn't sure if it would have an impact on her life.
"I feel a little strange that this is the first time we're forced to do something by our government," said Seibert, who said she'd be taking a wait and see approach. Currently, she pays doctor bills off in installments, though she admits she's been lucky to have had relatively good health.
Like Seibert, people without insurance in Allamakee, a county of about 14,000 people, said they manage in a variety of ways — visiting a free clinic in a neighboring county, seeking charity care at the hospital, putting medical bills on a payment plan, or just not going to see a doctor. Most who said they didn't have insurance, or had limited insurance access, said they knew little about the health care overhaul — officially the Affordable Care Act, but often referred to as "Obamacare" —and were not sure it would solve their problems.
The federal law will expand state-run low-income health care in Iowa and will set up new health care marketplaces where people can shop for private coverage and apply for government aid to pay premiums. People can start signing up for plans Oct. 1, with the coverage to start Jan. 1.
Under the new law, insurance plans must all provide certain benefits, like emergency care, maternity coverage and prescription coverage. In Iowa, six companies have been approved by the state to participate in Iowa's exchange, including two — Coventry Health Care of Iowa, Inc. and CoOportunity Health — that would offer coverage to individual buyers throughout the state. No information has been released yet on what the premiums will be for those buying on the public exchanges in Iowa, but there will be a variety of options. Those who don't have health insurance will be subject to fees when they pay their federal taxes, though the very poor could be exempted.
So far, there has been little information released about the new law in Iowa. The state is partnering with the federal government to set up the exchange. Iowa Insurance Commissioner Nick Gerhart said he expected a marketing effort from the federal authorities, though the state has done some outreach, like setting up a booth at the state fair.
"It's a heavy lift and a big job," Gerhart said of the education effort. "There is a lot of trepidation in the minds of consumers."
Rochelle Becker is one of those consumers.
"I'm afraid it's going to jack up everybody's prices," said Becker, 55, a divorced mom who has insurance but finds the $400 monthly cost so expensive that she avoids the doctor for fear of additional bills. She said her three young adult children don't have health insurance.
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