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Need health insurance? State Rep says shop with caution

You won't find Republican Barbara Sears on Fox News railing against the Affordable Care Act.

Sears sees health care from two points of view: one as an Ohio legislator entrusted with public policy and two as a veteran insurance agent who co-owns a firm specializing in employee benefits.

Rep. Sears is the majority floor leader of the Ohio House of Representatives where she serves on three health care related committees: insurance, health and aging, and finance and appropriations. She shared her expertise with members of the East Toledo Club last week in a talk at the East Toledo Senior Center.

BarbaraSears1a
Representative Barbara Sears spoke at the
East Toledo Senior Center.
(Press photo by Ken Grosjean)

Not once in a 45-minute talk did she call the Affordable Care Act “Obamacare,” the moniker used by the President's critics.

Rep. Sears is pragmatic, not dogmatic. While her party fought the Affordable Care Act and tried to overturn it, Rep. Sears stood with Republican Governor John Kasich to support expanding Medicaid in Ohio. The expansion comes at no initial cost to the state and Rep. Sears has seen how a lack of insurance can devastate a family during a health crisis.

While the national media fixates on the government website, Rep. Sears said consumers have many other options to find a plan that fits their needs and budget. Insurance companies and organizations like the National Federation of Independent Businesses offer such calculators without asking for private financial information.

She suggests you protect yourself while shopping these sites by setting up a free gmail account through Google. It'll allow you to remain anonymous while you get closer to a buying decision. It’ll also protect you from fraud from scam artists trying to steal your identity.

Rep. Sears says unless you are eligible for a subsidy there is no reason to go to the exchange. Go to an insurance agent. The available plans will be cheaper and provide you with more choices.

A good simple site I've visited is healthsherpa.com. It was designed by three techies disappointed in the customer experience at healthcare.gov. You can get a ballpark number for your situation in just a few minutes.

Rep. Sears also cautioned consumers to beware of fees. When you find your premium, tack on $99 a year for various reasons and 2.4 percent to your monthly premium.

The government is training navigators to help you through the process, But Rep. Sears said be wary. Navigators receive five to 12 hours of training to learn about Medicaid, Medicare and the new law. While they can be helpful, they are not licensed, bonded or required to carry liability insurance, whereas insurance agents are. When it comes time to share confidential identity and financial information, consider who you should trust.

You will also want to inquire if your preferred physicians and hospitals participate in the plan you choose. Lower reimbursements are driving costs down and efficient high-volume medical providers will be prized by insurance companies, while the inefficient will be weeded out. Your choices will more than likely be restricted in the future.

The key will be whether young healthy people sign up. In a talk Rep. Sears gave to the Eastern Maumee Bay Chamber of Commerce in April 2012, she said the young would not be able to keep their plans and they would pay more. This was not a surprise then, although, now that the bills are coming due, many people seem astonished.

Will this increase be so large young people will choose to pay the cheaper penalty rather than buy insurance?

Rep. Sears thinks that’s likely. She gave a personal example. Her son, 27, had insurance for $50 to $60 a month with a $2,500 deductible. That same plan will cost him $190 a month with a $6,200 deductible.

Will he buy?

"With all due respect, and saying it politely: gas money, beer money, and date money. He’s not doing it," she said in jest.

Seriously though, and with all due respect to the President, $190 a month to many young people who have only been able to find part-time work, or are underemployed, or have student loans and a car payment, that can be a formidable payment.

Rep. Sears is also concerned about the so-called marriage penalty. As companies eliminate spouses from their plans, some are forced to go on the exchange. Unfortunately, to qualify when married, they must file a joint tax return which could at tax time, cost considerable more.

Is there hope the Affordable Care Act will survive?

"It'll work for us. We're business. We'll adapt," she responds.

Rep. Sears would have liked to see a state solution to the health insurance question. She thinks most policy is better made closer to the source. A local solution is better than a state one, a state one better than a national one.

"We’re here, we’re touching you, we’re seeing you....I think it’s ridiculous that congress has their own special little plan that insulates them from what everybody else is going through… Look who’s actually doing the rule writing on this law. It’s not your legislator, although, it’s their office. It’s this young man who has his masters and his doctorate degrees and who went straight from his mom and dad’s house, through law school to wherever he got his masters at into a job making $150,000 a year and who has never had to figure out how to buy groceries at the end of the week, never figure out to how to save enough money to take someone out on a date, or never wondered whether or not the gas you save Monday through Friday will get you home on Saturday or Sunday… There’s an applied disconnect.”


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