At the end of October, Ryan Smith received a letter from Florida Blue, the state鈥檚 largest health insurer, informing him that his policy would be canceled after it expires next June.
Mr. Smith is one of 300,000 members of Florida Blue to receive such cancellation notices, as the insurer began to revamp its plans to comply with requirements of the Affordable Care Act, which goes into effect starting January 2014.
That letter prompted Smith, who runs a metal and plastic parts business out of his home, to begin shopping for a new policy. What he found was that he and his wife, Ning, a cook who specializes in Thai cuisine, would most likely pay double for their health insurance, from the $260 a month they pay now to something around $500, Smith says.
The uproar that ensued as canceled policies multiplied 鈥 to at least 4 million, by some counts 鈥 led President Obama on Nov. 14 to concede that an Obamacare fix was needed. Now, insurers such as Florida Blue will be able to offer people such as Smith their old plans for another year, the president said.
"If I can keep my current plan, then I probably will keep it," Smith said by e-mail the day after the announcement. "Not sure what Florida Blue will do though. It may be too late for them to reverse course."
That puts Smith in a holding pattern. And with all the snafus at HealthCare.gov, the federal online exchange where people from 37 states are supposed to be able to shop for health plans, he wonders if more changes lie ahead.
He has been on the Obamacare exchange, but says he didn't find a suitable plan. The open market plans are a little cheaper, he found, because they have a more stable pool of nongroup members 鈥 at least for now. And, frustratingly, his income from his small business was 406 percent of the federal poverty level in 2012 鈥 or just about $1,000 too much to qualify for a federal subsidy to help defray costs of health coverage.
Still, given his past experience with 鈥渋ndividual鈥 health plans 鈥 a market pool notoriously volatile for insurers 鈥 he鈥檚 not altogether upset by the changes that have come with Obamacare.
鈥淚n some ways, I feel better, because I can鈥檛 get rejected,鈥 he says. 鈥淭hat makes me feel a lot better, actually. Yeah, I鈥檓 paying more money 鈥 maybe $200 a month plus 鈥 and I don鈥檛 like that. But I鈥檓 more confident I鈥檒l have insurance 鈥 companies won鈥檛 be able to drop me for some little rule or something.鈥
When Smith and his wife, who are both in their early forties and who do not have children, relocated to Cape Coral from West Des Moines, Iowa, in 2012, they say they were refused coverage by Golden Rule, a division of UnitedHealthcare, which serves 27 million members. Smith takes lisinopril for high blood pressure and pravastatin for high cholesterol, so when a broker then hooked him up with a Humana policy, the Kentucky-based insurer serving more than 11 million customers said no to him, too.
Despite these preexisting medical conditions, after a few months in their new home the Smiths were approved for a bare-bones, high-deductible policy by Florida Blue. Now, just a year later, he has to go through this process again.
鈥淚t鈥檚 all myself 鈥 no employees,鈥 Smith says. 鈥淪o if I do get sick or anything 鈥 I mean, if I鈥檓 down, I鈥檓 in trouble.鈥
But he and his wife are happy to be in Florida. They even hope to open a Thai restaurant in the near future. And although they鈥檒l be paying more for insurance, they feel a bit more secure.
Smith is shopping for a 鈥渂ronze plan鈥 now, the cheapest of the metallurgically-labeled coverage levels that many private insurers are using, echoing the labels of Obamacare. With the cheapest plan, Smith and his wife will each have a $6,350 deductible, or a $12,700 yearly out-of-pocket cost for health services they use. Until they cross that threshold, this type of plan pays only for a few primary-care visits and a basic drug benefit.
鈥淚 have more confidence that I鈥檒l have real insurance now,鈥 he says. 鈥淵ou know, I don鈥檛 like to pay more, but I have more confidence that I鈥檓 going to have some coverage that won鈥檛 get yanked from underneath me.鈥
鈥 Harry Bruinius, staff writer