Affordable Care Act ‘success story’ at State of the Union needed extra help to sign up

A few weeks ago, Rep. Donna F. Edwards (D-Md.) invited a guest to President Obama’s State of the Union address: Lorita Katherine Waltz, a 49-year-old nurse from Prince George’s County who the congresswoman considers an Affordable Care Act “success story.”

But Waltz’s family did not become enrolled in a new insurance plan until Tuesday — the day of the president’s address — after weeks of trying and only with help from state leaders.

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After Maryland launched its online health insurance marketplace Oct. 1, Waltz said that her husband tried to enroll but that the Web site was not properly functioning and their status in the system was unclear. He would periodically try to log in without success, but given that the family has coverage until the end of January, Waltz said they were not worried.

On Tuesday morning, Waltz said she told Edwards’s office that she had not yet enrolled in a new health insurance plan. The office quickly put her in touch with a navigator, whom Waltz described as an official in Gov. Martin O’Malley’s Office of Health Care Reform. Waltz said that she and her husband put the navigator on speaker phone and that they tackled the health exchange Web site together.

“She also had some hang-ups,” Waltz said of the navigator, “but she got us accepted.”

Also that morning, Edwards’s office sent out a news release that stated: “Thanks to the ACA, Ms. Waltz was able to sign up for a quality plan that meets her health care needs and fits into her family’s budget.”

In an interview Tuesday evening, Edwards said she selected Waltz because “I’m just really excited about our health-care system.”

Waltz said Tuesday evening, while sitting in Edwards’s office, that she is not irritated or frustrated by the delay. With anything new, she said, there will be problems at the beginning. She’s just glad that her family will soon have health insurance that fits in their budget.

“Today we had success,” she said.

Waltz and her husband live in Landover. For the past few years, Waltz’s husband received health insurance through his employer that covered the two of them plus two children, one in college and one in high school. When her husband decided to retire, the family began to look for new insurance.

Because Waltz is a floating nurse, her benefits are limited. She said that coverage through her employer would cost at least $1,000 a month.

So the family looked to the Affordable Care Act for help. Maryland is one of 14 states that decided to run its own online insurance marketplace instead of relying on the federal marketplace.

On Tuesday, the family enrolled in a plan through Evergreen Health Co-op, a start-up in Maryland that aims to bring competition to a marketplace long dominated by major insurers. Coverage will start March 1, Waltz said, and the family plans to go without insurance in February.

Hours after becoming formally enrolled, Waltz listened to the president praise the Affordable Care Act, list off its successes thus far and ask his audience for help.

“Tonight I ask every American who knows someone without health insurance to help them get covered by March 31st,” Obama said. “Help them get covered.”

 
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