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Texans Brace for Potential End of Obamacare’s Insurance Exchange

Martin do Nascimento/KUT News
Sarah Mealey says it was a relief to get insurance through the federal health exchange so she could afford to take her daughter Emma to the doctor.

The enrollment period for the federal health insurance exchange ends Jan. 31. For many Texans who don’t get their insurance through an employer, this has been an affordable way to get a policy in the state for the past few years.

But if the Affordable Care Act is repealed, this could be the last year it’s an option.

Sarah Mealey, a self-employed house cleaner and single mother, was one of the first people to sign up for insurance through the marketplace.

“The minute it became available,” she says, “I got on Obamacare.”

This was the first time Mealey remembers ever having health insurance. She runs her own business, but doesn’t make enough money to pay for insurance on her own. When the Affordable Care Act, also known as Obamacare, was passed, she thought she might finally have a shot at getting covered.

“I never thought that I would be able to afford health insurance, and I was really skeptical about the whole process,” she says. “And I’m like, ‘It’s going to be ridiculously expensive, I won’t be able to afford it.’”

But she was able to afford it. The way the marketplace works is that different insurance companies sell their plans directly to customers through an online system. Customers can shop around for a policy that works best for their needs and budget.

"It was a really wonderful kind of experience for me to be able to go to doctor for just a copay and not the whole payment. So it was a big relief." - Sarah Mealey

The program also offers subsidies to help some people pay for their premiums. For Mealey, this was a game changer.

“It was a really wonderful kind of experience for me to be able to go to doctor for just a copay and not the whole payment,” Mealey says. “So it was a big relief.”

For the next three years, Mealey relied on this insurance. She was able to take her young daughter to the doctor, too, and found out her daughter has asthma. Finally, Mealey says, she could afford treatment.

Her insurance also came in handy when she hurt her back and had to go to physical therapy for six months.

“If I didn’t have health insurance I wouldn’t have been able to do any of it, but it saved me,” she says. “It saved my back. So there are moments like that where I would just be so lost without it.”

This is why community organizers like Foundation Communities have been working hard to get the word out about the marketplace for the past couple of years.

At their office on Airport boulevard, marketplace navigators help people walk through the process of finding a policy that works for them. They’ve done this every year since the federal health insurance marketplace launched.

Elizabeth Colvin, the director of Insure Central Texas at Foundation Communities, says the marketplace was created to help folks who don’t get insurance through an employer, a spouse, Medicaid, Medicare or the Department of Veterans Affairs. She says self-employed folks like Mealey are among those using the marketplace. 

“We work with people in Austin who are involved in the gig economy,” such as musicians, she says. “They piece together income through various jobs where they are not offered health insurance. We also see folks who have retired, but they are too young for Medicare.”

Texas has the highest number of people without insurance in the country. More than 775,000 Texans had health policies through the marketplace last year; about 75,000 of those people live in Austin.

But this could be the last year they have this option. Right now, Republicans in Congress are working to dismantle the Affordable Care Act.

“This is the first time in five years we will finally put a bill on the president’s desk that defunds Obamacare,” House Speaker Paul Ryan said earlier this month. “For years Senate Democrats have been blocking and filibustering these bills. This is too important to let up.”

Ryan says he plans to replace Obamacare, but he hasn’t said what that replacement will be.

In the meantime, Colvin is urging people to sign up for what might be at least one more year of health insurance.  

“The contracts to have insurance for 2017 are in place and have been in place for some time,” she says. “We are confident those contracts will remain enforced for 2017. People have a chance to get insurance, and they are taking advantage of it now.”

In fact, Colvin says enrollment numbers at Foundation Communities are up 10 percent from last year.

Mealey has already purchased a plan, but she’s scared 2017 might be the last time she’ll be able to afford insurance.

“Health care through the marketplace has been totally invaluable to my life and my daughter’s life,” she says. “And I feel really, really, really lucky to have been able to have health insurance for four years. You know? And if that’s all I get out of it, OK. What are you going to do, you know?”

Ashley Lopez covers politics and health care. Got a tip? Email her at Follow her on Twitter @AshLopezRadio.
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