Marcine Wheeler doesn’t know where he would be without the Affordable Care Act.
Wheeler, a 54-year-old DeKalb resident, became ill while visiting his sister in October 2012 in Chicago, and was checked into the John H. Stroger, Jr. Hospital of Cook County, where he was diagnosed with diabetes. His blood-sugar level was 1,400 milligrams per deciliter. He said 95 is considered normal.
“Most people call me a miracle,” he said. “I should have been dead.”
He was in a coma for a month, and afterward was able to afford three months’ worth of medication through CountyCare, a Cook County Medicaid program for uninsured adults available under the Affordable Care Act.
However, the program is limited to Cook County residents. Wheeler is unable to get health insurance in DeKalb where he now lives because he’s unemployed and doesn’t qualify for medical assistance through public aid.
Although he’s rationed his medication so far, eventually he’ll need health insurance to afford more. Wheeler plans to visit the DeKalb County Health Department to sign up for a plan through the Health Insurance Marketplace in the coming weeks.
Wheeler is one of more than 8,000 people in DeKalb County living without health insurance. They can finally receive it through the Health Insurance Marketplace, which opened Oct. 1. The marketplace, or the Exchange, is a website that will help people and small businesses shop for health insurance plans.
It’s one of many initiatives under the Affordable Care Act, signed in 2010 with provisions being phased in through 2020, meant to make health care more affordable and accessible nationwide.
The Exchange is meant for people who had no health insurance options before, said Cindy Graves, director of community health and prevention for the health department and who is part of the department’s Enroll DeKalb County initiative.
The department was one of 82 statewide to receive state funding to educate residents about the Exchange and help them enroll. So far they’ve handled more than dozen phone calls from people of every age group inquiring about the Exchange.
Although many uninsured people who are sick stand to benefit from the Exchange, the system also depends on participation by the healthy uninsured.
“You have an overburdening of the system by people who need [insurance] with no ground to support it,” said Cameron Zelaya, in-person counselor with Enroll DeKalb County. “The part of this push is trying to create a ground for a culture of coverage.”
A culture of coverage – trying to convince everyone that obtaining health insurance coverage is the right thing to do – is what the health department encourages, Graves said.
The health department is trying to reach the “young invincibles,” young adults who might not be inclined to purchase health insurance because they don’t think they need it. Graves said they will hold educational seminars at Kishwaukee College in Malta and may also hold some at Northern Illinois University.
Starting in 2014, anyone without health insurance coverage will have to pay a fine. Next year, the penalty will be either $95 or 1 percent of their annual income, whichever is greater, but will increase significantly in the future, Zelaya said.
One provision of the ACA allows young people to have coverage under their parents’ health insurance plan until they are 26, and that’s the case for Jewelle Hill, an 18-year-old Kishwaukee College student. Hill said she would try to find health insurance if she was no longer able to have it under her mother’s plan, which she thinks she might have to next year.
“I feel like I would need health insurance because you never know what happens,” she said.
The health department plans not only to target young adults in the county, but everyone. In the next few weeks, they plan to hold seminars at social service agencies such as Hope Haven and sign-up sessions at public libraries.
Those countywide sessions may help people who are curious about the Exchange or still unaware of it, such as DeKalb resident David Anderson, 32, who’s gone four years without health insurance.
Anderson, a Kishwaukee College student and math tutor, said he had tried to secure health insurance through a public aid office in DeKalb County, but did not qualify because he’s single and without children.
Anderson said he will need insurance soon to treat a hiatal hernia. With hiatal hernia, the upper part of the stomach is pushed through the diaphragm and into the chest. He said he won’t know how severe it is until he sees a doctor.
“I’m frustrated with it,” Anderson said of health care in the U.S. “Because I need care and I can’t go see the doctor I need to see and they don’t make it very accessible.”
After learning a bit about the Exchange, he said he might look into it or find health insurance from another state such as West Virginia, where he is originally from. He said he was able to receive assistance there, unlike in Illinois.
People such as Anderson can’t be denied health insurance coverage through the Exchange.
When it comes to the cost of coverage, Graves said it can vary by a person’s age, whether they smoke, their location and family size.
As the health department continues to field inquiries and reach out to people in the county, one of the challenges it faces is making sure people are able to see all the coverage options they have in an unbiased way, said Peggy Newby, pediatric program coordinator and part of Enroll DeKalb County.
“It becomes our challenge to present to them through the marketplace what their options are and how those best fit with what they told us,” she said.