DES MOINES, Iowa — The federal health care law is now in effect, but many Iowa residents are still trying to figure out their new insurance plans or are continuing to seek health coverage.
Jan. 1 marked the first day for many provisions of the new law, including insurance coverage for those who signed up for private plans on the federal enrollment website. Iowa's modified Medicaid expansion — which uses federal dollars to offer coverage to some low-income Iowans — also started that day.
Experts at insurance companies, health clinics and enrollment centers said they've been busy fielding questions from people who either have coverage or need it. And some Iowa residents who thought they might be getting Medicaid coverage remain in limbo due to processing delays by the federal government.
Chris Petersen, 59, is among the state residents who still haven't been able to sign up for a plan through the federal website. A farmer and consultant from Clear Lake, Petersen said he was still waiting to hear what kind of subsidy he and his wife would qualify for to offset the insurance cost.
"I've had probably dozens of phone calls trying to get to the bottom of things," said Petersen, who said that he is still paying for a plan that costs him over $16,000 a year in annual premiums, which he said he can't afford. "These Healthcare.gov people, it's no or I don't know."
Iowa is one of 36 states using the federal HealthCare.gov enrollment website, which was beset by technical problems after its Oct. 1 launch. Those glitches contributed to the troubled rollout for President Barack Obama's health care law, though upgrades have helped ease the website issues.
The health care law seeks to reduce the number of people without health insurance — estimated at roughly 300,000 in Iowa — both through an expansion of Medicaid and by requiring individuals who don't have employer-provided health insurance to purchase it. There will be federal subsidies available to help some people with their premium costs, and those who don't buy insurance will pay a penalty.
People can continue to sign up on the exchange through March 31 and Medicaid enrollment is possible year-round.
Among the headaches for Iowa officials is a large group of people who tried to apply for insurance through the federal hub and were told they might qualify for Medicaid. The state Department of Human Services recently sent emails and letters to nearly 16,000 Iowans to tell them a delay in paperwork on the federal level meant they should reapply using the state website, and there was no guarantee of coverage on Jan. 1.
DHS Spokeswoman Amy Lorentzen McCoy said nearly 4,000 of those people had also applied with the state. She said the department was working to process applications as quickly as possible.
One insurer participating in the exchange said the opening days have been busy, but without major complaints. Cliff Gold, chief operating officer at CoOportunity Health, a new provider that is offering insurance plans for Iowa on the exchange, said Thursday that they were getting a lot of calls, mostly with questions about the coverage.
"Most of the questions are about things like ID cards. Making sure drugs are covered. We're getting calls about doctors and hospitals," Gold said. "It's awfully early to declare victory. So far it's a normal day in the office."
Some experts cautioned that this transition to the new law will take time. Andrea Pearce, health benefits coordinator for Primary Health Care, which operates clinics in Des Moines, Ames and Marshalltown, said people should expect this period to be complicated. She noted that the law is helping provide health insurance to many people who've never had it before, who will need time and education to understand how to use the coverage.
"You've got them enrolled and now what," Pearce said. "It's not a one-time appointment."