2264 Whatcom County residents sign up for health insurance in October

Marty Knapp doesn't yet know what he's going to do, but he's leaning toward taking his chances next year when it comes to having health insurance.

The self-employed Bellingham resident and his wife were among the estimated 290,000 residents in Washington who were notified that their existing health insurance policies were being canceled because they didn't meet the higher benefit requirements of the federal Affordable Care Act.

Under their current individual plan, Knapp and his wife paid $585 a month to cover both of them, with a $2,750 deductible for each. But they're now facing premiums of $850 to $950 with a much higher deductible, he said.

'I'm seriously considering not having any insurance,' the 59-year-old Knapp said, adding that he might instead pay a fine for being uninsured next year.

Most people must have health insurance beginning 2014 or pay a fine of about $95 or 1 percent of income.

The couple makes too much to receive financial help for a new plan, according to Knapp, who operates a one-man software company out of his home.

'We're going to wait until after Thanksgiving, the first part of December, and see what things are looking like,' Knapp said. 'We'll have to make some kind of decision. How does this remotely fit under the umbrella of 'affordable?''

Knapp said he knows the previous system was broken, but he's never before faced such a steep increase in premiums.

The enrollment deadline is Dec. 23 for coverage that starts Jan. 1.

Under the federal health care law, all health plans must cover 10 categories, including maternity and newborn care, wellness services and chronic disease management, pediatric services, hospitalization, prescription drugs and treatment for behavioral health. They also will cap out-of-pocket costs consumers pay each year.

Those requirements have led to sticker shock in Washington and other parts of the country for some buying individual health insurance who make too much money to get financial help paying for their plans - and who say they're paying for benefits they don't expect to use.

Still, state insurance officials said the point is to make benefits more affordable by pooling them and to replace bare-bones polices with benefits offered for years in employer-sponsored health plans, such as prescription drug coverage and maternity care.

Meanwhile, Washington insurance commissioner Mike Kreidler estimated that at least 145,000 state residents buying individual health plans will get help paying for their premiums.

Among them is self-employed Bellingham resident Rod Burton, a graphic artist.

He and his wife will pay $457 a month for a plan that will cover both of them, thanks to a tax credit. That's better than the $533 monthly premium he now pays just to cover himself, while the deductibles will be about the same.

'It's a much better plan than either of us had had before,' the 63-year-old Burton said, adding that his new plan will have needed prescription coverage, unlike his old plan. 'I'm thrilled.'

People have until March 31 to sign up for coverage that begins later in 2014, under a longer-than-usual enrollment for the rollout of a key piece of what also is known as Obamacare.

FIRST-MONTH RESULTS

A total of 1,977 Whatcom County residents enrolled in Medicaid and 287 bought private health plans in October - the first month of the rollout.

The county's first-month totals make up 3.9 percent of the statewide enrolment of 57,719 people, with 51,368 of those in Medicaid, according to a report released Friday, Nov. 15, by Washington Healthplanfinder.

Whatcom County's enrollment was seventh highest in the state.

Of the 287 people who bought private plans in the first month, 234 qualified for help paying out-of-pocket costs.

Washington state was among those that elected to launch a new insurance marketplace, or exchange, that is known here as Washington Healthplanfinder.

Residents in states that didn't do that had to go through the federal exchange.

Washington also was one of the states that opted to expand Medicaid, a state and federal health insurance for the poor and disabled, to allow more people to obtain free insurance.

The state exchange is different from the much-maligned federal exchange at Healthcare.gov, which has been beset with technical problems that have, in turn, led to very low enrollment rates in the 36 states served by the exchange.

In Washington state, 6,351 people bought private health plans in October.

More than 21,000 have applied for a plan but haven't yet sent in a payment to complete the enrollment, while more than 70,000 applications are being processed, according to the state report.

And while news reports have focused on enrollment rates across the country missing their target during the first month, Washington state officials expressed confidence in the rates here.

The goal is to have 130,000 people signed up in private health plans, beginning Jan. 1, said Bethany Frey, spokeswoman for Washington Health Benefit Exchange.

'We're well on our way to reaching those goals,' she said.

Also of note, state exchange officials said, was the number of young adults who signed up for health insurance in the first month - more than 6,000 people age 18 to 25 and more than 11,000 age 26 to 34, with more than 15,000 of them to receive free insurance through Medicaid.

Bellingham resident Lisa McShane is among those grappling with the increased cost of buying a new private health plan for her husband and their 21-year-old son. They now pay $616 a month with a deductible of $2,750 per person, which they combine with a health savings account.

They're looking at a plan that will cost $972 a month with the deductible going up to $5,250 per person.

McShane, 54, said they might buy coverage through her husband's small business, which could give his business a tax credit of up to 50 percent. If the tax credit is an option, then they could end up paying about what they pay now.

'It's such a moving target right now,' McShane said.

She doesn't expect to use the benefits that will be part of their comprehensive coverage because they're healthy, don't use much in the way of prescription drugs and don't expect to have more children. Still, she said she recognized that insurance isn't tailored to individuals but for large groups of people.

Despite the possible increase in premiums, McShane was philosophical - 'I think things are going to settle out in the next few years'- and remained a supporter of the Affordable Care Act, including the provision that no one can be denied health care coverage if they're sick.

'That's a big deal. In America, we had too many people losing their homes and really losing lives they've taken decades to build because something went wrong with their health,' she said. 'You've got to start somewhere, and this is it.'

WASHINGTON EXCHANGE INFO

Washington's health exchange, where you can compare and buy health insurance plans, is online at wahealthplanfinder.org.

Reach KIE RELYEA at kie.relyea@bellinghamherald.com or call 715-2234.