Name: Barb Gabri

Age: 55

Location: Lewiston

Insurance for 2014: Employer

Barb Gabri isn’t a fan of the ACA. At least she hasn’t seen it help many people, especially families that earn too much for government assistance but not enough to pay for their own health insurance.

“My heart breaks right down the middle and I don’t know how to help them,” she said.

A human resources professional for more than 20 years, she now works for a nonprofit health care agency. The organization’s health insurance costs have skyrocketed recently, up 20 percent one year, then 30 percent the next, despite the cost-containment promises of the ACA. To compensate, the organization has slashed the percentage it pays toward health insurance, both for its workers and for their families.

“They were devastated, just like I was,” Gabri said. “I had people crying, going into the HR office and saying, ‘Remove my child from my insurance for next year.’ They don’t qualify for MaineCare because they make $60,000. They don’t qualify for a subsidy (on the ACA marketplace).”   

In case some workers could qualify for a subsidy, Gabri’s employer brought in experts to guide them through HealthCare.gov, the ACA insurance marketplace. But the help seemed more confusing than helpful. And while some people qualified for subsidies, Gabri discovered a number put down the wrong information, such as net pay instead of gross. It’s a difference that could cost those people their subsidies, and their affordable insurance, later on.

“I think that is going to be a fiasco when that all starts to unravel,” she said.

Gabri herself didn’t qualify for a subsidy. She and her husband earn too much. But they couldn’t afford insurance through her employer anymore, either. 

What had cost them $108 a week will, in 2015, cost $183 a week. That’s an additional $300 a month. Plus a higher deductible.

As a part-time, six-day-a-week postal worker, Gabri’s 58-year-old husband doesn’t get help with insurance through work. He’d have to pay for the entire thing himself, and that would cost even more than sharing Gabri’s. 

So they made a decision: Take him off her insurance and pay the penalty for not being insured in 2015. It’s not a decision they’re happy with, but it’s the only option they can see. 

“He’s not insured now at all,” she said. “We’re rolling the dice.”

She added, “We hope we can figure it out before the February deadline for the ACA (marketplace).”

Supreme uncertainty: The future of the Affordable Care Act in Maine
Here’s what to expect from year two and beyond for the ACA in Maine.

Lewiston insurer is a national ‘rock star’
Today, a year after it started offering health insurance from its Lewiston headquarters in the Bates Mill, Maine Community Health Options has more than 40,000 members.

Profiles of Mainers who bought health insurance through the ACA marketplace:

• : ‘Rolling the dice’ without insurance

• Charlene Brousseau: Sticking with the ACA
• Sherri Tripp: ‘I think it’s wonderful’
• Blake Pooler: Finally insured, for $160 a month
• $22 a month: ‘I am totally flabbergasted’
• Business owner: ACA offered another option

You’ve seen how the Affordable Care Act affected other Mainers in 2014. How about you? Good, bad or neutral — share your ACA stories

Resources:

• How the ACA changed your insurance
• Who are the health insurers competing for Mainers’ money
• Where to get help
• Tips, hints and other things you need to know
• Get insurance: The step-by-step
• Answers to frequently asked questions
• Know the lingo
• ACA by the numbers

From ‘hellish’ to health care: The ACA in Maine one year later
A one-year checkup on how the ACA is doing in Maine and a subsidy calculator can be found at SunJournal.com/ACA201

Affordable Care Act 101: We break down the ACA, what it does and what it requires you to do.