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Barriers to health insurance: doubt, distrust and glitches

A Florida woman has been trying desperately to log in to the new federal health insurance website but can’t get through. There’s the salesman in Indiana whose premiums have gone up but who’s afraid to try the website because of news coverage about its failures. Then there’s the lawyer in Iowa who doesn’t see the point of switching insurers, even though her premiums have doubled.

Three people, three different barriers keeping them away from what President Barack Obama is telling them is their best hope for affordable health insurance.

JoAnn Smith, a medical transcriptionist in Clearwater, Fla., is desperate for health insurance and has been trying for two months to log on to to buy some, but with no success.

“On the first day, I went on and I got all the way to a sign-in page and I was so excited,” Smith told NBC News. “And then it was like, ‘please wait’ forever.”

Like millions of Americans, Smith got caught in the now-notorious website hangups and glitches.

She’s tried every week or so since then. “But I haven’t been able to create an account,” says Smith, who’s 60 and whose income has fluctuated from $60,000 to $20,000 a year in recent years and whose employer doesn’t provide health insurance.

“I’ve tried, I’ve tried,” she says. “Every time I try to create a new one, and every time it comes back saying ‘This account has been used.’”

The Centers for Medicare and Medicaid Services, which operates the website, has added a “reset” button to help people like Smith, who often have created multiple aliases as they have tried to get on to the site and buy insurance. “Yay!” Smith said when she heard about this new feature.

“I could hardly contain myself at work … I was so excited about trying again,” she said the next day. “So I tried to create an account, didn't work, found a thing that said ‘type forgot my username at log-in.’ That didn't work.” After a few instant message exchanges, Smith decided to try the call center.

“The lady I dealt with was so nice and patient,” she said. “We got all the way to the last page of the application and she was getting ready to sign it for me, when my name came out wrong, and once she tried to go back to fix it, guess what? Computer crashes,” she said.

She’ll keep trying. Smith’s husband is covered by a bare-bones policy but she is paying for her own care — she doesn’t need much — out of her pocket. “I was thinking I was going to have to keep going (without insurance) till I was 65,” Smith said. “As far as I know I am in good health but since I haven’t seen a doctor for years I could be all full of diseases,” she said.

Smith is precisely the type of person the Affordable Care Act is aimed at. She’s one of the more than 40 million Americans who go without health insurance, gambling that they won’t get sick or be hurt in an accident.

“Most of the places I worked, they pretty much screw you with insurance,” she said. “They pretend you are an independent contractor or they pretend you don’t work enough — all these excuses.”

Not everyone is so eager to go to the mat with a balky website.

“With the negative publicity in recent months, regarding the website, we have been waiting to see if they can improve its performance,” says Larry Biddle, an independent salesman living in Zionsville, Ind.

Biddle, 63, says he’s been paying $652 per month for what he calls catastrophic coverage from Anthem Blue Cross for himself and his wife Kathi, who’s 62. He’s one of the millions of people who buy their own health insurance and who got cancellation letters from their providers.

“We got a letter in September from Anthem that said our policy does not fulfill the requirements of the Affordable Care Act, so that, effective Feb. 1, if we did nothing they would offer us a comparable plan for $1,671 a month,” Biddle told NBC News. “That’s about $1,000 a month more.”

Biddle may opt to change to a new plan that costs about $88 a month more than he's currently paying, but that “grandfathers” in some of the old coverage rules that don’t meet all the strict new requirements of the Affordable Care Act, including rules for covering screening, rules prohibiting caps on coverages and requirements to cover mental health conditions.

He hasn’t looked at “As of Dec. 1, 2014, if we do nothing, we are going to have to go with their $1,600 a month policy or I will have to go onto the Obamacare website,” he said.

Why not look now? The government says it’s much better than during its first two rough months of rollout. “We have not done it yet because it’s been such a mess,” Biddle says. “I truly don’t believe it’s that much better.”

Instead, Biddle is putting his trust in his insurance agent.

Premiums have been rising for everyone in recent years -- a rise that started before the Affordable Care Act. Currently, according to the Kaiser Family Foundation, employer-sponsored health insurance costs between about $15,000 to $16,000 for an average worker. Workers at bigger firms pay more. Coverage is about $5,600 a year for a single person.

Kathryn Mahoney of Waterloo, Iowa puts her trust in her insurance company. The 51-year-old lawyer has been paying for her own health insurance for years. “I have a private policy that I’ve carried with Wellmark Blue Cross/Blue Shield since 1997,” she said. “The premiums reached up to $2,891.40 a quarter or $963.80 a month. That is $11,565.60 a year.”

The company told Mahoney that the requirements of the Affordable Care Act were forcing it to raise premiums. “In 2006 and 2007 I paid $5,832 for my health insurance per year,” she said. “For all sorts of reasons, your premiums go up all the time. Wellmark tells you it’s not because you are using your insurance and you are, like, ‘Well, right,’” Mahoney said, expressing skepticism.

Mahoney said the insurance company told her it was forced to raise rates again this past year because of the Affordable Care Act’s requirements that insurers take all comers, even if they have preexisting conditions, and because it forbids them to cap coverage once customers spend a certain amount.

She hasn’t looked at options offered by other companies. “I wouldn’t trust anyone else,” Mahoney says. “I have always had great experiences with them. …They are so trustworthy. They are not going to leave the market tomorrow.”

For Mahoney, continuity is important.

“I don’t know what other health care there is out there. But I am not going to sign up for Acme health care,” she added. Wellmark has offered her a new policy that will cost her around $6,000 a year, but with less generous prescription drug coverage.  

She agreed to let NBCNews see what might be available on for a woman her age in her county. Mahoney earns too much to get a government subsidy, but the federal government website offers 30 different health insurance plans for her.

They range from a bare-bones bronze plan costing $235 a month or $2,820 a year but with a $6,300 deductible before she can see a doctor or fill a prescription without a co-pay, to a gold $5 co-pay plan offered by Unity Point Health costing $343 a month or $4,116 a year with a $1,750 deductible and a $3 per prescription co-pay; to a CoOportunity Health Platinum plan costing $608 a month or $7,250 a year with a $500 per year deductible and a $10 deductible for generic medication.

“I could go on the website and I could look around and I could check,” Mahoney says. “But I am not the kind of person who will read everything. I am not a good comparison shopper. I just want something that works.”

Mahoney believes the Affordable Care Act will eventually lower premiums. “All legislation is never rolled out perfectly,” she said. ”It’ll take a while, but it eventually will work itself out.”

Mark Schone contributed to this article

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