It has only been a few days since Irene Jacusis' new health insurance under the Affordable Care Act took effect, but the secretary has already scheduled a surgery for Monday.
Jacusis, 50, is having a benign tumor removed from her uterus. She couldn't afford to meet the $5,000 deductible under her old insurance plan so she didn't have the surgery. Under her new silver plan, she has a $1,600 deductible and pays a monthly $150 premium. The government also kicks in $226 each month.
She's one of more than 18,000 Floridians who signed up for health insurance. The Jan. 1 start date brings the most personal test yet for President Barack Obama's health care overhaul as patients begin to seek care, shifting the burden for implementing the law to insurance companies and health care providers.
A surge in late applications trying to meet the Dec. 23 deadline, which was extended twice, has overloaded government agencies, creating stacks of yet-to-be-processed paperwork from people unsure about whether they have insurance. Health insurance companies complained they were receiving thousands of faulty applications from the government. That means early this year insured patients could go for a medication refill — or turn up in the emergency room — only to be told there is no record of their coverage.
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"I'm getting daily phone calls from people who are a little nervous," said Orlando insurance agent Leslie Glogau.
She spent roughly seven hours on the phone with Humana this week trying to confirm that four of her clients' applications did go through. Their applications had been processed, but Glogau said she had 20 or 30 clients who enrolled in plans in the federal marketplace but are still waiting to get their information packets and ID cards from insurers.
"There are a lot of people on my books that aren't able to access anything. They're just waiting," she said.
Most of the patients in the exchanges are still waiting for ID cards, said Dr. Aaron Elkin, a Broward County obstetrician. But he said doctors and hospitals can still treat those patients because their offices can verify benefits with insurers directly.
"It's going to be more complicated, of course, because it takes more time, but we can see them," he said.
Major drug store chains such as CVS and Walgreens have announced they will help customers who face coverage glitches, even providing temporary supplies of medications without insisting on up-front payment.
In Florida, home to roughly 3.5 million uninsured residents, many experts predict the demand for doctor's appointments will be high as patients rush to schedule appointments that had been put off for years because they didn't have insurance or couldn't afford it.
Elkin, former president of Broward County Medical Association, said his office hasn't received any calls from newly insured patients yet.
"The truth is people don't really work that way," said Elkin, who predicted patient loads will increase gradually over the year. "Even if they do have insurance they wait and do things when it's convenient for them."
Dr. Alan Harmon, a Jacksonville gastroenterologist and president of the Florida Medical Association, said patient loads were also way down at his office this week, which is common in the first few days of the year.
The health care law's troubled rollout has been an easy target for Republicans, who have criticized the website and seized on a public relations nightmare when existing policies were cancelled, prompting the president apologize for promising that people who liked their old plans could keep them.
The shaky start could provide more fodder for Florida Republicans this legislative session as Democrats try again to expand Medicaid coverage to roughly 1 million people.
Supporters point to Florida's high enrollment numbers in the federal exchange as a sign of pent up demand. The Sunshine State led the country in enrollment among the 36 states using the federal exchange with nearly 14,500 Floridians signing up in November.
Jacusis, a New Port Richey resident who has been without insurance for the bulk of eight years, said she's ecstatic about her new plan. She didn't mind waiting more than 45 minutes on the phone with her insurer Friday to get her ID number.
"It's peace of mind knowing that as healthy as I am, because there are silent killers out there, that I can go to the doctor for these annual checkups and for the slightest symptom."