Fed money in hand, parts of health law start in NH

PORTSMOUTH, N.H. (AP) -- As a grant writer who does a lot of research on federal websites, Deborah Lielasus was impressed by how easy it was to use the new online insurance market that launched Tuesday — until it stopped working.

"They're telling me the system is down at the moment," she said from her home office. "I will re-click."

Soon after the six-month enrollment period opened for the online markets created by President Barack Obama's health care overhaul law, federal officials were working to address website problems that left many unable to sign up. Among them was Lielasus, who had to go to a meeting but planned to finish enrolling later.

The law will require nearly everyone in the country to have health insurance or face fines. Insurance markets will offer subsidized private coverage to people who do not have health insurance on the job, including the uninsured and those who buy their own policies.

Lielasus, 54, currently spends about $8,500 a year in premiums and more than $10,000 for out-of-pocket expenses because she has a health condition and her only option has been the state's high-risk insurance pool. Her husband also is self-employed, and the COBRA continuation coverage he has now will run out in December.

They aren't sure whether they will qualify for a subsidy, but even if they don't, they expect their costs to decrease significantly when they are able to sign up for insurance on the marketplace. Under the law, consumers can't be denied coverage for pre-existing conditions.

"It affected me right away, immediately," she said. "As sort of a citizen of the world, I want, of course, other people to have access to affordable health care. But it hit home on the pre-existing conditions."

Though she had been looking forward to Tuesday, her excitement was tempered by the federal government's partial shutdown.

"I feel like it's a child caught in the middle of a really bad divorce," she said. "Obviously it makes me excited on a personal level that I'm going to save a few dollars, but I would almost pay those dollars to get the government back running."

Though New Hampshire opted not to run its own online markets, Gov. Maggie Hassan's administration has tried to have the state partner with the federal government to manage health plans and provide consumer assistance. Republicans had blocked the state insurance department from accepting a $5.3 million federal grant for consumer outreach and education, but it was awarded late Monday night to the organization that runs the high risk pool.

At a news conference Tuesday, the New Hampshire Health Plan announced it had contracted with six social service and health care provider groups that will offer direct, one-on-one guidance for people and small businesses. By week's end, the plan expects to announce an outreach campaign that will include a state-specific website and advertising to educate people about the health care plan and how it affects them.

Planned Parenthood and Bi-State Primary Care Association were chosen earlier by the federal government to offer education and guidance to consumers. These navigators, assisters and other enrollment specialists will explain the options available to help people choose from among the 13 plans offered in New Hampshire, all from Anthem Blue Cross and Blue Shield of New Hampshire. They are not permitted to recommend a plan.

"Get ready to get covered," said Jennifer Frizzell, senior policy adviser for Planned Parenthood of Northern New England, using the phrase that adorns the bright blue T-shirts worn by the agency's navigators. "Today marks the turning point for millions of Americans. Let's move from confusion to clarity."

The state expects to add about 145,000 people to its insurance rolls. Bruce King, president and CEO of New London Hospital and a member of the New Hampshire Health Plan board, said anxiety was expected as the nation undergoes the biggest change in the way people get and pay for health care since the advent of Medicaid a generation ago.

"It's going to be wild," he said.

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Associated Press writer Rik Stevens in Manchester contributed to this report.