Millions of Americans to Have Insurance Jan. 1

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As 2014 comes to a close, many Americans are looking forward to a big change in their lives: health insurance coverage. Plans take effect on New Year's Day 2015 for those who signed up through government-created marketplaces by Dec. 15, 2014. For those who signed up for Obamacare in 2013 – the first year that marketplaces became available – plans automatically renew unless customers select a new plan. 

Workers Are Spending More of Their Income on Employer Health Insurance]

Eleni Vokas, 23, has set a "to do" list of health care resolutions that having insurance now makes possible: eye doctor, undergo a mammogram, and have a doctor look at her knee injury from spinning. "I need to be on top of it," she says.

Though provisions in the Affordable Care Act allow young people to be covered under their parents' plans until they are 26, Vokas doesn't qualify because her parents are in Greece. A medical emergency she faced last year, as well as a nudge from Planned Parenthood where she in interning, convinced her to sign up for insurance of her own.

"I thought I was above [health insurance] for some reason," the Washington, District of Columbia, resident says. "I'm young. I thought I would be in the clear." Then she developed a cyst on her ovary, which became infected because she delayed getting care. When she finally had no choice, she paid hundreds of dollars to bounce around to various referrals. When she finally signed up for coverage, she says, it took about 10 minutes.

According to the Department of Health and Human Services, more than 4 million people selected plans in time to receive coverage for the new year – half of whom did so for the first time. The deadline for signing up for insurance without getting penalized, or for making changes to a current plan, is Feb. 15. People enrolling by that date will get coverage starting March 1.

Not everyone expects 2015 to bring a positive change for their health care. Diane Wonnenberg, 63, and her husband, Charles, 63, are both ordained ministers who live in Wakonda, South Dakota, and took early retirement this year, which led to them losing their health insurance. But Wonnenberg does not want to sign up for new insurance, and says she is unhappy that the health care law forces her to do so.  "I feel my liberties​ are violated," she says.

She and her husband bought health insurance through the marketplace during this year's enrollment period to abide by the law, but though their premiums are $28 a month, their deductible is $12,000, which is more than they could afford to pay if they were to face a health emergency. The Wonnenbergs live simply, devoting their lives to charity and missions. "This does nothing for us ... it's worthless," she says of the health care law. Still, the penalty would be worse for them because they have a son who is a dependent to consider, so they signed up with help from an assister at a community health center​. ​​​​

  1. Plans are offered to Americans vary significantly according to geography, with rural or less-populated areas having fewer options. According to government data, about one in five people who selected a plan for 2015 live in rural zip codes.

Even as the year is winding up more people are signing up for coverage. Latest figures released Tuesday from the Department of Health and Human Services show that as of Dec. 26, more than 6.5 million people had selected a plan or automatically re-enrolled. Those who selected a plan after the initial Dec. 15 deadline will see their coverage begin Feb. 1.

​In general, young people aren't signing up for health insurance in droves, which could mean trouble for the president's signature health care law. The participation of these adults is needed to make the health care reform plan work – their payment into the system helps offset the cost of providing insurance to patients who are older or sicker. Figures from Health and Human Services show that about 24 percent of the enrollees are 18 to 34 years old. Americans Unhappy With Obamacare Shopping Experience]

The agency projects that as many as 9.9 million people in total will sign up by the government's deadline – a reduction of about 3 million from previous estimates.​

Alexandro Salazar, 30, who lives in Wichita, Kansas, was just a couple of days after the deadline.​ He has worked full time since last summer as a retail salesman at a mattress store, and has gone without insurance since he left his parents' plan years ago. He simply could not afford health insurance before now, he says, so he avoided going to the doctor. Once he saw how affordable it was on the marketplace – because of federal subsidies – he says he had no problem signing up. About 87 percent of people who select health plans through are getting financial assistance, health officials say.

His initial motivation for getting insurance was to to avoid having to pay a penalty. Those who do not have health insurance for 2015 have to pay a penalty of $325 per person in 2015, or 2 percent of their household income – whichever is higher. "If I’m going to pay a penalty then I might as well get health insurance," Salazar says.

He also wanted to assuage his parents' worries about his health. He doesn't have any pre-existing conditions, but going without coverage puts him at risk if there were to be a health emergency. His father, who sells other types of insurance products, suggested that he get signed up with the help of the insurance navigators at Via Christi Health, a member of Ascension. "She asked me some simple questions, entered in my answers and up popped five or more options," he says. "I picked the one at the top of the list because I couldn't believe how inexpensive it was." His medical insurance was $28 a month, and he decided to add a dental plan for $16 a month. The whole process took about 30 minutes, he says. "That was only that long because I was talking and joking with her," he says.

He plans to take charge of his health as soon as his coverage kicks in. "I can't remember the last time I had a physical," he says. 

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