With six hours remaining before the deadline to submit an application for health care insurance through an insurance exchange, the HealthCare.gov website has gone down, creating anxiety for applicants. Among those who have waited until today to apply are of course many who habitually delay. Others may have been waiting to scrape together money for this previously unbudgeted expense. Those who are not signed up for health insurance by midnight will face penalties unless they purchase private insurance later.

Philadelphia residents reported on their experiences and their thoughts on this final day of an America where the overall commitment to good healthcare for all was not a given. Preventible illness costs the country billions of dollars per year in lost wages and higher overall costs for management of a sicker population. With the deadline at hand to put in an application for health care insurance, the number of successful applications on HealthCare.gov website rises, but anxiety persists for procrastinators, and for those who continue live on the edge of poverty.

Philadelphia’s extensive poverty reinforces the sense of two groups, one rich and one poor. The poor live in a separate economy. Residential segregation is pronounced. In some neighborhoods those living on Medicaid are the only ones who receive regular health care. The uninsured seek preventative care through medical practitioners much less often. Even those on Medicaid may be less likely to seek medical attention unless they have chronic issues. Philadelphians in the city and from surrounding areas in Pennsylvania and New Jersey are divided by financial, and by racial and ethnic segregation. Separate social worlds exist where health, economic optimism and expectations for the future differ radically.

The expansion of health insurance will assist many who might not seek preventive care to do so, or to deal with problems before they cause permanent damage or become acute. Those who are insured, after never being covered or not recently, may feel a “safety blanket” that covers them, which comes from an external network concerned with their health. Decreasing anxiety over health, and over the prohibitive costs of health care, frees up individual bandwidth that can be turned towards economic activity, family and community. Physically and emotionally healthy people contribute more to healthy communities.

The deadline today, which for procrastinators feels like tax day, has brought many to begin the process of signing up, only to discover slowdowns and delays. Procrastinators also finally deal with their obligation to the collective body politic. Buying into Obamacare brings the newly insured into a community, building and maintaining good health institutions and economies that serve all.

Following very heavy traffic to its website in the last few days, HealthCare.gov took its website offline Monday morning between 1 a.m. and 5 a.m., though the site stayed down for several additional hours because of bugs. At noon today over 100,00 people were on the site. Slowdowns occurred but appeared to resolve before 2 p.m. Later in the afternoon applicants on the website were told the wait was long due to activity, but encouraged to stay on the site. The toll free number of Healthcare.gov, to apply over the phone, had only a busy signal.

Calls to the Philadelphia Health Department revealed that the insurance navigators at health centers had done huge a volume of advising and referral during the last week. Representatives of the Health Care Marketplace have also been very busy and did not answer calls this afternoon. Independence Blue Shield’s website was still able to take applications this afternoon but not over the phone. Those who called were advised to leave a phone number and expect a call back within five to seven business days, to complete their application, without penalty.

So despite the fact that the health care insurance website HealthCare.gov was down for parts of the day and unable to take applications, the number of applications taken in rises and the anxiety of ObamaCare supporters decreases. Many Philadelphia business owners, employees and freelancers will adjust to the idea of being part of the health care community of the insured. Despite the concerted opposition to ObamaCare, the program launches itself, and all will watch to see how it flies.

By Lawrence Shapiro

Sources:

New York Times

Boston Herald

Washington Post

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