People get information on California's health exchange at a table at Union Station in Los Angeles on Tuesday, the exchange's opening day.
Pardit Pri was excited to learn the new health insurance exchanges could help her.
Pardit Pri had health insurance until she quit her job as a legal administrative assistant to stay home with a new baby. Now that baby is 20 months old, and the Orange County, Calif., resident still hasn't found a job with insurance coverage.
Pardit Pri had health insurance until she decided to quit her job as a legal administrative assistant and stay home with her newborn son 20 months ago. She thought she'd have coverage by now. But it didn't work out that way.
"I knew that I wasn't going to be working for a while because I decided to stay home with my son, and I thought ... 'OK, fingers crossed. Nothing will happen during that time,' " she says, as she plays with her son in their Orange County, Calif., apartment.
She had planned to return to work when her son was about 8 months old and get insurance through a new employer.
What she found instead was an economy still sputtering toward recovery, and employers willing to hire workers only on a contract basis with no benefits. As a result, the 29-year-old Pri has been without insurance for nearly two years.
Her partner, who runs a local pharmacy, provides insurance for their son. But she and her 7-year-old daughter from a previous relationship have no health coverage.
They are part of the legions of the uninsured, including 20 percent of California's population. The Kaiser Family Foundation surveyed 2,000 of California's uninsured on the eve of the opening of health care exchanges that were created under the Affordable Care Act. Pri is one of those people, some of whom will be followed over time by Kaiser Health News to see how they fare. (Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.)
That lack of health coverage adds anxiety to seemingly benign events, like when Pri's daughter asked about tennis lessons. "She asked me the other day, 'I thought I was supposed to be in tennis?' And I'm like, uh oh. There's no insurance yet. They won't let you play sports unless you have proper insurance."
Even though she and her daughter are healthy, the fact that they don't have health coverage is always in the back of Pri's mind. What if there's a car accident? Or she catches pneumonia? These are poor people's problems, Pri once thought — not the problems of a solidly middle-class family aiming for success.
"If I ever mention it to someone or someone knows I don't have health insurance, which I wouldn't want to hide, they'd be like, 'Oh, OK. Well, what kind of a job does she have where she's not able to get health insurance?' "
Pri says she would like to look into insurance through the health care exchange, and she has a vague notion that under the Affordable Care Act she will have to buy health coverage soon or pay a fine. But she's concerned about the costs. She hadn't seen ads yet for Covered California, the state's online insurance marketplace, nor had she gotten anything in the mail.
"If you can get insurance for $95, $100, it's worth it. I'd rather get the insurance than be fined. But if the insurance is like $400, I might just think about getting fined then. I don't know. ... Right now it feels like a lose-lose situation for me."
Pri thinks she will earn just under $40,000 next year. So a fairly minimal plan might cost her about $260 a month, but with lots of out-of-pocket costs.
Another possibility weighs on her. "That's my projected income, and I go and buy insurance based off that projected income, then I lose my job. What happens then?"
One of the uncertainties for people like Pri is that her income in the coming year is uncertain. That means that the amount she would pay for health insurance, as well as the size of possible government subsidies, is hard to predict. If she pays too much, she could receive a refund when she files her taxes for 2014.
The process seems a little dizzying, and the dawning awareness of the law's intricacies and monthly costs raise Pri's anxiety about the new requirements.
She says, "I'll figure it out before Jan. 1."