by Nathaniel Shahan and Deborah Malamud

“On and off, I’ve been able to afford insurance and then I’ve had to take it away again,” Kristi Layton, a 49-year-old resident of Centerburg in Knox County, said. As a self-employed small business owner, Layton explained that she has only been purchasing insurance for herself. Her ex-husband’s private plan covers her daughter, Melissa Layton ’18.

According to a New York Times article titled “Obama’s Health Law: Who Was Helped Most” published on Oct. 29, 2014, a data set from Enroll America and Civis Analytics show that the largest gains in terms of healthcare coverage were realized by states that expanded Medicaid, rural areas and Republican counties. Blacks and Hispanics benefitted more from the Affordable Care Act than whites and Asians, low-income areas more than high-income and people from the age of 18 to 34 more than any other age group.

Mount Vernon embodies several of these characteristics: it is rural, predominantly Republican, located in the state of Ohio — which expanded Medicaid to cover a greater number of low-income adults — and has a per-capita income approximately 17 percent lower than the national average. Shortly before the implementation of the Affordable Care Act (ACA), also 17 percent lower than the national average.

Shortly before the implementation of the Affordable Care Act (ACA), also known as “Obamacare,” Layton had to drop her insurance due to a rate hike, but thought she would be able to sign up for cheaper insurance through the Ohio online exchange. After going through the registration process, she realized her rate would be around double what she paid previously.
The ACA “involves healthy people, people who can afford [private healthcare], paying into the system [so] that the people who need it most are getting the coverage,” Sam Whipple ’16, president of Kenyon College Democrats, said. The act, Whipple said, was projected to see “revenue from healthcare … go up dramatically” and a “55-percent drop in the number of uninsured.” According to the Advocates for Ohio’s Future webpage, “only three percent of Knox County residents” would still not have insurance in 2015.

For Layton, the implementations have not been favorable. She looked into the price of the fine for not buying insurance through the Ohio exchange, which ended up being less than the insurance. “I figured, well, I won’t carry it and I’ll just pay the $65 fine, and I was going to be stuck without insurance again,” Layton said.

She then looked into coverage through Medicaid, for which she was initially denied before Ohio changed its requirements. “I get insurance for free with Medicaid, not that I like that,” she said. “Usually you think of Medicaid as … welfare, [for someone who is] not working.” Layton works more than 70 hours a week, yet her coverage now is worse than her pre-ACA private insurance. Layton has yet to find a dentists who will accept Medicaid.

Layton said she would attempt to enroll in a plan listed on the Ohio Health exchange in the future.

The office of Congressman Bob Gibbs, the representative for Ohio’s 7th Congressional district, which covers Knox County, did not respond to requests for comment. But, Gibbs’s website expresses anti-ACA feelings: on a page labeled “Health,” the site reads: “I understand the need to make medical care more affordable for families. … However, Obamacare does not accomplish that goal.” Gibbs, a Republican, ran unopposed in the 2014 midterm elections.

The Knox Community Hospital (KCH), according to an email to the Collegian from KCH Director of Marketing and Development Jeffrey Scott, “did see an increase in the number of patients who were covered either by a commercial insurance policy or Medicaid last year following the original enrollment period for the Affordable Care Act and Ohio’s expansion of the Medicaid program.”
Professor Emeritus of Economics Richard Trethewey, retired in 2007 but has returned to the Hill several times to teach. He could not teach a course this semester due to an ACA provision, as the act “prohibits hiring anyone who is retired from a self-insured institution and purchasing or receiving supplemental health insurance provided by the institution,” Trethewey wrote in an email to the Collegian. Trethewey was informed this past December, that the only way he could return to teach was if he dropped his insurance — something he was not willing to do. According to Trethewey, this provision has affected other Kenyon professors.

“There are still places where the law is having negative effects, in terms of people losing coverage and premiums,” Whipple said. “But I think the goal has been to dramatically decrease the amount of uninsured, and that’s happening.”

For Layton, the law has not shown positive results. With open enrollment for the ACA continuing until February 15 in Knox County and around the country, the results of public opinion will soon be in.

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