Three and a half years after the law was passed, consumers will get their first look at the Affordable Care Act on Tuesday when enrollment begins in the new online health insurance marketplace.
In Beaufort and Jasper counties, more than 32,000 uninsured residents will have the choice of 27 insurance plans offered by three companies.
But area insurance agents, health agencies and officials who have rushed to prepare employees and customers for the marketplace in recent months don't expect Tuesday to bring much excitement or a flood of applicants.
In fact, the day might prove anticlimactic, says Gaynelle Dantzler, administrative director of reimbursement services at Beaufort-Jasper-Hampton Comprehensive Health Services.
"It's just another day," she said. "We're as ready as we can be to this point."
Dantzler has spearheaded the health center's effort to inform the public about the law that requires most adults younger than 65 to have health insurance or pay a fine.
As part of a $144,514 federal grant, the center hired and trained three full-time employees who, along with more than 20 volunteers, will help the uninsured navigate the online marketplace.
Starting Tuesday, workers will set up laptops in lobbies at the health center's eight sites and assist uninsured patients.
The applications of those who don't qualify for the marketplace will be sent to Medicaid administrators to determine whether they're eligible.
Last year, the health service served about 7,700 patients who did not have insurance. Dantzler hopes to insure about 1,500 by the March 31 deadline.
The law will begin delivering insurance coverage through private plans bought on the marketplace and through Medicaid on Jan 1.
There will be some trial and error, Dantzler said, especially because no one knows exactly how much in federal subsidies each patient will receive.
"We know what to do; we've just never done it live," Dantzler said. "But tomorrow is day one. We have six months to get people signed up and educated."
Larry Holman isn't sure how many people will enroll Tuesday at the Beaufort Black Chamber of Commerce. The chamber is hosting an open house from 10 a.m. to 5 p.m. at 801 Bladen St., the first of many events in the next six months to encourage uninsured residents to sign up for the health insurance exchange.
Holman, the chamber's president, said his organization is targeting churches and community events in seven counties for health-coverage sign-ups.
On Tuesday, nine certified employees will be on hand with tablets to guide people through the online application. The chamber received $234,000 in federal grants to train the employees.
Holman said applicants need to know their Social Security numbers and annual incomes, and the process should take 15 to 30 minutes, depending on the applicant's computer literacy.
Applicants can always create an account, discuss the plans with a health care navigator and come back later, Holman said.
"You don't have to make your decision tomorrow," he said. "It's like buying a car. It's a major investment."
Insurers can expect a specific segment of the health care market to apply early, said Harry Hornsby, an agent for Coastal Plains Insurance of the Lowcountry in Bluffton.
Early applicants will predominately be the uninsured with medical problems and the insured whose carrier doesn't cover pre-existing conditions, he said.
After that, Hornsby says, enrollment might slow.
"I don't know that it will have the big boom-pow of a start-up that they think," he said. "I don't really think people are aware."
Hornsby said the success of the law is contingent on signing up young people.
Because the law prevents discrimination against people with pre-existing conditions, there will be a larger number of higher-cost individuals in the market. That means the number of young people who enroll in the system but use it infrequently will keep costs down for everyone.
But Hornsby doesn't foresee young people enrolling -- not Tuesday, or down the road.
"I quote too many young people who say insurance is too much money," he said. "They're not going to pay for something they don't use."
In South Carolina, about 733,000 people -- nearly 20 percent of the population -- are believed to be uninsured. Most will have until March 31 to purchase insurance and avoid paying a penalty. Here are per-month price ranges for the lowest and highest levels of individual coverage in Beaufort and Jasper counties, without factoring in tax credits based on household income, according to the U.S. Department of Health and Human Services:
- Age 0-21: $90.47 to $135.92
- Age 21: $142.47 to $214.05
- Age 30: $161.70 to $242.95
- Age 40: $182.08 to $273.56
- Age 50: $254.54 to $382.29
- Age 60: $386.66 to $580.93
- Age 64 and older: $427.41 to $642.15
Follow reporter Dan Burley at twitter.com/IPBG_Dan.