Unemployed and set to lose her existing health insurance on Dec. 31, Mary Levanavage knew she needed to act quickly.
For years, the 51-year-old Pittston Township woman and her husband received coverage through his employer, paying $100 a month for a plan that covered doctor's visits, prescriptions and various other services.
But HarperCollins Publishers closed one of its warehouses in August, leaving both jobless and on a COBRA continuation plan set to expire Dec. 31 - one day before coverage under the federal health insurance marketplace begins.
"I've made it my priority to find affordable insurance so we can be covered on Jan. 1," Mary Levanavage, who selected a silver-level plan via HealthCare.gov, said. "I think maybe if I was 20, I wouldn't be as worried as I am at 50. But God forbid something happened."
Today marks the deadline for most Americans to sign up for marketplace plans in order for the coverage to begin Jan. 1, a looming date that signals the start of key provisions under the Affordable Care Act. Among the various provisions that go live on New Year's Day is the law's individual mandate, which requires most Americans to have at least minimum essential health insurance in 2014 or pay a fee.
Americans, however, have until March 31 to enroll in a plan without facing a penalty - an often overlooked fact, officials said, as consumers scramble to get covered.
And following the error-plagued online marketplace's rocky debut, the Department of Health and Human Services announced several alterations to the process, such as requiring insurers to accept payments through Dec. 31 for coverage scheduled to begin Jan. 1, or giving people enrolled in the federal pre-existing condition insurance plan a chance to extend their coverage through Jan. 31.
"We're giving folks extra time because this is, like I said, the first time we are doing this," said Lorraine Ryan, a spokeswoman for the Centers for Medicare & Medicaid Services in Philadelphia. "We wanted to give people sufficient time to explore their options. A lot of the folks who are going to be signing on for the marketplace insurance ⦠never had insurance before. It can be a daunting process."
Despite the relaxed deadlines, a growing number of Pennsylvanians have selected marketplace plans since mid-November, officials said.
From Oct. 1 to Nov. 2, just 2,207 people selected a marketplace plan in Pennsylvania - an average of 67 people a day. Over the next 28 days, an additional 9,581 Pennsylvanians selected a marketplace plan, leaving Pennsylvania with the third highest total (11,788), behind Florida (17,908) and Texas (14,038) among the 36 states with marketplaces supported or fully run by the federal government. County- or region-specific statistics aren't yet available, Ryan said.
"I've been booked from 9 (a.m.) to 4 (p.m.) every day since mid-November," said Suzanne Slussar, a certified application counselor hired by the Scranton Primary Health Care Center.
As a designated counselor, Slussar helps consumers enroll in health plans by guiding them through the early stages of the process, such as creating an account and finding out if they are eligible for advanced premium tax credits.
Since Oct. 1, when the marketplace's open enrollment period launched, she has assisted 135 people, with the majority coming in the last 30 days.
"I think a lot of people are anxious about the deadlines and some even thought it was still Dec. 15," she said. The Department of Health and Human Services on Dec. 12 formally announced its decision to give people until Dec. 23 rather than Dec. 15 to sign up for coverage that would begin Jan. 1.
"They just want to make sure they have coverage by Jan. 1."
But even as more people rush to select plans and news about the Affordable Care Act occupies national headlines, officials said lack of education remains a lingering issue.
Some consumers still don't understand the program or if they are eligible for advanced premium tax credits, said Bill England, the Pennsylvania director for Enroll America, a nonprofit group dedicated to maximizing the number of uninsured Americans who enroll.
"It remains the greatest barrier to people applying," he said. "People just don't have this kind of information. So, it's one of the things we try to do ... taking the very complex information and making it digestible."