And about obama care. Despite it all signups for new insurance did go into effect this week. Love it or hate it, this is a big deal. I mean, not since the creation of medicare and medicaid nearly 50 years ago has the country expanded its safety net to know many people or at so much cost. Its a historic moment so we decided to spend the week traveling the country on the cnn express to try to get a glimpse of how the Affordable Care act is going to impact you and it does impact everybody. I do have to say that i quickly realized that for most people some of the details have really gotten lost in all this. In fact, take a listen to a little bit that jimmie kimmam pulled earlier this week. Were talking about health care today, which plan do you support, obama care or the Affordable Care act . So, the Affordable Care act is more affordable than obama care . Just the name says it all. So you disagree with obama care . Yes, i do. Do you think Insurance Companies should be able to preclude people with preexisting conditions . No. Do you agree that young people should be able to stay on their parents plans until they are 26 . They should be able to, yes. Do you agree that companies with more than 50 employees should cover their employees . Yes. Do you know that obama care and the Affordable Care act are the same thing . They are not. Thanks, you made me look stupid. Seemingly a lot of people dont try to hide it. A recent poll found that twothirds of americans dont know the basics about it. I personally had the opportunity to hear from hundreds of people as i traveled around the country this week. We hear a lot of rhetoric about how much the Affordable Care act will hurt the economy, but i wanted to know, do you have any idea of how much based on the Preventive Care portion of this act, how much of a return on investment that could bring to the economy. A lot of people have tried to answer that very question. Trying to figure out over the long run could it actually save our Health Care System money, and theres an institution known as cbo or Congressional Budget Office that says basically over ten years, these are projections, that it could save money while the costs may be higher initially, this is, in part, part of what this whole idea of bending the cost curve down. Yes, sir. And basically says if we are a healthier america because more people are getting Preventive Care and not getting sick in the first place, that could save us money. And not everyone agrees with that. I wanted to know if a persons age was going to impact the premiums, whether its going to be higher for older people or lower or just how that was going to work out. I think the best way to sort of explain that is that you cant be discriminated against based on preexisting conditions. Youve heard that, right . Right, right. Diabetes, heart disease, cancer, they dont even ask you about those things when you are filling out this threepage application. They will ask your gender, female, male. They will ask your age. This develops a community rating, so what they want to do, jeani, ultimately you pay the same price as another person living in your community thats of your gender and your age. It doesnt matter what preexisting conditions you have, but its your gender and your age that sort of ultimately reflect the premium. I currently do have insurance through my employer but i found out this monday im getting laid off and i was hoping i could talk to you about what the next steps forward are with the Affordable Health care act, whats available for me and what the next options are. By january of 2014, youre going to required to have Health Care Insurance or you pay a penalty. Now, if you have money to be able to pay for it, you can buy it. If you dont, then you can get the subsidies. You may fall into a position where if you have a job, again, before that happens, you may get insurance through your employer again. Thats probably the best option, still. People who have insurance through their employer, their lives probably dont need to change a lot as a result of whats happening. If youre still unable to have a job or get insurance go to healthcare. Gov and look at the options and see whats the best option for you. Do you have Health Care Insurance . I have dental. I have dental. I dont have Health Care Insurance. Were you on your parents plan prior . Yes. Are you familiar with what this means for you particularly as a 23yearold . Im not. Im not. So, i think theres good news here for you which is that you can now stay on your parents plan up until age 26. So you get three more years of Health Care Coverage that is not something you have to go out and buy. This is part of your parents plan under which you will now be covered. Have you had heard that before . I had not. And thats youre the bearer of good news. After south carolina, my next stop, kentucky. Now, its leaders and congress and senate are republicans. They are fiercely opposed to this law. But not the governor. Hes a democrat. Hes for it. In fact, his state is the only Southern State setting up its own marketplace and extending medicaid to more lowincome families. Weve got 640,000 uninsured kentuckians in our state. And we now have the opportunity for the first time in history to provide Health Insurance, Affordable Health insurance, for every single kentuckian and thats going to be a transformative period for us. Look, we have some of the worst Health Statistics in the country. We dont rank well at all. And those rankings arent just this year and last year. Weve ranked like that ever since theyve kept rankings and weve made some small, incremental changes to try to improve things, but weve never had that that major transformative time of event that can make a huge sea change in kentucky. I do want to tell you that we did reach out to senator paul, senator mcconnell, and to the republican congressmen who represent lexington, all of them declined to speak about it this week. I got to speak to matt beven who runs a Small Business and hes running for Mitch Mcconnells seat. Those subsidies for three years are going to cover kentuckians three years and its being paid for by other taxpayers including those from kentucky. When the subsidies are gone, then it,s increased increase in tax. Its a regressive tax on the working poor. Thats the primary reason im opposed to this. Now, the rollout has been a little bumpy. Its no secret. As traffic on the signup sites has been heavier than expected, thats what were seeing. The white house said that 4. 7 Million People went to healthcare. Gov in just the first 24 hours. 8 00 a. M. Eastern, the doors fling open on the new marketplace, where millions of americans should be able to sign up for Health Insurance. But within minutes, thud. The site started going down. Overwhelmed, they say, by heavy traffic. New york state, internal service error. Washington state. The same thing. The federal website is handling signup for 36 states, including pennsylvania. Thats where 25yearold lauren heartleeb tried to sign up. And then on the third page i asked for, you know, security questions, but the page just wasnt populated. So, theres some sort of Technical Glitch and it just wasnt working. By midday both the president and his critics were weighing in. Like every new law, every new product rollout, there will be some glitches in the signup process along the way that we will fix. Ive been saying this from the start. And were going to be speeding things up in the next few hours to handle all this demand that exceeds anything that we had expected. In a system thats full of glitches, i think thats the word thats most frequently being used today, glitches means its not working. Now, we did check back in with lauren. She hasnt logged back on yet. Shes not worried about this because she says she has time, and she does. Look, the Enrollment Period is six months long. So, if you want your new Health Insurance to go into place on january 1st, you do need to sign up by december 15th, but the Enrollment Period goes until the end of march. The glitches and the backlog, they did seem to get better as the week went on. In fact, we decided to stop by one of the governmentsponsored call centers in baltimore, maryland, where they were fielding calls from consumers. I hear from a lot of people talking, they are just frightened of doing this. People signing up for anything makes them nervous. You are here to shepherd them through, what advice would you give to them . Give us a call. We have navigators, local health departments, department of social services and Insurance Brokers out there, theres a lot of avenues to get help. So, are you still confused by all this . A lot of people are, obama care, just the facts. Were going to have it for uf, come i coming right up. Dad dad katy perry is coming to town. Can we get tickets, pleeeeease . . . Tickets . Hmm, sure. How many . Well, theres hannah, maddie, jen, sara m. , sara b. , sa whoa, whoa. Hold on. under his breath here it comes. We cant forget about your older sister thank you, thank you, thank you seriously . What . I get 2x the thankyou points on each ticket. Can i come . Yep. The Citi Thankyou preferred card. Now earn 2x the points on entertainment and dining out, with no annual fee. To apply, go to citi. Com thankyoucards [ male announcer ] the parking lot helps by letting us know whos coming. 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Whats your policy . You know, millions of americans are now for the first time able to purchase insurance with no questions asked. So, we asked cnns tom foreman to take a closer look at how this new marketplace works and what your insurance plans may look like as well. Hey, sanjay, despite all these monumental changes to health care, most of us who have insurance and that is most of us probably wont see much change. Maybe some immediatefications but this is really about the 48 Million People who do not have insurance, about half of whom are now expected to buy it through these health care marketplaces. And about 7 million by the end of the year, i can point out, to give you an idea how fast it will be moving along. So, how will these marketplaces operate . Imagine a store where you can go in and buy one of four different types of health plans. Bronze, silver, gold, or platinum. Heres the difference between them. If you buy at the lowest level, the bronze level, for example, your premium each month will be fairly low, but if you go to the doctor, your copay, your deductible, and your other fees will be higher. Platinum, just the opposite. You will pay a higher monthly premium, but at the Doctors Office all of your fees will be lower. This will not be exactly the same state to state to state because there will be local companies involved, and that could make a difference. But this part should be the same no matter where you go in the country. You will not have higher premiums if you get sick. You should not be denied coverage if youre already sick, and you will not pay fees for Preventive Care. You get a mammogram, your kids get vaccinations, you get a general physical, you wont pay any extra for any of that under this plan. Still, theres a lot of money involved in all of this, and the government wants to help people who may have trouble paying for it, because a lot of people who dont have insurance dont necessarily have a lot of cash for it. If you make 40,000 or less an as individual or 90,000 or less for a family of four, theyll give you a refund to help pay for this. Nonetheless, no matter how you get there, everyone is going to be involved. It doesnt even matter if you live in one of the dozens of states that have said they want nothing to do with obama care. Youre still going to be part of this program. The federal government will administer the marketplace in your state instead of the state. Thats simply how its going to work, but you will have to get involved. Because if you dont pick a plan, if you dont get involved, youre going to be fined by the federal government. Thats how this is going to work. So, if youre uninsured in this country, the time is upon you now. You are going to have to make a decision no matter where you live coast to coast. Sanjay . Thanks, tom. And ill tell you that some of this is enough to make you sick as well. There are criminals out there who are taking advantage of all this confusion around the law to rip off unwitting consumers. Zain asher joins me now from new york with the top obama care cons. I cant believe, zain, im putting those two words together in the same sentence. I know. What should people be looking out for . It represents the opportunity of the decade for scam artists and there are a number of scams we do want to warn viewers about. Number one fake Health Insurance sites. These are the sites that might look like state Exchange Sites and the appearance of them, but they are fake. You type a state Exchange Website into your browser, for example, and you misspell it by one letter and you are redirected to a fake site, so its important that people be vigilant. Most but not all of the legit sites do end in. Gov. And another thing we do want to tell people about is people impersonating navigators, so if the people that dont know navigators are certified professionals who can help you shop for Health Insurance. But an impersonator say, hey, sanjay, pay us and well help you sign up. Watch out for anybody asking you for money. Sadly another thing that breaks my heart is that seniors often do become targets with these kind of things. Someone might tell you theyll lose coverage if they dont get a new Medicare Card and theyll begin to press for your Social Security number. Bottom line is you do not need a new Medicare Card with obama care and its important that people know that and tell their parents the same thing. Lastly, watch out for Companies Offering a cheaper alternative to insurance. The socalled medical discount plans are bogus. They falsely claim to exempt you from minimum Insurance Coverage requirements. Bottom line if youre unsure, stick with the federal and state exchanges. Sanjay . So, is there anything you can do if you think youve come across one of these bogus scams . Yeah, absolutely, there are a number of things you can do. You can file a complaint with your state attorney general or your local Consumer Protection agency, but, you know, listen, under normal circumstances under normal circumstances you would be actually file a complaint with the ftc, but because of the Government Shutdown, unfortunately they are not taking complaints at the moment. Sanjay . And the ironies just remain breathtaking, i think, zain. Thank you so much for joining us. Very Important Information there. And coming up, perhaps the saddest part of this whole thing, this whole Government Shutdown, locking kids with cancer from taking part in Clinical Trials. Well be right back. Lary once. The physical damage was pretty bad. The emotional toll was even worse. Our daughter had nightmares. What that robber really took from us was our peace of mind. With adt, we got it back. 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The cascading effects if you will of the Government Shutdown could be felt all across the country, even maybe putting some lives at risk. 200 people, 30 of them who are children, unable to start Clinical Trials for the crucial medical treatment that they need at the National Institutes of health. And my good friend and colleague Elizabeth Cohen has been following this and joins me now from the cnn center. Youve been talking to the family of one very sick child it sounds like. Right, sanjay, her name is Mckenna Smith and shes 12 years old and her last hope at life is an experimental drug, but, sanjay, this week that hope began to fade. Reporter Mckenna Smith spends most of her time in this wheelchair because of a rare genetic disease doctors say she probably wont see her 20th birthday. Sometimes i dont even feel like i want to get up because my back is aching so bad. Reporter the pain she feels is caused by tumors that wrap her way around her nerves and compress her organs. Theres no cure, but there is hope. On monday, mckenna and her dad, justin, arrived here at the National Institutes of health in bethesda, maryland, so mckenna could start taking an experimental drug that might shrink the tumors. But with the government shut down including most of the nih, the family was told there was a chance mckenna might not get the medicine. I hope it doesnt make me or anybody else who have an Immediate Impact and some of the things may have longerterm impact, the fda as well, you and i report on food disease outbreaks, what are you hearing about the food supply investigators . Well, those investigators, many of them have been furloughed, so the fda has really had to curtail their produce inspection program, and theyre the ones who inspect produce before its allowed to go on to Grocery Store shelves, so they cant be there in full and they also cant do their laboratory kinds of work in full, so all sorts of things, things we dont even really think about, just cant happen. You know, its, again, such a great piece and a great reminder, i think, that there are real lives behind all of this. A lot of people are hearing the politics and the numbers, but mckenna is a great example. Elizabeth, thank you so much. Well hear much more from the road as well as the cnn express rolls on. Stick with us. Were visiting many states. Well bring it all to you. Stick with us. Though she doesnt need them, cheryl burke is chachaing in depend silhouette briefs for charity, to prove that with soft fabric and waistband, the best protection looks, fits, and feels just like underwear. Get a free sample and try for yourself. At any minute. You could be a victim of fraud. Most people dont even know it. Fraud could mean lower credit scores, higher loan rates. And maybe not getting the car you want. Its a problem waiting to happen. Check your credit score, check your credit report, at experian. Com americas number one provider of online credit reports and scores. Dont take chances. Go to experian. Com. My crew and i spent this past week on that bus there behind me. Long road trips and maintaining Good Nutrition in a situation like this can sometimes be tough, but we did our best. All right, so youve seen the outside of the bus. This is what the inside looks like. People working very hard. I want to talk about food for a second, you know, one of the things that we try and do our best on trips like this, you know, maybe getting the baked chips instead of the fried chips and we really focus on protein. Lots of nuts. This is hummus, for example. Water. It gets very dry on a bus like this. So we do the best we can. We did the best we could a trip like this. What might be more dangerous than the food, though, could be the way we were forced to sleep. Thats going to wrap things up for the special edition of sg md. Stay connected with me at cnn. Com sanjay and keep the conversation going on at twitter. And its time to get you back to the cnn newsroom with don lemon. Welcome back, everyone, to our live news coverage, im don lemon, youre in the cnn newsroom. Congress working today, but if you heard my conversation with the two congressmen at the top of the last hour, were going to be hearing a lot of talking points, but no solutions to end this shutdown. There are some developments, some federal workers being called back now, thats what were hearing. And were going to get to all of that just ahead. But, first, this