Papers, Please: There’s A New Front In The White House War Against Obamacare
I was almost ejected from my health insurance by a system increasingly designed to drop consumers
Back in 2017, my husband and I became eligible to enroll in a Marketplace plan, the coverage made available through the Affordable Care Act. Yes, we’re talking about the nefarious Obamacare program that our Fearful Leader — in fact, the entire Republican party — is still trying desperately to kill.
Signing up for coverage was pretty easy. All I had to do was visit the Healthcare.gov site, looked at my options and chose a policy. When I finished signing up and paid for my first month of coverage I was almost giddy. No more turning over a mortgage-sized check each month for a COBRA plan larded with high copays and fees! A large part of my premium was covered by a subsidy provided for by the ACA.
I was far from alone. Despite direct attempts to sabotage the ACA (such as its successful effort to eliminate law’s penalty for failing to have health coverage) the number of consumers taking advantage of Obamacare’s premium subsidies has continued to grow, most recently from 8.2 million in 2017 to 8.6 million in 2018.
For years, the Marketplace plan worked beautifully. I had affordable health insurance and reasonably comprehensive coverage at that.
For just over two years, the Marketplace plan worked beautifully. I had affordable health insurance coverage and reasonably comprehensive coverage at that. Not only that, I had a 90-day grace period in which to get current if I fell behind on my premium payments, which protected me from losing my coverage more than once.
During those years, I ran into a few administrative hiccups which could have led to the end of my plan, but the Marketplace emailed repeated reminders as well as several snail-mailed notices warning me about these issues. I was able to address them with little problem.
In May of this year, though, things changed dramatically. Over a relatively short period, the Marketplace seems to have stopped keeping people informed about problems that could cause them to lose their subsidies.
Apparently, in February the Marketplace had wanted some financial documentation from me that it didn’t have. Instead of sending me multiple reminders, Marketplace sent one advisory letter via snail mail.
Unfortunately, I somehow failed to receive it.
As a result, the first time I became aware of the oncoming train speeding my way was in May, when I got a letter from my health insurer telling me that I’d lost my subsidy. According to the letter, I was now on the hook for more than $1,000 a month in premium costs, up from an already hard-to-afford $424 per month.
To get my subsidy back, I now had to go through the Marketplace Appeals Center, a separate unit of the Marketplace I’d never contacted before. Things got ugly — and strange — quickly from that point on.
First, I tried telling an Appeals rep about my desperate need for continuous healthcare coverage. Sure, reps said, I had a right to an “expedited appeal” if losing my coverage would create a life and death emergency (which it would given my health issues). However, the Center seems to have nearly unlimited time in which to decide if it will agree to expedite the appeal. Seriously. It’s hilarious, in a dark, cynical kind of way.
Unless you ask specifically they don’t make a point of letting you know more help exists
Oh, and what was I to do to pay for my care while I waited? In theory, the Center could have restored my insurance premium subsidy while my appeal was being processed.
But apparently, unless you ask about this specifically they don’t make a point of letting you know it exists — and since I didn’t ask until after some internal deadline had passed, I was out of luck. Too bad for me!
Fortunately, I found another way to work things out. I’m very happy to say that when I saw where this was heading, I was able to qualify for Medicaid coverage to replace my individual commercial policy.
In the past, I wouldn’t have qualified for Medicaid, as my income would have been too high. Thankfully, due to my state having gone ahead with the Medicaid expansion available under, you guessed it, Obamacare in January, I was able to squeeze in.
The administrative “gotcha” game I encountered is just one of a long list of tactics intended to make Obamacare programs collapse. All are unsavory (and according to one former Marketplace administrator, unconstitutional). But the fact that this one is aimed at individual consumers without the resources to fight back is particularly despicable.