The Affordable Care Act and Me, by Catherine O’Sullivan, June 2018
Not having health insurance scares me, a lot. In 2013 I didn’t have it, wound up in the ER with a nasty infection, and walked out with a bill for 3,000 dollars. Oh, I’d tried to buy it, but this was pre-ACA and someone had decided I had a pre-existing condition, so I was denied by every insurer available. Then things changed. Obamacare kicked in and not only couldn’t they deny me coverage any longer, my grown kids were able to stay on their father’s insurance until they turned 26. Seeing that neither of them had jobs with benefits, this was a big help.
Back in the early days, the fledgling AFC, while not perfect, made things easier for a lot of people, especially the ones like me for whom working 40 hours a week at a meaningless job just for the insurance, is untenable. Over the last few years I’ve witnessed Obamacare getting steadily worse, with higher copays, ridiculous deductibles—my most recent was 5600 dollars, but hey, if you’re hit by a bus or get cancer, who wants to split hairs, right? However, lately things have spiraled right into the crapper. I blame the Trump administration and its gutting of the ACA from the inside. When everybody hates the Affordable Care Act as much as I do, repealing it will be a breeze.
It took me awhile to figure out something was up, and looking at the last 5 months or so it’s not surprising. A dentist biopsied a thing on my gum, which turned out to be nothing, but anytime anyone scrapes or digs something off or out of you, we’re talking heavy dough. I was told my insurance would pay for it, but soon began receiving bills from the dentist’s office. It seemed strange, but every time I called I was told to ignore the computer generated bill, and they would put it through insurance again. In addition I was seeing a provider about once every three weeks through CODAC, and one day their office called and said that I couldn’t come anymore because my insurance wasn’t paying its portion of the bill. I figured it was a mistake I could iron out. Wrong. I called Health Net (my insurance provider) and the guy told me that my insurance has been cancelled as of January of 2018. “Whoa, what?” I said. “But I’ve got papers and booklets all labeled “proof of health insurance, 2018,” and I did, too. I know because I was waving them in my hand as I talked to them on the phone, (as if that could help, Do’h!)
“Sorry,” said the guy on the phone, and after some sniveling and apologizing, he connected me with Healthcare.gov. They were quick to inform me that their records indicated that the policy holder (me) had called and cancelled the policy. I hadn’t. I never would have, not in a million years, but no matter who I talked to and how many times I stated this fact they insisted that I had, in fact, cancelled my health insurance and they knew this to be the case because otherwise, it wouldn’t have been cancelled. They assured me that they have very strict procedures in place including security questions to insure that only the policy holder can make this kind of change. The longer I spent on the phone the more I got the feeling they thought I was either incredibly thick or otherwise addled, for not remembering cancelling my own insurance. Because I had done this, they assured me, I did not qualify for “special enrollment.” Nobody’d died, I hadn’t gotten divorced recently, and I hadn’t had a baby (it’s a good thing too; I’m 60 years old.)
Finally, after about an hour and a half on the phone with various flow-chart wedded dunderheads, I pulled out the old standby. “May I please speak with your supervisor?” Eventually, I got to someone who sounded like she had some degree of neuronal activity. She was able to bring up a whole new category. Something called a “disenrollment error.” I wasn’t sure whether she was admitting a mistake on their part, or implying I’d sleepwalked and accidentally cancelled my own health insurance, but she gave me an iota of hope. She said they’d investigate and while it could take up to 30 days, and I’d have to pay all the premiums I’d missed at one time, they might reinstate my policy. I took off for a couple of weeks for cooler climes, figuring everything would work out.
Yesterday, upon my return, I found a letter dated May 11, 2018. It says, “After reviewing your case, we’ve denied your reinstatement. Our records show your Ambetter Balanced Care 9 plan with an effective date of 01/01/2018, has been cancelled effective 01/01/2018 due to voluntary withdrawal.”
I’m fairly lost at this point as to even how to argue this. The letter goes on to say that I didn’t pay an invoice dated 1/15/18, but I can only assume that since the insurance was cancelled two weeks earlier, it was never sent, which would explain my never getting it, but not the fact that I have a cancelled check for a payment on 1/4/2018.
During my panic in the midst of this, I looked, for about 5 seconds, on the internet for health insurance alternatives. My phone started blowing up with calls from private companies trying to sell me insurance. This lasted for several weeks and I still get one or two calls a day; my inbox is still full of junk mail from fly by night health insurers.
I assume I’ll be penalized for not having health insurance when I file my income taxes next year.