Thursday, December 26, 2013


For more than 40 years I have been dealing with federal and state governments, as a driver, a college student, an investor, a professional tax preparer, and an individual citizen.  During this time nothing has ever been as frustrating as trying to apply for health insurance under “Obamacare” (aka the “Affordable Care Act”).  Dealing with the IRS and, yes, even the NJ Division of Taxation (although NJDOT has been much more frustrating than my encounters with the IRS) has been a walk in the park compared to my experience with Obamacare.

My saga begins on the morning of October 1, 2013.

For weeks the airwaves and internet had been full of stories and articles telling us we would be able to apply for healthcare and an advance payment of the “Premium Tax Credit” at the online Health Insurance Marketplace beginning on October 1st.

I had used an online calculator I came across in my wanderings on the web to estimate the cost of insurance and the amount of the Premium Tax Credit I would receive based on my location and income.  I learned I would receive a substantial credit.  My total premium would be more than I was currently paying, for additional coverage, but after the advance payment of the credit was applied I would be spending much less “out of pocket”.

I went to at 8:00 AM on the morning of October 1 to submit my online application.  I was unable to complete the application process.  I continued trying the rest of the morning and into the afternoon, and finally gave up at about 2:30 PM.

I next called the 800 number listed on the website and, to my complete surprise, I got a live person almost immediately.  I provided all the required information and answered all the questions.  When we were done the person to whom I was speaking told me that my identity was verified and I would receive a notice listing the insurance options available, and the amount of credit to which I would be entitled, in the mail, and perhaps also online, “shortly”.  Nothing ever arrived, either via postal mail or email.

The country soon learned that, despite all the advance publicity, the Health Insurance Marketplace website was not ready to begin processing applications on October 1st and was eventually shut down due to the large volume.  We were promised that the site would be fixed and running properly by the end of November.

During the third week of November I received two emails (one after the other) from telling me “You have a new message waiting for you in your Marketplace account. Click here to log in and read the message.”  I did as instructed, but there was no message to be found.  I could not even find a “message center” under my account to look for any message. 

While I was on the site I attempted unsuccessfully to complete the application and verify my identity twice, but “an unexpected error occurred when we tried to verify your information”.  I was instructed to call the Marketplace Call Center.  When I tried my call was promptly “auto-answered”, but I was promptly cut off.

I went back to my Marketplace account on December 10th to try again.  But I got the same message when attempting to verify my identity.  An unexpected error occurred when we tried to verify your information.”  This time I decided to try a “live chat” and after venting my frustration and telling my story I was told to go to a certain website (click here) and download a paper application, which I did.

I wished I had been made aware of the paper filing option much earlier.  Perhaps I missed this alternative on the website or in the publicity, but I do not think so. 

I promptly completed the paper application and mailed it with copies of my Social Security card, Driver’s License, health insurance card, and my most recent premium bill (this was not requested in the instructions, but I figured it couldn’t hurt) to the Department of Health and Human Services in London, Kentucky on the morning of December 11th.

On December 16th I received an 11-page form letter in the mail from the Health Insurance Marketplace telling me that I was “eligible to purchase health coverage through the Marketplace”.  The letter also indicated that I was also eligible for a tax credit and identified the amount of the credit.  Under the category of next steps was “choose a health plan and make first month’s payment”.

On the top of Page 2 was the heading/question “What should I do next?”.  This is exactly what I wanted to know.  However the only item under this heading concerned “if the table above tells you that you are or may be eligible for Medicaid or Pennsylvania CHOP”.  It did not so tell me, so this did not apply.  The remaining 9+ pages of the letter was pro-forma information and disclaimers.  The letter did not tell me “what should I do next”!

With no instructions provided I reluctantly returned to the website, but found nothing there.  I initiated a live chat and asked what to do next.  I was told to “log in” using the “Application ID” number that was provided in the letter.  I clicked on “log in” but was not asked to enter an ID number.  It asked me to log in using my username and password.  I did so and was told my application was still being processed.  This was not true – according to the letter my application had been fully processed and approved.  I went back to “live chat” and was told to call the 1-800 number.

I called the number and promptly connected with a real person.  I gave her the information and she proceeded to provide me with my policy options and, according to her, successfully enrolled me in the plan I chose.  I had selected the lowest price policy in the top “platinum” category.  I was told I would receive a bill from the insurance company in the mail in a few days. 

On the day after Christmas (today) what to my wondering eyes should appear but a letter from my new health care provider welcoming me and telling me that I must submit payment for the first premium “before your insurance can be put into effect” and indicating the amount due.  I sat right down and wrote out the check and rushed to the local Post Office.

I finally successfully acquired Obamacare insurance partially funded by an advance tax credit.

As a point of information, the cost of my current insurance premium increased, without notice or explanation, by 33.5% with the November 1st invoice.  It was not my policy’s “anniversary” date.  I can only assume that was because the plan had to change to meet Obamacare requirements.  I did turn age 60 in mid-November, but I do not think this affected the premium cost.

The final result of my frustrating saga is that, beginning January 1, 2014, thanks to the advance tax credit available to me, I will be paying less out of pocket for my health insurance than I was prior to the November 1st price increase for more and better coverage than I previously had.

So what can we take away from my saga?

If I was not eligible for coverage and a credit via the Marketplace my private health insurance cost would have increased by 33.5%.

The website was a total waste of time. 

My first call to the 1-800 number on October 1st was also a total waste of time.  The person to whom I spoke apparently lied to me when he said my application was received and processed, my identity was verified, and I would be receiving information on my eligibility in the mail within a few weeks.  I never received anything. 

The live chat function was only partially helpful – telling me where to go to get a paper application.

I had to go “old school” and submit a paper application in order to get any results.  This process was easy and I got a prompt response.  I should have done this on October 1st! 

Whatever problems that had made my October 1st call to the 1-800 number a total waste of time have apparently been fixed – my December 16th call actually got results.  Or maybe it was just the competence of the person I spoke to that made the difference.

And the bottom line – the US Tax Code is not the only mucking fess to come out of Washington.

Just so you know here is my opinion on “Obamacare” in general.

“Obamacare” is not the spawn of the devil, nor is it the answer to all our problems.  It is a flawed piece of legislation that was passed by flawed idiots in both houses of Congress (and upheld as constitutional by the Supreme Court) who did not actually read in full the bill they were voting on (it appears that this is also a common practice in Washington).  The Act was not well thought out and was created and pushed through Congress in haste (more common practices in Washington).   

While the Act itself is a convoluted mess, the basic underlying concept is a good one.  Universal health insurance coverage is good for the individual American and good for the country as a whole.  It is good public economic and health policy to encourage and assist individuals to acquire health insurance coverage, whether through direct individual purchase or employer group coverage.  But individuals should not be forced to sign up for health insurance, and businesses should not be forced to provide coverage for employees, by being assessed a penalty for not doing so.


1 comment:

Stephanie Chen said...

Thanks so much for sharing your trip through the new healthcare system. Your piece is a real eye opener and makes me so glad I'm on a company plan, at least for now!