Dispatches from the Healthcare Marketplace

Dispatches from the Healthcare Marketplace

A woman shares her real-life experience with trying to navigate Obamacare online..and why it's worth the trouble

by Afi-Odelia E. Scruggs, November 5, 2013

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Dispatches from the Healthcare Marketplace

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After a week of late night log-on attempts, buggy screens and extended error messages, I finally registered – again – on healthcare.gov, the online federal marketplace for the Affordable Healthcare Act or ACA.

I say again because I successfully registered once, but forgot my password and username. The reminder prompts never arrived in my email. After a couple telephone calls, the customer service representatives suggested I start anew.

That was on October 22. I couldn’t even access the site until October 31.  To my amazement, I was then able an account. I grabbed my credit card and prepared to buy a new policy. But the healthcare.gov kicked me out.  The latest error message said my identity couldn’t be verified.

I followed directions on the site and called Experian. The credit monitoring company is checking identities for the ACA. Why, I asked, can you verify me online so I can view my credit report, but you can’t confirm my identity so I can buy health insurance?

“It’s a bug in their system,” the customer service representative said. “Call them back.”

I called a customer service representative for the federal marketplace. She put me on hold, and returned with her solution: mail a copy of my driver’s license and they would verify my identity manually.

“Oh hell no!” I said. If the website was such a mess, what would they do with a letter?

But I caught myself and calmed down. I imagined she and her long-suffering colleagues had heard worse. When I returned to the site,  I found I could upload a document to get verified online.

I pulled out my camera and took a picture of my driver’s license.

I’m still not verified. But you won’t hear me cursing so-called Obamacare. I’m not joining the cadre of finger pointers, even if they do include Health and Human Services Secretary Katherine Sebelius. She heads the department that oversees the Affordable Health Care Act. At the end of October, she spent three hours in a congressional hearing, apologizing for its chaotic implementation.

I’m not playing politics. My support has nothing to do with my antipathy for the Obama administration’s Republican enemies.

I’m supporting the healthcare reform because I’m self-employed and self-insured. If the premium calculator on the Kaiser Family Foundation site is correct, the amount I’d pay for a year’s worth of insurance will equal the amount I now pay for a single monthly premium.

Now you understand why I was up at 2 a.m., trying to break into an impenetrable site. For once, my income works in my favor.

I'm benefiting from the tax credits that remove the sting from the cost of the premium.  Folks like me, who purchase insurance, can get a reduced premium or a tax credit if their household income is between 100 to 400 percent of the federal poverty level.  My two-member family makes much less than the maximum income of roughly $64,000.  Millions may not have to pay a dime for premiums, according to the McKinsey Center for U.S. Health System Reform. The research center estimates that 6 to 7 million folks might be eligible a free bronze plan – the lowest type of  coverage available under the ACA. Bronze plans cover 60 percent of healthcare costs. About 1 million might not have to pay premiums for a silver plan, which covers 70 percent of health care costs.  In order to get the tax credit or subsidy, however, insurance must be purchased through the healthcare exchange.

In a crazy twist, the benefit doesn’t necessarily help folks who need it most.  People who are on Medicaid aren’t eligible for the subsidy. That applies to really poor folks whose income is less than 138 percent of the federal poverty level. If those people live in one of the 25 states that refuse to expand Medicaid coverage, they’ll have to pay for a premium themselves.  The Urban Institute estimates more than 16 million folks could be in that predicament.

My homestate, Ohio, would have been one of the holdouts. But Gov. John Kasich executed a political maneuver that expanded Medicaid without the permission of the Republican legislative majority.  Still, Kasich, also a Republican, is no fan of the Affordable Healthcare Act. Ohio doesn’t have a state-run insurance exchange, so residents are forced to use the federal-run marketplace. Plus the Ohio Department of Insurance website barely mentions the Affordable Healthcare Act – although the home page urges Ohioans to be careful of deer on the roadways. Ohioans trying to sign up for insurance have to find their own way.

That’s another reason I was logging on to the federal site three and four times a day.

Actually, I’ve been navigating the shoals of health insurance since I began freelancing 10 years ago. I quickly learned the policies I could afford where beyond minimal; they were skeletal. They didn’t cover pregnancy, contraception or most prescriptions. The deductibles were so high – and the annual limits so low – I’d be on the hook for most of healthcare costs.

But most times, I couldn’t get coverage. I have Grave’s disease, a thyroid condition I control by taking a daily pill and visiting the doctor once a year. But that was enough for insurers to refuse coverage because I have a pre-existing condition.

I finally gamed the system by joining a media association that offered access to insurance plans as a membership benefit.  I got a bargain. My premiums wouldn’t increase for three years. That incentive made it easy to bear the insurance company’s refusal to pay any thyroid-related expenses for a year. Not that it mattered; I would have had to go to 10 doctor’s appointments at $250 a pop before meeting the deductible.

My premium has increased by 20 percent each of the last three years – even though I don’t smoke or drink and my medical expenses consist of annual checkups to my endocrinologist and my gynecologist.  In order to keep premiums affordable, I’ve raised my deductible to $5,000.

My company gave me a final surprise: I could keep my policy under ACA.  It turns out that my flimsy coverage is a bronze plan. It provides the essentials required by the ACA, such as access to emergency services and free screenings for conditions like colon cancer, blood pressure and depression. Even though I couldn’t afford to use the insurance company’s discounted prescription coverage – my discount drug store is cheaper  – I had it.

But I’m not settling for the bronze; I’m going for silver.  With subsidies and tax credits, I’m hoping to step up to better coverage.  I’ll use the online site if it ever works correctly. If not, I’ll pick up the telephone.

But I’m getting through.

Afi-Odelia E. Scruggs is a freelance content creator who lives near Cleveland. Her website is www.aoscruggs.com

 
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