Misadventures with healthcare.gov

[illusionofjoy]

Anyone following my 140 character rants on Twitter should know that I oppose the Affordable Care Act because it is not liberal enough. If the for-profit health insurance industry was going to be allowed to continue to exist, it should be kept on a short leash. In this aspect, the ACA is somewhat successful. No longer can those with pre-existing conditions be turned away, children may stay on their parent’s health insurance plans for much longer and a much larger percentage of monthly premiums paid must be used on healthcare rather than administrative expenses. All of these are good things, but not nearly enough in a nation which has not only some of the finest healthcare in the world, but some of the most unaffordable. The lion’s share of the blame for that lands on the for-profit health insurance industry.

I consider health insurance premiums to be blood money. Consider this: the prime goal of any corporate/capitalist endeavour is to make money. Insurance is a pool of shared risk where the gamble is that enough people not needing a large payout are in the pool to counteract what is hoped to be a slim minority of those who do need a payout of any type. This is where the free market always fails in the public good: unless the system is gamed through strategic denials of coverage, there always eventually needs to be a large payout. Human beings are fragile creatures with a built-in expiration date. Eventually everyone is going to need that large payout – it’s not a matter of “if,” but “when.” Cut out those who are likely to get the sickest and you can maximise your profit margins – who cares if human lives are at risk so long as the money keeps rolling in? Besides, no guilt for anyone over age 65 as they have Medicare.

The Affordable Care Act is really a blessing and a curse for the health insurance industry. It is a blessing in that millions of Americans are now going to be strongly persuaded to purchase what is, frankly, a crappy product thus increasing the coffers of those who dabble in blood money and it is a curse in that said coffers may not bloat as desired if the new customers turn out to be less healthy than desired.

I remember talking with my grandfather back when the ACA was being debated endlessly, before it was eventually signed into law. He said that getting on Medicare was the best thing to ever happen to him because he no longer had to deal with an insurance company. Medicare is a single-payer health insurance system: the citizen pays his or her taxes, said tax dollars are used to pay the doctor of said citizen’s choice. It is elegant in it’s simplicity, however you have to wait until you are elderly to be part of the Medicare system. Why not allow every American system to be a part of something that not only works well, but has been proven to work in various forms throughout most of the civilised world?

Obama supporters would tell me that it’s not politically feasible. Obama detractors would tell me that they don’t want “European style socialism” in America. Well, okay, I’m not interested in “politically feasible” but what is good for the nation, so why couldn’t Obama have gone all FDR on healthcare reform and given us some nice American-style “socialism” akin to the The New Deal? My rhetorical answer to my rhetorical question is that Obama is no FDR. To me, he looks a lot like Ronald Reagan, a figure who both literally and philosophically should remain buried deep.

Americans have until midnight tonight to get started on the signup process at healthcare.gov. Uncharacteristically for me, I attempted to be an early adopter and tried to sign up when the site opened in October 2013. Unfortunately, we all know how that turned out; the site wasn’t so much open as it was slightly ajar...or maybe you could peak through the keyhole. Bottom line: the website didn’t fucking work!

I tried for several weeks before I managed to get a profile set up at healthcare.gov. It wasn’t until December that I managed to finish and submit an application. The results a received back from healthcare.gov were not encouraging. I was too poor to get fined if I opted to be an uninsured scofflaw, but somehow I wasn’t seeing any tax subsidies for any insurance plans either. Frustrated with the whole affair, I put it on the back burner...for about three months.

It was True, my domestic partner, who got me to log back onto the site again to give things another go. About two weeks ago she said to me that I’d better get to work on the healthcare.gov application – see if I could fix whatever was wrong with it – because the deadline was coming and there would probably be a rush of procrastinators. She was correct about that, of course, as I write this, healthcare.gov is down because it is over capacity.

So, one fateful evening True handed me my cell phone and a vodka soda (which I attempted to merely sip) as I settled in behind my laptop with several documents laid on the table next to it. Having hit a dead end on the website, I dialled their consumer help line.

After telling the robot menu that I wished to speak with a customer service representative, I began a conversation with sweet-sounding woman who asked how she could help me. I laid out the situation: I had put in an application for my family, however it was requesting additional information but then neglecting to give me a form to input said information.

After a few questions back and forth, I was finally told that I’d have to redo my application. I was told to reapply with only myself and True as the applicants. Since our children were going to be rejected by the system and forced into state Medicaid coverage regardless, it made no sense to include them. After the call concluded, I withdraw my long-festering initial application and filled out a new one. I then ran into another roadblock.

I called the customer service line again. This time a young man was at the other end of the line. He looked up my just completed new application and said, “okay, I’ve got some good news and bad new for you— ” at which point the signal faded from my cell phone.

I dialled the help line again. Before the robot menu could even ask me which state I lived in, my cell phone signal died once more. If I wasn’t wrestling with healthcare.gov, I was wrestling with Sprint! By now my vodka soda was half-finished and True, apparently seeing veins begin to crease my forehead, offered to make the call for the next go-around.

I gave her my phone and she dialled the number. About halfway through the conversation, she was asked to give the phone to me since the application had been filled out under my healthcare.gov account. The new bottom line: since True and I aren’t married, we would have to do separate applications under separate accounts. The fact that we cohabitation but aren’t married was pertinent information that I had given to the other two representatives. I was beginning to believe that none of them had the whole picture and could only be as much help as their little puzzle piece of the healthcare.gov operator’s manual allowed.

I got back on my laptop and applied for myself. True then did the same. I waited for the results...they came back: I had cleared all of the hurdles, jumped through all of the hoops and my reward was the ability to purchase health insurance with a tax subsidy.

True, however, got the short end of the healthcare reform stick. Being only a part-time worker, she would not be subject to a penalty for not being insured, however she also did not qualify for a tax subsidy. The site helpfully suggested the she apply for Medicaid, before quickly reminding her that Pennsylvania’s governor (the jagoff known as Tom Corbett) declined to expand Medicaid in the commonwealth (thanks to a Supreme Court bloated with right-wingers who said that such things were a-okay). She then got a list of “catastrophic coverage” plans which neither she nor I could ever hope to afford...not without giving up paying the mortgage, or the utilities, or perhaps not buying food. And which, let’s face it, were shit for coverage anyhow.

Many people would tell me that I am a healthcare.gov success story. “Congratulations, you’re insured,” I can hear the pundits saying. Honestly, I don’t feel any sense of victory here. I have a safety net now, which is cold comfort when I consider that True, who would really benefit from coverage, got screwed – not only by the law itself but it’s partisan detractors. The single-payer solution is so simple, yet in America we can’t for some stupid reason, just do the simple and right thing. It enrages me.

Is my coverage “affordable?” Technically, yes. However I can’t help but be annoyed that $40 of what used to be disposable income – of which I don’t have much – has been turned into yet another monthly bill. As to whether or not the coverage is any good, forgive me if I say that I hope I never have to find out firsthand.

The midterm elections are on the way. The Republicans are convinced that they are going to retake the Senate backed by the chant of “repeal Obamacare.” This may or may not be the case. I, for one, have no interest in whatever they intend to replace the ACA with (if anything) and I know for certain that a single-payer system is not on their agenda. Meanwhile, the Democrats have nothing to motivate their so-called base with (a base they laughingly think I am part of). The truth of the Affordable Care Act is that it is neither wonderful or horrible. It’s really just...tepid. And tepid doesn’t win elections. Worse, tepid doesn’t really help people as much as they need it either.