Affordable Healthcare Act – The Ideal and The Reality

Throughout October and November, I experienced the reality of the new healthcare act.

I believe that public perceptions are affected by personal experience shared –

Hence, I’m gonna tell you all about it….

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For the record – After my stroke and divorce, the only health insurance I qualified for was a state (Colorado) run program for those with pre-existing conditions. I was lucky to live in a state that provided this option.

Because I still was renting a room from my mom at the time of my application, I had to report both her earnings and mine – even though I did not have any access what so ever to her earnings, either through good graces or by law.

Surprisingly, I still qualified for the reduced price of $154.76/month of basic coverage, with a $10,000 deductible – which meant, I could go for any office visit or yearly check-up i.e. if I have pneumonia, but anything other than wellness/yearly/routine fell under deductible.   My rates raised to $189.64 in August this year because you miraculously become a higher risk the second you turn 45 years of age.

(The company I purchased from will no longer be in business come 12/31/13 – for the scoop on how they handled the customer service relations for their impending closure Click Here)

On October 1st, I dutifully created an account and logged into the New Marketplace for Health Insurance for my state. (connectforhealthcolorado.com)

If I told the truth about my monthly income, the calculator referred me to another state run site to apply for Medicaid.

(I’m lucky, Colorado chose to embrace the new Medicaid income guidelines – many states did not and those who live in those states are just as screwed as they were before the law took affect.)

I dutifully apply for Medicaid on October 1st.   I answer honestly about who lives in my household.  The website form automatically signs my son up for Medicaid, because he lives in my house, even though he still has insurance through his Dad.

(and, another example of my ex’s generosity, if the laws allowed ex-wives to be kept on policies, I wouldn’t even have to be doing this shit….)

Some two weeks after submitting my application, I receive form letter pages from the county/state agency requesting proof of a variety of things – i.e. income, citizenship, etc.    After a phone call to straighten out that I’m not applying for my son, just for me, I learn that the web form is not functioning the way those who actually have to deal with it’s repercussions wish it would and I inform the gal that if the state ever wishes to hire someone who builds tools that End Users Love, please call me, I have a good track record and need work – she is friendly and polite even in face of my arrogance.

I get off the phone and submit the requested information.

Note – they have my divorce decree showing my child support though I never submitted it – they can view my bank records to make sure I”m not lying about my income, but they can’t tell if I’m a US citizen?!?  They are the state, but they can’t confirm me or my son’s birth records?  (yes, we were both born here in Colorado)

Hey, Big Brother, falling down on the job, there!

After jumping through the hoops, I’m informed that I do not qualify for Medicaid – because the software is basing it off the old income standards and not the ones that are in effect come January 2014.

(Do not ask what the old income qualifications are – neither I, nor anyone else knows – come Jan. 2014, if I make less than $3,118, for my household, according to the marketplace website, I qualify – according to the Medicaid website, I must make less than $1,781/month, because even though I house, clothe and feed my son, he is not counted as a person, unless I sign him up for Medicaid.)

Even though I qualify come January, my application is denied for now.  I”m instructed to re-apply January 1st (or the first day their government run offices are open) and yes, they will have on file everything I’ve submitted and it will go through, no problemo.

I must interrupt myself here to tell you, the case worker assigned to my case was Awesome!   She, a worker bee, is just as frickin’ frustrated as I am.   She was ticked that what they were told in ‘training’ for the new system and what’s actually occurring are two different things.   She specifically asked during training if the new system would allow early registration of the new 01/14 guidelines and was told “Yes”– she’s not a happy camper – – I told her it was okay – that those who build these tools will say anything to sell them, because they aren’t the poor saps that actually have to use them everyday….

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The plot thickened when I learned if I didn’t sign up for some kind of coverage by Dec. 10, 2013, then my coverage would be delayed on starting by Jan. 1st.

And, since I can’t apply until Jan. 1st, but Medicaid can take up to 60 days for a decision, it seems that I may be uninsured for a month or two – –

Thank god the law says the companies and government can no longer penalize me for daring to go uninsured awhile….

When I was 18, my boyfriend’s brother borrowed my car – – -and blew the engine in it – – I lived in town and walked to work, so whaddo I care?   I didn’t own/drive a car for 18 months.   When I purchased another used car (paid cash, no loan) and went to insure it, they were going to charge me a higher rate, because I had been “Uninsured” for 18 months – even though I wasn’t even driving a frickin’ car to be insured – – When I pointed this out, the agent said, “Where is that car now?  The one that you used to own?”  “At my Mom and Dad’s – they towed it home and there it has sat, waiting to be hauled to the scrap recycler.  Too expensive to repair.”  

“Well, see,” she said,“It should have been insured,  What if visitors to your Mom and Dad’s played on your car and got hurt?

And I said, “Isn’t that covered by their ‘Homeowners, We Pay For Other People’s Stupidity‘ policy?”

Seriously, who the fuck plays around and injures themselves on a 1979 VW parked on the back 40 acres of a place in the middle of Nowhere Eastern Colorado?

After much discussion, the agent removed my ‘elevated’ rate increase, because I dared to not insure what I wasn’t even using.  I’m sure this is because the discussion lasted past 5 o’clock, she was dating a good friend of mine and I bought her pizza and beer for supper….

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Alas, this is all irrelevant now –

Since my hiring of my two, part-time jobs, I will be, for at least 3 of the next 6 months, $34 over the maximum income levels I can have to qualify for Medicaid.

The cheapest insurance policy I saw, after tax credits, was more than $34/month.

I’ll keep you posted, but I don’t hold out much hope for me.

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I will say that I support and defend the Affordable Healthcare Act.  I don’t care if Obama or someone else tried to make changes to our healthcare system in this country, they were doomed to criticism and failure – – Our country has chosen to walk the line in Twilight Zone – that thin line between State Provided and Free Enterprise healthcare.

Each system has it’s pro’s and con’s – – If you don’t believe me, then watch “Sick Around the World”

Anyone who tried to get us moved to one system or the other would have experienced defeat – for there are those (hardworking Americans/entitled rich) who can afford their own healthcare and abhor the “Lazy, Good-For-Nothing Poor” milking the system whose views are just as ardently opposed by those (Social Justice/pinko commies) who believe everyone is entitled to basic benefits regarding health.

I may not agree with every line of the law or the implementation of it – I may not agree with the disparity caused by states exercising their 10th amendment rights in regards to income guidelines and paying for their own marketplace infrastructure – but if we are going to pretend like we have a democratic, free & advanced society, health care reform, of some sort, had to happen and had to be watered down enough to frickin’ try to please everyone.

I dare anyone to come up with a comprehensive bill that would have passed uncontested and been applauded by the majority – Oh, in case you are thinking you’re up to the challenge, it had to actually make a difference for the majority of American Citizens….

Until we find our way, we must walk through experimentation – and yes, not everyone will be taken care of – but dammit, it’s better to try, fail and fix, than it is to do nothing at all….

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As for those who met with the software programmers and/or the programmers themselves –

YOU GUYS ARE IN THE DOG HOUSE!

You clowns failed to provide a satisfactory experience for those employees and customers who use these tools everyday.

Politicians – Please take a refresher course in “Learning Worker’s Who Actually Implement the Laws you Pass” and “Geek Speak 101”

Programmers, attend “Understanding Your True Customer, 101”

‘Nuff said…