When I first
heard the words “Affordable Care Act” and a brief explanation of its intent, my
initial reaction was “sounds like a good thing – everyone should have health
care they can afford”. It sounded good,
in theory, but I wondered how it would end up affecting my family’s health
care.
Health
insurance has always been a sticky issue in my family. Since my husband, Ken, was self-employed, at
the beginning of our marriage, our insurance was purchased through my job. Due to some unexpected circumstances, I left
that job just before our first son was born.
We were able to continue that insurance through a COBRA policy, at a
much higher rate. After Jesse was born
and we knew he and I were both healthy, we dropped the COBRA policy because of
the high cost.
Somewhere
between the births of our first and second sons, we were able to get a hospital
policy, but it covered virtually NOTHING, it just got us in the door if we
needed treatment. It was only after
Benjamin arrived and we saw how little the policy paid on the maternity costs
that Ken even considered that we even needed health insurance. He had always been a healthy man, so he had
never needed insurance. He was also a
“cash-only” kind of fellow. His motto
was, “If you don’t have the money in your pocket for it today, you don’t NEED
it today.” That included going to the
doctor. When he realized how many bills
we incurred during the birth of Benjamin, Ken began to see that health
insurance could be a good thing. Luckily
for us, at about this time, BCBS was offering policies for self-employed
families at group rates. We applied and
were approved.
We kept that
policy for the rest of our married life together. Ken would complain from time to time about
the cost, but he never tried to get me to cancel it. Later on, when Ken was diagnosed with cancer,
the policy was an absolute God-send. But
even with BCBS paying like they should, during the first year of Ken’s illness,
we paid roughly $12,000 out-of-pocket.
It really would have been devastating if we hadn’t had the coverage.
After Ken
died, the boys and I moved to Alabama to be closer to my family. I contacted BCBS of AL and asked them if we
could transfer our coverage from TN to AL.
They said we would have to apply for a new policy. Well, since I am a fat girl, they refused to
cover me, except for one of the hospital policies that doesn’t cover anything
except getting you through the door.
Said the only reason they even offered me that is because I was coming
from another state with a BCBS policy. The
good news was that they agreed to write regular policies on Jesse and
Benjamin.
A few years
later, BCBS began running an open-enrollment for a policy that required no
medical underwriting. It was a much
better policy than the one I had, and of course the cost was much higher, but I
didn’t feel as I really had a choice but to apply for it. So I did.
BCBS had to accept me… it was open-enrollment. During the 4 to 5 years I had that policy, I
think the premiums increased at least 4 times, and the policies for Jesse and
Benjamin increased at least twice. I was
paying $500 per month for our health insurance, which was a LARGE percentage of
this single mom’s take-home pay.
That is when I
started hearing about the “Affordable Care Act”. I worried about my premiums going up
again. After all, I knew that SOMEBODY
would have to pay for all the people who would now have to have insurance, but
didn’t have the money to pay for it, but there was really nothing I could do
about that. Our president was assuring
us that if we were happy with our current policies, we could “keep them … no
matter what” (remember when he told THAT lie?).
So, I figured I would just keep what we had and hope the premiums would
not go up too dramatically. (Eyeball roll … head slap … HEAVY SIGH. How could I have been so naïve?)
Around the end
of September, the dreaded information packets from BCBS arrived. I was astounded by what I read! My policy alone was going to almost double in
cost each month! The policies Jesse and
Benjamin had were no longer going to exist (remember, these are the policies
that the president said we could keep) and the premiums of the most comparable
policy would be a full third more than their old premiums had been. And of course, coverage in all three policies
was not as good and deductibles were much larger. I immediately called BCBS because the info
packet also said that I might be eligible for some sort of subsidy or tax
credit to help pay my premiums. Well,
they said the only way I could find out if I was eligible would be to go on the
healthcare.gov website and fill out an application. (We all remember the amazingly infamous
rollout of that particular website, don’t we?!)
Anyway, at this point, I felt that I was in effect, being held hostage. I couldn’t afford to keep the insurance I
already had, and the only way to find out if I could get help paying for the
premiums was to sign up through the Marketplace. And there would be no other insurance
companies offering better prices, because in my county of AL, BCBS was the only
game in town. No other companies opted
into the program. SHEESH!!
I went on the
website, or at least I tried to… I think it took about 2 weeks before I was
finally able to create an account and get to the application process. Some of the steps in the application were
confusing, so I tried to “live chat” with a representative. FORGET THAT!!
I finally called the telephone number and spoke with several very
friendly representatives who obviously knew less about the Affordable Care Act
and the healthcare.gov website than I did.
I felt very sorry for them, truthfully.
They were very pleasant, but they just didn’t know the answers to my
questions. They didn’t know the answers
because they had not been properly trained. They weren’t properly trained because NOBODY
KNOWS WHAT THE HECK THE ACA MEANS AND/OR HOW TO PROPERLY APPLY FOR COVERAGE
THROUGH THE WEBSITE!!!!! (Whew! Please
excuse that little explosion… let me continue…)
So, I finally
filled out the application as best I could.
I hit the “review and apply” button and immediately got an ERROR
MESSAGE!! I called the number again and
spoke with a couple of different representatives who apologized about the “few
glitches” in the system and told me to sign out, wait a while and try
again. Well, that went on for the better
part of another two weeks. In the
meantime, Jesse, my older son, signed up for health insurance through his
employer, but didn’t tell me. So when I
finally got the button to work, the information was now incorrect. It also said that Benjamin, my younger son,
was eligible for Medicaid. But by this
time, he was two weeks away from his 18th birthday, which would make
him too old for that program. I clicked the “edit” button so I could go in and
correct my information. You guessed it…
another error message!! SIGH… so I
called the number again. I told them all
of my troubles and said I needed to either delete the application I had filled
out and start over again, or edit the info that was there. They couldn’t figure out how to do that
either. Said they would send a request
to their “Advanced Resolutions Center” and someone would call back and help me
within 5 business days. That was the
first of three times I called and was referred to ARC. NO ONE EVER CALLED ME BACK!! In the meantime, a “delete application”
button appeared on the website. I tried
it and POOF! My application disappeared.
So, I began
again. Put in all the correct info and
with baited breath, hit the “review and apply” button. I think I only had to log out and sign back
in three times this time before it actually worked. It said that I actually did qualify for a
subsidy that would enable me to get a better policy than the one I had for a little
less than I was already paying. It also
said that Benjamin qualified for AL All Kids insurance, which covers dependent
children through age 19. Great,
right? Well, I immediately contacted All
Kids and they said, “if the marketplace said he is eligible for coverage, then
he will be covered as of January 1st”. Said that the marketplace would be sending
along Benjamin’s information and they would send out an insurance card. I asked if there was anything else I needed
to do. “No”, they said. “All is well.” Just so you know… if a government agency
tells you that all is well, you should probably NOT believe them.
My new
insurance began on January 1st, I got my new insurance card and the
subsidy worked the way they said it should, so I was all set. I was still waiting on Benjamin’s new card
and the information from All Kids. I
waited, and waited, and WAITED SOME MORE.
The website showed that they had B’s application, but it never showed
that he was covered. The only way to
check on the status of the application was to call All Kids in Montgomery. I lost track of how many times I was “lost in
the land of hold” for so long that I finally gave in and hung up the
phone. If I ever did get to speak to a
person, they always blamed healthcare.gov for the delay. If I called healthcare.gov, they always
blamed All Kids. It quickly became
obvious that neither agency knew the status of Benjamin’s application and
neither of them particularly cared whether or not he was covered.
Now, it is the
end of February. I stopped paying the
BCBS premiums at the end of December, and no one can tell me if Benjamin is
covered, so I have been holding my breath that he would not get sick or injured
until All Kids can get their act together.
Yesterday, I FINALLY get a letter from All Kids and I’m almost
rejoicing. I open it up and see the
following sentence, “We are sorry to inform you that it doesn’t appear that
your child is eligible for this program.
Our records indicate that he is covered under private health insurance.”
WHAT THE HECK???!!!! And then it hits
me… when I began this whole process, waaaaay back in September, he was covered
still under BCBS. Because they told me
that he would be eligible for All Kids and I couldn’t afford to continue the
insurance through BCBS, I let that policy lapse. So, as of January 1st, Benjamin
HAD NO INSURANCE!!!! But between two
government agencies, no one can figure that out!!!
I’ve been
hitting my head against this wall for so long now, that I just don’t know what
to do anymore. The last three times I
spoke to a real person at All Kids, they said, “it could take another 4 weeks”,
so I really don’t even want to try getting them to understand that yes, when we
started this whole crazy debacle, Benjamin did have insurance, but no, he does
not have insurance NOW, because they said he was eligible for All Kids. So I called BCBS to see if I had any options
with them. They said I have two: 1) go to healthcare.gov (AGAIN) and make a
new application for Benjamin, which could take another month or two to go
through, or 2) reinstate the old policy at the new expensive price by paying
for the two months that have already passed and the one that is due
tomorrow. REALLY??!!
So here I am,
being held hostage once more. It would
take two months to get a new policy for Benjamin in place. He will be graduating from high school in two
and a half months and will be going into the Army. By the time I got him covered with a new
policy, he would be graduated and gone.
So my only real choice is to pay three months’ premiums (that I really
don’t have) to reinstate the old policy.
Mr. Obama, I don’t know, for some folks your
“signature legislation” may be a good thing.
But for this fat widowed single-mom, working as hard as she can to make
a living and pay her bills, there is NOTHING affordable about it!! L
