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The Cost of Obamacare: Website Problems, Cont.

Updated on December 18, 2014

Background

Last year I spent something like 547 hours attempting to access the Obamacare website (aka: Healthcare.gov) and get my family of five signed up for healthcare. The nightmare seemed never ending.

Click here to read all about that experience.

Because my children were flagged last year as potentially eligible for Medicaid benefits, we have branched our healthcare struggles across two government agencies entirely, one on the state level and the other on the federal level. I just can't seem to get enough of bureaucracy and government paperwork, not to mention the reminder of exactly who and what my tax money keeps employed around here.

What follows is the ongoing update of our continuation with Obamacare, our application for Medicaid, and our 2014 experience with open enrollment. If you have experienced personal frustration with the same process, hopefully you have found a place of empathy here. Our problems may be all but solved, but at least we aren't alone, right?

January 1, 2014: Update

Despite receiving nothing in the mail (at all, so far) and making no payments so far, we have news. Despite hour long hold times to speak to a customer service representative in the accounting department of Blue Cross Blue Shield which have yielded very few concrete answers, magically, the website switched everything over to our new plan on January 1st.

It seems they got everything as we thought it should be. We were able to print temporary cards and now simply wait for an "invoice" to come in the mail so we can pay our bill. According to everything we've read, this is proof enough of coverage, and should something happen in the next couple of weeks, a visit to the doctor will not cause us to be turned away or to pay in full and seek reimbursement later.

Happy New Year indeed.

May 20, 2014: Appeal Update

We bought a new house and are planning to move in less than a month. I started packing and ran across the appeal form I printed out several months ago.

Just for fun I filled it out completely today and mailed it in, without any other paperwork. Let's see how long this takes, shall we?

June 21, 2014: Medicaid Update

We electronically filed our Medicaid application last year sometime (probably in December). It is June. I just moved into a new house and one of the first pieces of mail I received was a letter from Medicaid requesting more information for my application.

Six months later, they need more info. Specifically, they need proof of income, proof that we are US citizens, and proof of our North Carolina residency. (They mailed me this to a house in North Carolina and I received it, but obviously that doesn't count as proof.) I sent in a copy of our 2013 tax returns. It seems to me that covers all of it. *But I also happen to know that if something makes sense to me and other intelligent people, it probably doesn't count for any governmental paper-work.

It is June 21st. I mailed in all the information today. Kids are not covered on Medicaid right now, and not covered on Obamacare, and we're expecting baby #4 sometime in August.

It is currently more expensive to insure my three children on wellness-only super-high-deductible plans than it is for John and my Obamacare plan that has a $1000 deductible.

I'm also dreading our annual dentist bill, yet again.

Meanwhile, still haven't received any communication concerning the appeal form I filled out. But I just know it is sitting on the corner of Obama's desk in his "To Do" pile. He'll get to it. I know he will.

September 2014: Medicaid Update

Baby #4 was born in the middle of August. John called to get her put on our insurance. Big surprise, she's also a supposed Medicaid recipient.

He called Medicaid. They confirmed over the phone that we have been denied. (Note: we were given no such physical notice of this rejection. I guess we were just supposed to assume that no news was bad news? Surprise?) He requested they send the letter of rejection in the mail so we can send it with our appeal for next year, because we figure this year is pretty much a wash.

Right now, my 6 week old is uninsured. Praying my breastmilk gives her superhuman powers and protection from any emergency room visits. Meanwhile, I'll be forgoing all well baby checks as long as she is consistently outgrowing onesies.

October 2014: Medicaid Update

Guess what? It is a month later and still no letter of rejection in the mail. John has called about once a week all month, and is told on the phone, "No problem sir, that should go out this week."

Alas.

November 1, 2014: Healthcare.gov Update

Today I woke up to four emails from Healthcare.gov reminding me that re-enrollment opens on November 15, and then assuring me that if I have any questions, they have answers.

I tried to log in to an account using the email address they obviously have. No account associated with that email address. I clicked "unsubscribe" on the emails.

November 15, 2014: Medicaid Update

At 12:01am my husband logged on to Healthcare.gov and went through the application just like last year. And just like last year, he made it all the way to the final page and the thing did not submit.

He logged back on around noon today, to find that none of his information had been saved.

Bottom line: problems are the exact same as last year. All of these commercials assuring the American public that "all the website problems have been fixed!" are wrong. Or, our information has been permanently flagged for endless frustration.

Please tell me I'm not the only one.

Meanwhile, I called the Medicaid office myself yesterday. I got a very nice lady on the phone, but you and I both know that in this case nice on the phone does not equal efficient nor trustworthy to do what she claims she's going to do.

After providing John's social security number (which they've had all along but still needed proof of our US citizenship 4 months ago) I simply stated that we need our letter of rejection so we can appeal our ACA plan to include our children.

Quote: Well, to do that you would have to speak to the person in charge of your case. Let me see what she says here.

Note: she does not offer to connect me with the person in charge of my case.

Quote: Well. Hm. This is strange. There's a note here that says this rejection was canceled. Hold on, I'm not sure what this means.

They canceled my Medicaid rejection? Because last time I checked, we still make the same amount of money and we still have approximately the same number of assets. I'm still driving a 2013 Honda Odyssey that we paid for brand new. I feel like that alone means we do not qualify for Medicaid. (If it doesn't, note this another reason to vote Republican, people.)

Quote: Well, I'm not really sure why this note is on here. It says you have been denied because of missing information. I don't see why we can't get this letter out to you. I'm going to email your case worker about it and it should go out this week! Anything else I can do for you?

This is where I should have said, "No, but I'll speaking to you again on Monday when the letter has not yet arrived."

I'm trying to be nice, but almighty God and Father, if this system isn't beyond repair I don't know what is.

I plan to call Medicaid every week until that letter is in my hands. My next phone call will include a fax number and perhaps I'll stay on the line until the thing prints out on my desk.

November 16, 2014: Email Update

I just want to include here that I have received no fewer than 2 emails a day from healthcare.gov to the email address I have repeatedly unsubscribed. This is the same email address that is not associated with a username, apparently.

At one point I even clicked "Forgot your username," and "Forgot your password," and nothing has ever come of that pursuit.

But I continue to get the advertisement emails on a seemingly regular basis.

November 25, 2014: Medicaid Update

Today my husband went to the Medicaid office in person. He was clad in his regular ready-for-court-because-I'm-an-attorney Monday attire, which is always a suit, but today included a non-standard bow tie.

Sidenote: a good looking man in a good looking suit anywhere, but especially in a government office, typically commands some serious attention and respect. I'm pleased to announce that today was no exception. We got answers people.

His plan was to simply ask for proof that our family has been rejected for North Carolina Medicaid so we can push that along in the appeals process and get all four of our children on our subsidized ACA plan. But as soon as the first woman pulled up his file, he was met with several questions.

Two more people ended up helping assist, and at the end of the surprisingly short interaction, all three could not understand why our children had been rejected in the first place. According to our taxable income from the 2013 fiscal year and the fact that we are a single home family with four children, it turns out at least two of our kids fully qualify for Medicaid benefits and the other two should qualify for a greatly reduced rate for insurance under the North Carolina Health Choice (NCHC) Health Insurance Program for Children.

I'm not entirely sure what this fully entails, but I know it means it should not cost me $400 a month next year to put all my children on wellness-only high-deductible plans because they fall through the benefit cracks.

I also know it means that assets do not count at all toward Medicaid eligibility. For those of you deep red Republicans out there, I hate to say this but I'm going to anyway. I drive an almost brand new Honda Odyssey mini-van. We own two houses (one is a rental investment). My Roth IRA is at a somewhat embarrassingly comfortable level for the fact that I'm only 33 years old. We are those freaks who, in the event of an emergency job loss, could actually live for the next three months without any income. Yet, because our monthly taxable income is relatively low, my children qualify for Medicaid.

The best/worst part is that by the power of a very complicated tax system in the United States, the completely legal loopholes are seriously working in our favor. (And by the way, our CPA is worth every dime he charges us.)

December 10, 2014 Status: COMPLETE!

We finally decided we weren't going to continue to battle the marketplace website, since in the end last year, it was a phone representative who finally got us through and set up with a plan.

Therefore, on long drive to Charlotte today, my husband got on the phone with Healthcare.gov. Once again it took almost exactly 97 minutes, answering almost exactly the same questions as last year.

I'm happy to announce we have officially secured health insurance for yet another year (hooray!), but once again, my husband and I are the only ones covered under the ACA. All four of our children were again flagged as potentially eligible for Medicaid.

I'm also happy to announce that unlike last year, we can now log on to our ACA account and actually see the healthcare plans. John made a choice on the phone today, and to our surprise, when we logged in later tonight we could see exactly what was chosen, as well as all the information that comes with it.

This was a beautiful site...

Even though our income has steadily increased every year (this year is no exception), much like last year, we got a very good healthcare subsidy. But likely due to the extra child this year, we also qualified for a "cost sharing reduction."

This means that our out of pocket monthly premiums are $100 cheaper next year. It means that our office visit co-pays and emergency or specialist co-pays are reduced, our deductible is actually lower, and our max out of pocket is much lower.

The "cost sharing reduction" only applies to "silver" plans. We had a gold plan in 2014 which was what seemed to be the best plan for cost benefits, especially because we had a baby this year. I was nervous that the silver plan would be worse, but ultimately, the biggest difference is that it is a "limited network" plan. It turns out all of our current doctors are in the "limited" network, so it doesn't negatively seem to affect us.

Now we just have to figure out healthcare for our children.

Stay Tuned...

I will continue to update this Hub as more information becomes available. Please check back. Also, please feel free to share your own healthcare.gov experiences below. If anyone can benefit from some trial and error or answered questions here, I feel like some good will come out of all this frustration.

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      Larry Wall 2 years ago

      You went through a nightmare. I had trouble the first year because of the computer glitches. When I renewed for this year, I did it in an hour. I chose different coverage. I went for the traditional 80-20 policy, with prescription coverage. I pay $730 a month for two people. I have a son, but he is on Medicare as a result of being almost blind and suffering a traumatic brain injury in a car accident. He is 30 but still my dependent because he cannot work. The program has worked for me. I am in Louisiana. Blue Cross was one of the choices. I did not even consider them because before the ACA I was turned down because of my age and prior health--turned down by a clerk without going through underwriting. I have spent a lot of time on the phone. I was hit this year with the notice that my 2014 subsidy was too much, and I had to pay back part of it. During the year prior to this year, I had three ER visits and a weeklong hospital stay--insurance cover cover most. Before the ACA I had two surgeries, cataracts removed and other ills. The hospital forgave one operation at $32,000. The other was a one-day event and not that expensive. My doctor charged the Medicare rate for the cataract surgery and got me a discount at the surgery center. I still spent $19,000 out of pocket during the year before the ACA. I am glad to have it. I hope your situation works out for you.