October 3, 2013

Finally got my Health Insurance. The Affordable Care Act isn't that good.

It is fucking unbelievable.

No wonder they are scared.

1) Application Process
I am 'beached' with nothing to do because of the shutdown so I have a lot of time and once it is settled will have nonstop work until December so I was highly motivated to get it done fast.

I made several calls, used the chat operation and finally found that 3 AM was the time when I could get on.

Once in the system the actual sign up process is amazingly well done. It is easy, approachable and if you have problems you can use the chat or the phone to talk to somebody. The phone wait time dropped from 45 minutes to immediate pick up right now.

The phone counselors don't have a lot of options at their end but I was able to get information to fix some hiccups. It was obvious that the entire site is straining and the people answering questions also are having problems using the site.

I finished all but the last page which sets up payment options and then the site froze again. When I talked with the operator I was shocked when he said that I was the first person he had talked to that was able to get that far in the process. Of course some people managed to get all the way through and wouldn't need to call.

What is interesting is that they have been able to ramp up the call center so that there is no wait at all but that the traffic on the site is staggering.

2) Subsidy

I think that most of us have had the experience of making too much to qualify for government support except in some exceptional times. I am sure that I am not alone in thinking that the subsidies wouldn't be that great.

I was shocked to find that the ACA is paying 40% of my premium.

Last year was something of an unusual year for me. I am self employed and moved states so my gross income was lower and I had a lot of business expenses so my adjusted gross income was in the low 40s to low 50s (not sure which income they used because I recently filed an amended return). I never expected that level of subsidy, hell I didn't expect a dime.

3) Plans

I intended to search and pick out the lowest non profit plan I could find. Because of the subsidy though I decided to go to get a gold plan.

It had low co pays, zero deductible and maximum $ 10,000.

It is 'for profit' but the HMO is ranked #1 in my state and I have 1000 primary doctors in the system.

Total Cost $ 765 per month, my monthly premium is $ 444 for my wife and I.

For a 59 year old diabetic that is a stunning, revolutionary change.

4) Glitches

There were several glitches along the way. Among them:

1) People who you call in to really don't have any 'super power' at this time to over ride the system.
2) Lots of little things aren't working for example I had a lot of problems logging in so I tried 'forgot my password' option and a message came up saying they sent an email to my account but none came.
3) Another glitch at one point I had a verification problem for my wife and had to upload immigration documentation but it wouldn't upload.

But the biggest problem we had was verifying my wife, a permanent resident. As part of the process they are using IRS and Immigration databases to verify and there is a typo in my wife's name on her green card.

They have a "live" human option to assist with verification. If you have a verification problem then you will need your ID# and phone in and tell them that you need to set up a "Verification conference call with Experian" to verify the disputed person.

Now here is the interesting part: We had the problem last night at 3:00 am "Experian" wasn't open so we had to get back in line this morning and try again but when we logged on the verification was settled. That means that either they began waving all of the people with similar problems (one of the phone counselors said they were getting a number of people with verification problems) or that they automatically flagged my application for review and did it individually. Either case that shows a pretty high level of course correction in the middle of a unbelievable traffic.



Some here have health insurance and don't realize what it is like to go a decade without access to good care when you have a serious problem (and this was after I had very high level PPO plans for 20 years but lost it when I got sick).

I know that there will still be some for who this plan isn't going to deliver as much help as they need.

But, at least in my case, it was a much much better plan than I think even the more optimistic of us thought. If the shutdown is concluded and I can get back to work I will be able to finish the year at a level that may make them take back the subsidy and that would make me very happy but I was stunned to see how big the subsidy was based on last year's numbers.

This is going to be a major improvement in a lot of peoples lives and that is why the Republicans are trying so hard to sabotage it.



There is going to be one economic boom related to the ACA early next year. There are going to be millions of people like me who have "pent up demand" for medical services who are going to rush in for medical care in January. In the beginning the insurance companies are going to have to write big checks for a lot of people who have been putting off medical care. I predict that the final irony of the initial stage of the ACA will be that it will be a minor stimulus event on its own during the first quarter of 2014.

This isn't the end but the first step until we get universal single payer. In my opinion its a much bigger first step than we thought it was.

The one thing they could and should still do is to restrict people applying on a particular day by limiting those to certain letters of the alphabet. For example first day Last Names starting in A-D and so on. That would solve a lot of problems and reduce wait time.