On several occasions in the past year, I’ve mentioned that I finally have health insurance coverage due exclusively to the efforts of President Obama and the Affordable Care Act. Confession: my insured status turned out to not be entirely true, unfortunately. Make no mistake, this isn’t my own personal Brian Williams fib. I legitimately thought I was insured, when in fact I really wasn’t at all.
Here’s the story.
In March of last year, as the first Obamacare open enrollment period was drawing to a close, and after the exchange in this state, the Hawaii Health Connector, finally got its online shit together (see my previous article about the Health Connector’s botched roll-out here), I signed up for a comprehensive “Silver I” plan offered on the exchange by Kaiser Permanente, one of only two insurers to offer marketplace plans here. My monthly premium would be $197 per month, and I didn’t qualify for any subsidies; $1000 deductible; $6450 annual out-of-pocket cap; no annual limit on coverage; $30 primary care visits; $15 generic prescriptions; $250 emergency room visits after the deductible; free preventative care; free eye care including glasses (which I desperately need). From what I’ve read, it’s comparatively a very good plan for the price.
After signing up online, I called the Health Connector just to confirm that they had received my information and to ask what the next steps would be. They of course confirmed my policy and told me I’d be receiving a “welcome package” with payment information from Kaiser Permanente within three weeks. Great! For the first time since 2005, I could rest assured in the knowledge that I wouldn’t go broke if I were to be injured or seriously ill. Happy dances all around. (It’s a long story, but I was uninsured for so many years due to a preexisting cycling injury — a condition that no longer disqualifies me from buying an affordable policy.)
A month passed and I received nothing in the mail from Kaiser. Hmm. Well, I thought, it could be a traffic jam at the fledgling Health Connector. This is, after all, a new bureaucracy and an all new way of signing up for health insurance, plus there’s the phenomenon of “Hawaii time” — the motto at the end of the day is, basically, “we’ll figure it out tomorrow.” Hawaii time isn’t about laziness or lethargy, it’s simply a lack of urgency here. Great when you’re on vacation, not so great when waiting for a health insurance policy.
Another call to the Health Connector. I’m told everything’s okay. My information was submitted to Kaiser and I should be patient. Fine. Hawaii time.
June rolled around and I still hadn’t received anything. So, I called again. This time they said they’d resubmit my information with an “urgent” stamp. At this point, I asked if I was indeed covered. The operator assured me that my policy would cover me retroactively. Circling back to my Brian Williams lede, I had solid reason to believe I was covered. But by August, I was beginning to think there was something terribly awry at the Health Connector or Kaiser or both.
That’s when I got a double-shocker. First I called the Health Connector. I ran through the usual list of grievances. Still nothing in my mail box. Where’s my “welcome package?” Where’s my payment information? Where’s my insurance card? The operator this time told me that I was still retroactively covered, but when the invoice finally arrives, I’ll be retroactively on the hook for all of the monthly premiums so far. Really? That was the first time anyone had ever told me this. At that point, the bill would’ve covered five months, costing me a total of $985 in one big chunk. Paid incrementally at $197 per month? Sure. Fine. But nearly a thousand dollars for a policy that was never invoiced? Come on! I mean, no one told me to start paying my premiums — only that an invoice and a “welcome package” were on the way.
My next call that day was to Kaiser itself. The first operator I spoke with told me that, yes, I’d have to pay all of the premiums retroactively. Infuriated, I asked to speak to a higher-up — a manager or whomever can get to the bottom of this growing mess.
That’s when I discovered that my policy had been, in fact, canceled on April 1 due to non-payment. I’m not making that up. Worse, open enrollment was long gone and it wasn’t due to start again until November. So, once again, I was de facto uninsured because I didn’t pay a premium to an insurance company that never billed me in the first place. I called the Health Connector back to offer up some four-letter-words, and they assured me they’d endeavor to resubmit the policy, even though the open enrollment period had expired — after all, there were extenuating circumstances.
Three-or-so months of nothing followed.
By that time, it was November and open enrollment had begun again. On the first day, I cracked my knuckles and hit the Health Connector website. I searched for the same policy only to discover the premium had gone up to $219 per month. It’s unclear whether my original premium would’ve gone up anyway, so I wasn’t too upset. After all, it’s an extra $20. I think I can afford $219, even on my The Daily Banter salary. Nevertheless, when I wanted to officially choose the plan, there wasn’t any way to select it on the screen. No “Order” button. No “Shopping Cart” button. No check-box or “Submit” button. Was it a Chrome issue? I popped open Firefox and tried it there. Nope. Same.
Back on the phone with the Health Connector, and an operator verified that, yes, there was a button missing from the site, but that he could set up my plan over the phone. First, we made sure my previous attempt was fully purged from the system, which was easy because it never really existed in the first place. Then we walked through the sign-up process. After 15 minutes BLAM! All set. The operator gave me a confirmation number and told me the first invoice would arrive in ten days. I’ll believe it when I see it.
Cut to December 15, a month later, and still nothing. No “welcome package,” no “invoice.” History appeared to be repeating itself. I hoped I was insured anyway because my head was about to explode and the reconstructive surgery would’ve cost a fortune. My initial reaction/panic was that they probably canceled the policy again due to nonpayment. I dialed the Health Connector phone number by memory. This time, the operator put me on hold and called Kaiser to find out what was going on. Once again, Kaiser hadn’t received my information, and so I was told they’d resubmit it — again! — the same dance from the Summer. The operator also told me that I should start to pay the premiums anyway, even though no one knew for sure whether I was actually covered. Yeah, great idea, Mr. Wizard. Because if my policy ended up being canceled because of another fuck-up, I’d be happy to donate $219 to Kaiser Permanente ever month anyway.
After the call, I resolved to give it one… more… month. If nothing happened I’d cancel my policy through the Health Connector and sign up directly through Kaiser.
This brings us to January, nearly nine months since I initially tried to sign up. This time, I called Kaiser directly and was told they still didn’t have a policy for me. But this time, there was something new — a “case ticket.” By establishing a case ticket, someone at Kaiser would have to determine what the hell was going on with my policy. Maybe this’d all work out after all, so rather than backpedaling, I decided to tough it out for a little while longer.
Last week, I called Kaiser again. Shockingly enough, the operator told me that not only did they have a record of my policy, but also that my invoice had been mailed the day before. I never thought I’d be so ecstatic over being sent an invoice for $219. Astonished, I asked him to double-check to be absolutely certain. We ran through my personal details again and he confirmed that the policy was set up and my first premium payment was due upon receiving the invoice.
And today, Tuesday the 17th, the invoice arrived in my mail box.
I paid immediately.
The colossal dose of irony here is that I’ve invariably supported the Affordable Care Act since the beginning, spending nearly all of 2009 and 2010 posting literally hundreds of items about it (including one that got an on-air shout-out from Rachel Maddow), plus dozens more since then — only to have such a monumentally difficult time signing up when it was finally my turn. I’d be lying if I said I didn’t feel a little burned for a moment there given all my efforts to support the passage of the law.
But realistically, this has little to do with the law itself, and I still firmly believe that it’s both a life-saver and the signature achievement of the Obama presidency. What I experienced has everything to do with the botched implementation of the law in Hawaii and several other states, not to mention the national exchange at Healthcare.gov. The Health Connector has a mountain of work to do if it’s going to succeed. Hawaii was the first state to announce the formation of an exchange, and it’s the president’s home state, you’d think it’d have its act together. I really, really wish I could have reported a smooth sign-up process, though now that I’m covered, and now that the stress and the phone calls are over, it’s still not lost on me that instead of paying my first premium since 2005 this week, I’d still be uninsured, surviving on nothing more than good luck, if it wasn’t for the Affordable Care Act. Thanks, Obama. Seriously.