An Open Break-Up Letter to Obamacare

Dear President Obama,

I was such a fan of the Patient Protection and Affordable Care Act. I even wrote an article about why I’m Republican and love Obamacare.

In that, I talked about how the old health care system picked winners and losers – about how sick people couldn’t get coverage or were locked out of the benefits they needed most. While our political ideologies differ, I was with you on Obamacare.

And I still am, in theory. But let me tell you Mr. President, your program is an absolute mess.

I was willing to overlook the fact it took three applications and long hours on the phone to get my coverage lined up the first year – after all, there are always wrinkles to iron out of a new system. The second year was better, and I thought it would be smooth sailing every year after.

Boy was I wrong.

You see, for some reason, your system decided my oldest daughter was on Medicaid this year. At first, we thought maybe I had answered a question incorrectly on the application. Later, we learned someone else on Medicaid was using her Social Security number so maybe that was the problem. Regardless, the Health Insurance Marketplace insisted I provide documentation proving her Medicaid case was terminated.

The problem is my daughter never had a Medicaid case. She’s never had anything to do with Medicaid. As I told your reps over and over, I can’t prove a negative. I can’t provide documentation for something she’s never had. I even got a hold of a Michigan Department of Health and Human Services caseworker who offered to talk to the Health Insurance Marketplace and confirm my daughter wasn’t in the system, but that apparently wasn’t good enough either.

So last month – after eight months of going round and round in circles with marketplace reps – I received a notice that the subsidy for my oldest daughter was ending.

While frustrating, that’s not what’s prompted this letter.

Here’s my breaking point: Two nights ago, I went to the pharmacy to pick up asthma medicine for my youngest daughter who is three years-old. They wanted to charge me $250 and when I asked about the price, I was told my daughter’s insurance had been terminated. A call to the insurance company yesterday revealed the marketplace was responsible for cancelling her coverage and the insurer could not add her back on. Apparently, that privilege is the exclusive domain of the marketplace.

Oh the irony of a law intended to make insurance accessible instead forcing my daughter to now be uninsured!

Now, you may be wondering how on earth we got to this point. Let me explain.

Somehow, in the process of dealing with my oldest daughter’s issue, our insurance application was re-run and my youngest daughter was deemed Medicaid eligible. At this point, I believe it’s because the marketplace only had her Social Security survivor benefits listed rather than our entire household income.

I talked to our local Medicaid office, gave them our correct household income and they promptly closed her Medicaid account. This was in June. I talked to a marketplace rep about it and thought that was that. Apparently not.

Unlike the situation with my oldest daughter, the marketplace decided not only to take away my three year-old’s subsidy but her entire coverage as well. They couldn’t even be bothered to notify me of the change either.

Don’t you think I deserved to hear the news from someone other than a pharmacy tech?

When I did try to call the marketplace about my daughter’s case, a rep – who apparently lacks both patience and empathy – hung up on me. However, I do give credit (and thanks) to the Department of Health and Human Services which saw my angry tweet about the situation and called me within an hour. While my daughter is still uninsured as of this writing, I am hopeful they will be able to reinstate her coverage shortly.

Still, I don’t feel like I can remain in a program that makes me jump through such hoops. I am a widow with five kids, an elderly mom and aunt and a full-time job. My life is complicated enough without being stuck in health insurance hell for nine months trying to sort out these two issues.

Plus, despite all I like about Obamacare, I have found two things I don’t:

  • If a child is Medicaid-eligible, the law forces parents to choose Medicaid or lose their subsidy. Why is that? The amount the government provides as a subsidy is far less than what you’d be paying to cover all her medical expenses on Medicaid. I don’t understand this requirement.
  • The marketplace traps you in their plans. My daughter is uninsured and I am ready to bail from the system right now, but I’ve discovered the law prevents me from getting new insurance until open enrollment. I understand insurers need an incentive to participate in the exchange, and this provision provides them with a captive customer base. So I get why we can’t bounce around between insurers, but I don’t understand why I can’t convert my current marketplace policy to a non-subsidy plan at the same insurer. In a country in which the economy is based on the free market, it seems like craziness that I have zero buying options right now.

So that’s it. When open enrollment comes around, I will be leaving the marketplace and buying my own individual health insurance plan for my family.

It’s awfully sweet of you to want to pitch in $200 a month toward my premium, but you’d better keep it. Paying full price for my health insurance is probably cheaper than the therapy I’m going to need if I have to deal with the Health Insurance Marketplace any longer.


A Former Fan

(photo credit)

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