Government health insurance: the ultimate sickness

Sometimes I forget how lucky I am. I have a wonderful job I love that pays me well and keeps me intellectually stimulated. I have health insurance paid, in part, by my employer. It isn’t fabulous, but it gets the job done, and I’m sure that if I ever wound up deathly ill, my family wouldn’t be financially broken.

Sometimes I forget to be grateful.

A friend of mine is an incredible intellect, who unfortunately lost his full-time job last year, and with it his health insurance coverage. The following is his account of his experience with

The website seized up four times, but finally we were able to make our application. We never got to the marketplace, because my salary as a part time adjunct was so low, we automatically qualified for Medicaid.

I want to stress this point. We never got to the marketplace because the system automatically booted us into the Medicaid application for our state. I will come back to this later.

So we got covered. Our kids got covered under Medicaid, and we got covered under Primary Care Network, which is Utah’s iteration of Medicaid.

And, it’s great! As good a coverage as I’ve ever had, low copays, no complaints.

Welcome to ObamaCare. Have a great trip!

Fast-forward to today. We get our 1095 form. It shows that our kids have been covered under Medicaid, which qualifies as full coverage under the ACA, but my wife and I, who have PCN, do not. PCN is apparently only a “limited” plan and does not qualify as full coverage under the ACA. We are now on the hook for penalties going back four months for not having adequate care under the ACA. And the enrollment period ended on Jan 31st, so we will be on the hook for the next year as well. We are talking thousands of dollars here.

This, understandably, sent my wife into a panic and tears. It’s money we don’t have.

I want to re-iterate: we went to the government website, which funneled us to a state website, where we got coverage, and NO ONE informed us that this did not comply with the law or that the coverage for us was not enough under the standards of the law. My wife and I are not dumb bunnies. This wasn’t an oversight. There was simply no way we could have known.

The website was worthless – an endless maze – so we worked the phones. We sat on hold for over an hour, but finally got a hold of a person, who admittedly, was very nice and helpful. We told her our situation, told her we acted in good faith, and wound up here anyway. She told us that since we make so little, we may qualify for an exemption. She gave us the info on how to apply for this exemption through the IRS, what forms to use etc. Part of this application for an exemption requires that we go to and look up and submit what the lowest bronze plan would have cost us.

But now you are probably seeing the first paradox: our income is so low, that the website automatically sent us to the Medicaid site without ever taking us to the exchanges. How do we get there to know what we didn’t know? She doesn’t have an answer.

Now comes the second paradox. Even if we get this exemption, how will we make sure we get adequate coverage in the future? My employment situation is unlikely to change in that time. How can we even get to the exchanges to get a plan we are REQUIRED to have when the website immediately redirects us back to the Medicaid application? Where do we go to buy into a plan we can’t even see because the application process won’t let us see it?

Again, she was very nice, but she didn’t have an answer. She thinks there might be a “tool” to help us on She suggests that we go to and search for “exemptions.” A search for “exemptions” on produces 50 hits, by the way.

Finally she suggested we talk to the local Medicaid office in Utah. Perhaps they can help. Maybe Utah offers a Medicaid benefit plan that has full coverage and qualifies under the ACA. So we do. The person at the Utah Medicaid office is very nice, but told us that there is only one full coverage Medicaid plan and it is basically only offered to invalids. PCN, which is, frankly, very generous (thank you, Utah taxpayers!) is what they offer to most of their clients.

It seems crazy that PCN somehow does not qualify under ACA, but here’s where the story gets surreal.

The person tells us that they have never been told whether or not PCN qualifies under ACA!

Let that sink in for a moment.

The ACA has been law since January, 2010 and been implemented since 2013. Six years in, and the state government Medicaid office STILL does not know if their main Medicaid program complies with the law. They still don’t understand the ACA. This is obviously the root of the confusion.

Is everyone on Medicaid in Utah in violation of the law? Are they all paying penalties or forced to go through the exemption process? Do they even know? The person, who again, is very nice, has no answers. Who does know? Again, no answers.

All of this happened this morning. We have been delivered into a system that is completely opaque, with a curtain of websites and applications processes that are nearly impenetrable, and been left at the mercy of bureaucrats who do not even know the full meaning of the law they expect us to live under.

This simply cannot stand.

insuranceI was speechless when I read this, and I asked if I could blog about it. The above is my friend’s post, unedited, other than small stylistic and grammar changes.

This appalling web of bureaucratic lunacy is brought to you courtesy of the Affordable Care Act. A man and his wife, whose takehome pay is so low right now, they qualify for Medicaid, are now being forced to pay thousands of dollars in penalties they cannot afford for turning to the government to get coverage that is now required by law.

The absurdity would be hilarious if a family’s livelihood wasn’t at stake!

And my friend’s story isn’t the only nightmare Americans have been experiencing. A Facebook page dedicated to ACA horror stories has been created, and the stories are heartbreaking.

FreedomWorks last year did an article of its own, detailing top ObamaCare horror stories, including that of a pastor diagnosed with stage three cancer of the esophagus who was told – just minutes before getting chemotherapy – that his treatment would not be covered.

Meanwhile, the left’s smarmy, arrogant, lying, biased, craptastic excuse for an economist Paul Krugman last year claimed the ObamaCare horror stories were “imaginary” – concocted by those who obviously just are too ignorant to know how FAAAAABULOUS ObamaCare and too stupid to know what’s good for them.

These are real people with real life problems, betrayed by politicians and pundits who couldn’t even begin to understand what it’s like to not know how your next grocery bill will be paid, or what it’s like to lose sleep, because the IRS says you owe them money you don’t have.

My friend’s dilemma is real. Imagine you’re so poor, you automatically qualified for Medicaid, but the state doesn’t offer a plan that meets ACA requirements, except to a few really sick individuals, so you have to buy more insurance… again… because you’re poor. And if you didn’t know you had to buy more insurance, you have to pay again. Because you’re poor.

File this under: Things politicians and the “Elite” couldn’t possibly comprehend.

36 responses

  1. Horrible situation. I hope they get it resolved.

    Personally, being a veteran, I use the VA for my health care. I’ve been very lucky and haven’t had any problems, other than two or three month wait times for primary care appointments.

    Fortunately, the VA does qualify as proper coverage under ACA.


  2. Reblogged this on That Mr. G Guy's Blog and commented:
    ObamaCare at work.


  3. When I was working, I had a 100% HMO with a modest annual deductible and co-pay that literally covered everything. Everything. The premium was split between me and my employer.
    All it takes to completely fuck up something like what I had is an ignorant, arrogant ass who has no understanding of anything more important than what tie to wear with which shirt. And he’s been in charge for 7+ years. He has fucked up everything he’s touched. I will be so glad when he’s gone.
    But cheer up. Howbadismycare can be repealed, you know. Overturned, revoked, etc., and people can get back to ‘normal’, whatever that is. Whether or not that will happen is the question.
    To tell you how completely fucked up Howbadismycare really is, anything I need from the VA that is not service-connected, I must pay for. I don’t have an issue with that, except that my only OTHER coverage is Medicare, and the VA won’t take Medicare as payment. Which means that I have to find a policy that will cover me for what I get at the VA, if I ever decide to go there for anything other than service-connected service. I don’t mind paying for flu shots, and I don’t mind going to my VA, because they have a walk-in clinic.
    Let’s just hope I never have any real problems.


    1. If you are a veteran, unless you make an awful lot of money, medical care is free, although there are significant wait times to see primary care physicians. Prescriptions are only 8 bucks per 30 day supply.( That was good for me because when I was being treated for Liver disease, one of the drugs was 12,000 bucks a month if I had to pay for it out of pocket.)

      Of course, if you have insurance, they want you to use it to pay for some of your care.

      Liked by 1 person

    2. The VA does accept Medicare. There was a time not long ago when it did not.

      Liked by 1 person

  4. It’s not a bug, it’s a feature. It’s working as designed. This isn’t about healthcare, it’s about political power and control.

    I will NEVER vote for a Democrat again after this shit-bomb they foisted upon us. Should one ever walk up to my door to campaign, they will be lucky to be running away from it. It’s quite possible, depending on my mood, that the asshat will be carried away in a rubber bag.


  5. My daughter is barely making ends meet. She’s forced to buy health insurance now and she’s at the borderline for a state plan for herself. Florida will cover her two children, but not her. Working full time and going to school, this has added another layer of stress. In the past, she was able to pay for her yearly exams and her own birth control by going to a local, low cost clinic. A couple hundred a year.

    Now she gets the birth control at no cost (not really, because she’s paying for the insurance to cover it), but she gets the periodic shot instead of the pills. She had reactions to several types of pills. And here’s the catch. The medicine is free but she has to pay $75 for them to administer the shot. That wasn’t covered. And last year her mammogram indicated a shadow that they determined needed a second look. Guess what? The second mammogram wasn’t covered. That cost her another $400 she couldn’t afford. They found nothing the second time, but now she’s out another $475 aside from her monthly insurance payment that’s supposed to make all this stuff “free”.


  6. Obamacare is truly an Orwellian nightmare, and has ruined healthcare for every American. Even if you do not qualify for the exchanges, which we thankfully don’t, it has doubled our premiums and doubled our family’s deductible. Not one penny is covered until we meet the $10k deductible, so basically everything is out of pocket now unless someone gets seriously ill. The folks in the exchanges are in the same boat; they are subsidized with crappy high-deductible insurance. If they couldn’t afford the insurance before, how can they now afford the $5k or $10k deductible??!! Your friend’s situation sounds like a true nightmare. I wish them luck, but ultimately the only solution will be to get out of that system when he finds better employment. It is no wonder our congressmen specifically exempted themselves from Obamacare when it was passed; they wanted no part of it for their families! And it will get worse; many insurance companies have gone out of business, or have at least pulled out of the Obamacare marketplace. Obama is now considering bailouts for the insurance companies. As things get tight they will need to start rationing care, as they do in other broken government healthcare systems like England’s, where cancer survival rates are way below what they currently are in the US. Many people believe Obamacare is so bad that is was deliberately designed to fail, and push us into complete single payor healthcare, as we double down on government failure. I think this may be giving too much credit to the idiots who created this plan, but the end result may be the same.


  7. The sad fact is that even though the Democrats are the ones who rammed this mess through, it is also the Republicans who have allowed it to fester like a boil on the ass of the American people for far too long. In just the latest blunder, although perhaps the biggest, Paul Ryan and company passed a huge budget which could have been held up and forced Obama non-care to at the very least have light shined upon some of it’s more unsavory aspects, which are still to take effect. It is pretty bad when you long for the days when Richard Nixon was in the White House, as a Republican, because he at least was a more honorable man than all of this bunch of RINO’s put together. I am not sure if I am joking or being serious, but I think I am being serious. Too bad for our country. I think the worst part of the entire ACA fiasco is that everyone who is intellectually honest with themselves has to admit that Obamacare is a failure, no matter how you look at it. Designed to fail? Of course. Just like a woman’s nylon stockings are made so they will run. Don’t you think they can make them to not run when torn? Sure, they can, but why would they want to do that? Same thing as ACA, why would they want it to succeed completely, when they just want that camel nose under the tent, so they can rework the act into what they really want? The sorry thing is unless we get a president with some gravitas, they probably will get everything they want and more, because the house and the senate, even with Republican majorities, allow the Dems to control them.


    1. The President outside of signing a bill that repeals Obumfuckcare…matters not a fart in a gale of wind. You need a congress that isn’t filled with petty time servers, graft craftsman, professional race pimps and hookers who will sell that ass to anyone…even a syphilitic crack junkie who just fucked a dying camel and promises to pull out before he ejaculates.

      And people wonder why on my really bad days I say the major mistake the 9/11 terrs made was hitting the wrong target, on the wrong day in the wrong goddamn month.


  8. Being self-employed, or self-unemployed depending on the economy, I must take part in BarryO’s Health Care-less disaster. I elected to buy some non-compliant major medical plan at first, but as the penalties rose I signed up to be both in compliance and minimally insured. They fucked up my birthdate at 1-800-bureaucrat when typo-ing my info in. Guess the rest. I’m pretty much unsure if I’m covered, compliant, or a soon to be felonious scofflaw. My dentist just had to dummy the paperwork with the false date (I was able to determine the dummy-date) in the Gubmint Insuror’s claim system to get paid. I suspect I’m years from getting this cleared up. At least by Gubmint decree I’m 6 months younger. Vote Cruz.

    Liked by 1 person

  9. […] URGENCY OF GETTING HEALTH CARE TO THE POOREST AMONG US LEADS TO THIS: Government health insurance: the ultimate sickness.  And we had to pass it to see what was in it.  We see.  Now can we remove this craptastic mess […]


  10. These poor people are being taxed for being alive. They cannot afford care but have to get it anyway or pay a penalty on a tax for being alive. It is so twilight zone. I am all for getting healthcare to those who need it, but this law is an abomination.

    If repealed the health care mess will still not be fixed but at least you will not be taxed for breathing.

    Liked by 1 person

  11. Please don’t tell me your friend and wife voted for Obama


    1. I very much doubt that


  12. I would fill out the IRS form with all zero’s and add this letter with all documentation from the various health care entities. Do Screen captures. Make copies. Have several. Start looking for a pro bono law firm advocate. Prepare to have them sue the government in a class action suit. If it goes much further with threats and intimidation from the feds….file a RICO.


  13. They need to get their congress-critters involved.


  14. Socialism is the ideology that society will be better when everyone is forced to live at the expense of everyone else.

    When this idea was first floated, about 100 years ago, the public was told that it would force greedy capitalists to pay their workers more. After the utter economic collapse of the Soviet Union, socialists retreated and regrouped. Now we are being told that socialism will make our society more equitable, where we will have less “income inequality”, except of course Beyonce still gets paid millions of dollars


  15. Another sad example of how evil socialism is.


  16. You noticed yesterday that the head of the IRS, Koskinnen, said he had diverted a large part of the IRS customer service last year into Obamacare torment (that is to say, fulfillment)?

    Liked by 1 person

  17. Obamacare was to be a godsend to the poor who were not able to join the health insurance system. I wonder how many understand that the very poor are not eligible for Obamacare subsidies? Subsidies are for those who earn between 100% and 400% of the federal poverty level. Fair enough that those over 400% don’t get subsidies but know that those UNDER the 100% don’t either. So Obamacare created a system in which the poorest Americans are left without health insurance. Sure, they can go buy it still but they get no subsidies. If someone can explain a lack of subsidies because you are too poor I’m all ears. Oh, and you can then go to Medicaid if you are that poor – unless you live in a State that has not adopted Medicaid under Obamacare. In short, the system that was supposed to bring affordable healthcare to the poorest of Americans is set up to make it completely unaffordable to them. Isn’t this the sort of thing that used to happen in the old Soviet Union?


  18. […] on jobs.  Many of us run businesses.  All of us could get ill and need help tomorrow.  (And what one of my friends is going through with health insurance and the unaffordable care act is mind bending and terrifying, and I’m sure he’s not […]


  19. All those horror stories abut NHS care from Britain? Paulie “The Beard” Krugman called those lies, too.


  20. One thing to be aware of and that is that the only way the IRS can actually collect a fine is by taking it out of your tax refund. They cannot assess you. They cannot put a lien on your property. All they can do is withhold the amount from your refund. So, if you have no refund, there is nothing they can do. That was a deliberate choice by Congress. It was not an oversight.


    1. So what you’re saying is that it’s not the same as owing the IRS money because you underpaid your taxes? I’d like to forward some information to my friend, if you have a link. Thanks.


    2. This still hurts the poor somewhat. There were several years that my wife and I were looking forward to our (un)Earned Income Credit. This will disappear if you have to pay non-fine fines…

      (I don’t like taking government handouts, but at the same time, my wife didn’t mind…and I also realized that, even if I’m not paying *income* tax, I’m paying Social Security, FICO, and other taxes, so I figured it was a wash anyway…)


  21. It is important to note that the IRS can only take the ObamaCare penalty from your tax refund. They cannot send you a delinquency notice. They cannot put a lien on your property. They cannot take money from your bank account. If you have no refund coming, they have no way to collect a penalty.

    So, in a case like this, the trick is to owe them a tiny bit of money, but less than would mean a tax penalty.


  22. There is an exemption that specifically addresses their situation.

    How to claim an exemption if you’d have qualified for coverage if your state had expanded Medicaid

    It’s tragic that none of the people your friends spoke with have a brain. It took me about 5 minutes to find this on, although I am a health insurance broker (who’s about done with this POS).


  23. Well I tried to post this previously and it didn’t take. Perhaps the first post is moderated. There is a hardship exemption that addresses this exact scenario:

    How to claim an exemption if you’d have qualified for coverage if your state had expanded Medicaid

    It’s too bad that none of the advisors that this family reached out to were aware of this exemption. It took me 5 minutes to find on


  24. Obamacare is like the Cheshire cat. Pieces of it continue to vanish as time passes. First it was CLASS. Then various mandates came and went. The coops are vanishing, one by one, leaving hundreds of thousands uncovered and doctors and hospitals unpaid. The device tax went and the Cadillac tax is next up. The individual mandate is further out, but it won’t be long.


  25. A big part of “Barrycare” is to win the (voting) loyalty of eh, “illegal amigos”, i.e., the so called “Hispanic community” – in which, many are not American citizens, either legal or illegal immigrants.

    There are so many TENS OF MILLIONS here that the political class inside the Beltway can’t ignore them, especially the Democrats, who covet their votes slavishly – whether or not they are citizens and entitled to vote. lol

    And now Barry is importing his people – the Mohammedans at record speed.

    The goal: Spanish the primary language of the USA, with a mosque in every town, no matter how small.


  26. This is what happens when you “pass it to find out what’s in it”.

    (And yeah, that shrill harpy of Fuckery can’t step in front of a bus a day too soon.)

    Thank the FSM for TriCare. As long as I don’t really have to use it….


  27. […] Government health insurance: the ultimate sickness Sometimes I forget how lucky I am. I have a wonderful job I love that pays me well and keeps me intellectually stimulated. I have health insurance paid, in part, by my employer. It isn’t fabulous, but it gets the job done, and I’m sure that if I ever wound up deathly ill, my family wouldn’t be financially broken. […]


  28. Reblogged this on Spin, strangeness, and charm and commented:
    The Unaffordable Dontcare Act at work. Whatever bad stories you’ve heard about it are wrong. The reality is WORSE.


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