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 healthcare.gov.
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.
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 Healthcare.gov 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 healthcare.gov. She suggests that we go to Healthcare.gov and search for “exemptions.” A search for “exemptions” on Healthcare.gov 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.
I 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.
I apologize – I should have blogged about this earlier, but between my business trips and jetlag, I have dropped the ball. A week ago, a fellow Johns Hopkins alum and public heath professional Vik Khanna penned an essay that gave some doctors and other health professionals a bit of heartburn, because unlike many health professionals, Vik actually understands and appreciates firearms and the right to keep and bear arms.
In his essay, Vik addressed the so-called “gun problem” from a health care perspective, advocating for public education, training, and giving gun owners the benefit of the doubt that they are, for the most part, responsible, peaceable citizens. He was respectful, and he linked to credible studies and statistics to bolster his view.
Interestingly, and perhaps unintentionally, Vik also predicted pretty accurately what the response from the medical community would be to his essay.
Ironically, public health academics happily assert that there is a clear Constitutional right to privacy, even as they vilify a right that is actually expressed in the document, and they merrily condescend to its adherents, whom they regard as pathetic rubes.
Enter this arrogant, fat fuck.
Meet Art Caplan, MD. Art heads the bioethics program at the University of Pennsylvania, but judging from his snide, sarcastic, arrogant writing, he doesn’t know a whole lot about actual ethics, human interaction, or effective, respectful communication.
Instead of refuting any actual facts in Vik’s essay, Art simply proceeded to sneer out a “you’re a paranoid gun nut” reply, and in the process showed his absolute ignorance not just about firearms, but about current technologies, training opportunities, and laws.
Vik, buddy, no one and especially the roughly 28 folks in public health not completely distracted by their lack of funding and inability to secure tenure is capable of doing anything that will pry your gun from your warm-blooded grip. There is no political movement to take away anyone’s guns. The NRA is the mightiest lobbying outfit in these United States and the best Mike Bloomberg or Bill Gates are going to be able to do is to get the anti-gun lobby a few more op-eds and soundbites.
See that? No one wants to take your guns away. You’re paranoid. And by the way, GIVE US MORE MONEY!
My reply to Art’s patronizing gibberish is below. I also posted it in the comments section. The bolded text is my additional comments added in this blog post. I wonder how long it will last before it’s deleted…
Wow… condescending jerk much?
Someone offers an alternative view to your “kale crunching, fitbit wearing hordes of public health types” who cannot help but hysterically ascribe human traits to an inanimate object, and you have to come back with snide derision?
To be sure, Art, “buddy,” no you are not capable of prying anyone’s guns from their warm blooded grip. But make no mistake – when you “public health types” parade your medical authority as credibility on the gun issue, people who genuflect at the altar of your so-called “eruditeness,” will cite you as authorities on the issue.
So, to refute some of your histrionics…
1) Carnage is not CAUSED by guns. We analysts understand that using the passive voice in this manner serves those with an agenda well to obfuscate the problem. If you can’t determine the culprit, you will focus on the tool. The carnage is caused by criminals, and those who are ignorant and irresponsible on the proper handling of firearms.
2) “There is no political movement to take away anyone’s guns.” – Actually, you’re wrong there. There was a federal assault weapons BAN, which, even by the New York Times’ own admission, served merely to ban cosmetic features that had nothing to do with actual fatality rates. Until very recently guns were BANNED in certain cities such as Washington DC, and in many other locales, you have to ask permission from sometimes unwilling government authorities to exercise your basic right to keep and bear arms.
3) “Do public health folks have anything to offer that might reduce the mayhem while letting you hunt deer or shoot partridge or blast targets or whatever it is you and your son like to do with your guns?” — The Second Amendment is not about hunting, Art, “Buddy.” If you have any doubt about this, you should read the documents written by the men who founded this nation. (I would refer Art to Federalist 28, and this passage in particular: If the representatives of the people betray their constituents, there is then no resource left but in the exertion of that original right of self-defense which is paramount to all positive forms of government, and which against the usurpations of the national rulers, may be exerted with infinitely better prospect of success than against those of the rulers of an individual state. In a single state, if the persons intrusted with supreme power become usurpers, the different parcels, subdivisions, or districts of which it consists, having no distinct government in each, can take no regular measures for defense. The citizens must rush tumultuously to arms, without concert, without system, without resource; except in their courage and despair.)
4) “How about encouraging doctors, ministers, sporting goods salespeople and other community leaders to learn about and then talk about gun safety?” — The key here is LEARN about gun safety. Most doctors and other public health professionals with whom I have spoken don’t know which way the business end of a rifle points. When you learn the intricacies of using these tools, I might give some credibility to you when you discuss them. Otherwise, it’s much like turning to your plumber for a vasectomy. It might be cheaper, but I don’t recommend it.
5) “How about greater efforts to get gun owners to lock up their guns and ammo properly.” — Do tell me about proper storage for a tool of self defense, Art “Buddy.” Tell me how long it takes to unlock your pistol and load it during a home invasion. Have you ever experienced such an event in your safe, lily-white community? Didn’t think so.
6) “How’s about getting hunters to wear the right high-visibility gear.” — I’m all for it, but much like with seat belts, there are some folks who just don’t wear it, and won’t. You going to fine them? Throw them in jail for violation of safety rules?
7) “Is there any merit to making guns safer including ‘smart’ guns?” — The fact that you even ask that question shows your ignorance on the issue. There has been plenty of discussion on the topic, and there are some serious safety concerns with your “smart guns.” Until you get properly educated and informed on the topic, you have no credibility to speak on the matter, and yet here you are, hiding behind your “medical professional” shield and bloviating about things you obviously know nothing about. (There’s a good article in Forbes magazine on smart gun technology you should probably read, if you haven’t already)
8) “Can we teach people to call the cops when they know there is a gun in the house of someone who is mentally ill or under a restraining order?” Oh, so everyone is now a mental health professional? Everyone knows who is under an RO, or are we relying on ESP to tell us when is a good time to report your neighbor?
9) “A little training for kids about what to do if they find a gun?” – It’s called Eddie the Eagle. Look it up, “buddy.”
In other words, Art. You obviously have no credibility on this issue, and your little sneering note toward Mr. Khanna shows you to be a supercilious, arrogant wad.
Have a nice day.
Hey, I didn’t even curse. Are you proud of me?
Word is that there have been some consequences from the recent story about the VA’s obscene secret waiting list that resulted in veterans waiting months for appointments and dying in the process. Commenter Ole’Wolf has more:
Ms. Nicki -word just came down that the Quadrad was fired at the Phoenix VA Medical Center. Washington VA Central Office terminated the Director, Associate Director, Chief of Staff (senior Doctor), and the Associate Director for Nursing Services (senior Nurse) as the facility leaders. Good news, they’re gone. Better news, termination means no more Gubmint jobs for these career bureaucrats…bad news, I doubt seriously anything more will come of it. Families have started suing the VA but no word on direct lawsuits aimed at any of the key morons…
I sincerely hope that the director, associate director and anyone else responsible for this travesty see direct repercussions from this. I hope there’s jail time involved for all. Fraud is not a laughing matter. Fraud that results in the deaths of veterans to whom care was due is an abomination.
You know what uninformed votes get you?
The schadenfreudisaster that is the “Affordable” Care Act continues to screw Americans across the land, and those who were “cheerleaders” for the plan, such as these lying douchenuggets about whom I blogged a few weeks ago, are beginning to realize that rich people won’t be paying for their “free” health care. They ARE the rich people!
But… but… but… we thought others would pay for us! We didn’t think it would affect us! We’re not rich!
“I really don’t like the Republican tactics, but at least now I can understand why they are so pissed about this. When you take $10,000 out of my family’s pocket each year, that’s otherwise disposable income or retirement savings that will not be going into our local economy.”
Well, I have news for you, Cupcake – you are rich. You’re rich compared to those who spend generations on welfare. You’re rich compared to those who work only part time, but are required to buy health insurance anyway and will be subsidized with your money. You’re rich compared to all those who screech for free crap as a way to avoid working hard, advancing, going to school, learning a trade, and instead demand you, the taxpayer, foot the bill for their expenses.
Oh, you can’t afford it? That’s too bad. You’ve made your bed. Now lie in it!
“I’ve been a cheerleader for the Affordable Care Act since I heard about it and I assumed that it was designed for people in my situation,” Holly, a freelance yoga instructor, told KOIN. “I was planning on using the Affordable Care Act and I had done the online calculator in advance to make sure I was going to be able to afford it.”
Holly’s husband works for a non-profit organization that pays for his health care, but the couple is unable to afford to have her and their son covered under his plan. And she’s been told their combined income is too much to qualify for a subsidized health care plan under Cover Oregon.
“It wasn’t until I started the process and got an agent that I started hearing from them I wasn’t going to qualify for subsidies because I qualify on my husband’s insurance,” she told KOIN.
Now, before anyone starts screeching about how heartless I am, and about how I’m cackling with glee at people losing health care, I’m not. I hate the fact that our health care system – a system that wasn’t perfect, but that at least afforded the vast majority of Americans a decent chance at health care, is now booting millions out of their insurance companies, turning patients away from hospitals and leaving cancer patients with little to no hope.
All because the politicians in Washington wanted to appease those who would continue to vote for them as long as the freebies kept coming. All the Sandra Flukes out there, who demanded free access to contraception at others’ expense. All the leeches and moochers out there who demanded that others provide for them. And instead of fixing the problems, they created a multi-thousand page monstrosity, we had to pass to figure out.
And those who cheered and rejoiced at this ruinous legislation being signed into law are now reaping the consequences of their actions.
What they don’t understand is that when the vultures have picked dry the carcasses of the so-called “rich,” because they have nothing left to give, they become the next “rich” source of sustenance.
What they don’t understand is that there’s no such thing as being entitled to other people’s achievements, labor and earnings. That’s the clarion call of a thief.
What they don’t understand is that there ain’t no such thing as a free lunch.