Saturday, October 12, 2013

"Affordable" Care Act?

Hello, my faithful readers (all 3 of you). Just want to take a moment to regale you with my experience (so far) related to the "affordable" care act.

First, the website - virtually useless. After 12 days, I finally have completed the "application" process (although it didn't tell me when I did; I had to log off and back on to find out it had actually completed 5 times). Initially, I created an account, but couldn't log in with it. Eventually, after the site went down for maintenance (a couple days in), I ended up creating a second account, which could log in, but couldn't "verify" my identity (with Experian). I ended up on the phone with an ACA help desk guy who attempted to connect me with an Experian help desk person, but he couldn't figure out how to conference the phone call, and had it where I could hear him and the Experian girl, she could hear him but not me, and he could hear us both. I found it amusing that the Experian rep knew more about what was going on with the servers and the interaction than the rep did.

At any rate, eventually I went back to the first account (a day after another shutdown/fix), which now could log in, and it successfully verified my identity. I then spent the next few days entering my personal/family info. Over, and over, and over, and over... at least seven times I had to reenter the same info since kept forgetting everything I'd entered and forcing me to start over. And the UI for the application process? ridiculous. One to three minutes delay PER PAGE of info, with only one to three questions per page. And having to repeat the same info multiple times within the context of a single application process. Health insurance info - had to enter the same info for each family member, instead of having an option to apply the info to all family members. And the various employers of my family members? A total of four employers, I had to enter the employer info for each employer six times (one per family member). That's 24 separate steps for something that should have been done once in four steps.

Multiple times I contacted the chat help desk, usually with the response, "We have a lot of visitors right now, causing problems accessing the website. You can call the helpdesk to register." Occasionally I would get, "We are having glitches with the website right now, please keep trying." (Once, after successfully completing the application process, and still being unable to see health care options, the help desk chat rep said, "Please call the help desk; they will be able to help you complete your registration or your application" - I'd already told the chat agent that I was past that point - even providing the current URL and error message.) After finally getting the application process completed (without notification while logged in - I had to log out and back in to find out it had actually completed), I went to the "enroll" page to see what health plans would be available, and got a new error there ("General exception while call RetrieveAvailableOperations service"), with no health plan options shown. That's where I currently am on the application process - application completed, no health plan options available for review.

Why am I bothering? Since I already have decent health insurance through BCBSAL? Because I got a notice from BCBSAL that my current plan is being discontinued at the end of 2013, and they will automatically enroll me in a "comparable" plan that meets the new ACA guidelines as of Jan 1, 2014, unless I elect some other course of action. What's that "comparable" plan? Well, it increases my premium, for family coverage for my family of 6, from $553/month to $1080/month while reducing the coverage amounts. Specifically, copays (office visits, ER visits, hospital visits, etc.) and deductibles both increase. So, I'll be paying nearly twice my current rate for lower coverage. Just for fun, I checked the BCBSAL website to see what other plans they offer directly (since I can't get to the marketplace), and the least expensive plan that will be offered, the "bronze" tier, is still over $250/month more than my current plan and is essentially a "zero coverage" plan - it offers 3 office visits at a $40 copay (higher than my current copay), and then you're responsible for 100% until reaching the family deductible of $12,700. I checked the Humana website, the other insurance company that will be available on the marketplace, and their direct offerings are even more expensive than the BCBSAL options. With that in mind, I don't expect to have any great options available on the marketplace (probably not even a government subsidy to help with the increased premiums), but I can't tell you what options might be available since the site doesn't work. Nearly two weeks after it's opened.

Edit: I misread my notice from BCBSAL - actually, the change is from $503 to $1080 just for the health insurance, and the $50 dental rider is being replaced with a $75 dental plan, making the overall change from $553 to $1155, or an extra $602/month.

Fortunately, I do have an insurance option available through my employer. As of yet, I don't know what the cost of that insurance will be in 2014 (the open enrollment at work isn't until November), but I do know that they are no longer covering spouses if the spouse has insurance available at her employer (my wife does not, so will be insurable under my work plan). Why have I not used it before, and was using BCBSAL? Because the insurance option at work is a "high deductible" plan, and, since it's not an Alabama-based plan, the treatment options available to us in Alabama are more limited than what BCBSAL covers (yes, they will cover treatment, but a lot of it will be "out of network" and incur additional cost due to higher copays and non-negotiated rates). For instance, my current dentist is not included in the plan at work, but is included under BCBSAL. At any rate, assuming no major changes in cost of my work-offered plan, hopefully my family's available income will not be too severely impacted by the ACA.

But what if I was self employed instead of working for the company where I work? I'd be facing a major change in either my available income or my health insurance coverage (or both). Or I could elect not to carry insurance, and face a fine by the IRS when filing my 2014 taxes. That penalty is "only" $285 for 2014, but increases in 2015 and 2016 (to $2085) and beyond. Still, might be cheaper to pay the fine and put the remaining money aside to cover medical costs (than to carry the additional cost of BCBSAL insurance).

And what about other people in Alabama? I personally know of the following besides myself (which, I assure you, are all truthful, not hearsay, but I will not disclose who said what in order to maintain their privacy):

  • two people have had their part-time hours cut (in order to pull their hours under the point where the employer would be required to offer insurance under the new ACA regulations)
  • 3 people have their BCBSAL premiums double while offering less coverage (including one who has BCBSAL through an employer)
  • one person whose insurance increased "a lot" (I don't have specifics) with a 33% increase in deductibles
  • one person whose employer-provided BCBSAL "meets guidelines," but no information yet on whether premiums will change
  • one person whose company is likely dropping BCBSAL due to a 40% increase in premiums
  • one person who is on Alabama Medicaid with a BCBSAL supplement, which is "already very expensive," who had the supplement cost increase by $10/month
  • one person who says she will be now able to obtain insurance, although the details of this case are hazy at this point (I'm hoping for clarification)
If you're wanting to see more about increasing premiums in Alabama, check this article.

Also, in case you were wondering, the website cost a lot of money to create (and it doesn't work!), and a large chunk of that money was given to a Canadian software firm, not American software designers.

If you live in Alabama, the "Affordable" Care Act is likely going to cost you. A lot. Sorry, but know this: I didn't do it.


Laudio said...

Hey, your header says this blog offers "a lighthearted look at the world." I'm assuming it means you feel somewhat faint.

I can't think of an actual lighthearted spin on this situation. I wonder how many people have similar scenarios developing.

Tony M said...

Note: as mentioned in the edit, I misread my notice from BCBSAL - actually, the change is from $503 to $1080 just for the health insurance, and the $50 dental rider is being replaced with a $75 dental plan, making the overall change from $553 to $1155, or $602/month.