We interrupt the ongoing saga of R.S., the client who magically received the retroactive insurance policy, to bring you an important warning. It appears that I have found the one thing you can do as a consumer that will absolutely tilt the out-of-balance pinball machine that is Healthcare.gov.
Do Not Have A Baby
One of the hallmarks of the Patient Protection and Affordable Care Act (PPACA) is that maternity coverage is built into all of the policies. We now cover maternity the same as any other illness. The deep thinkers in Washington inserted coverage for contraceptives and for pregnancy. They just are totally unprepared for the results of a successful pregnancy. The perfect Obamacare pregnancy lasts 78 trimesters!
I have had two clients attempt to add newborns to the government’s exchange. Remember, the policies purchased through the exchange are just like policies purchased directly from the insurance companies. By taking you through the exchange I may be able to get you a subsidy. The trade-off was that you gave the government a lot of personal information and the government helped pay for your insurance premium and possibly even some of your deductible. Since it is pretty clear that the government already has access to all of this information, why not take the money?
What we didn’t know was that we were also adding the government’s inept bureaucracy into every little transaction.
Adding a newborn to his/her parent’s policy was one of the easiest and most positive tasks I had as an insurance agent in the old days (prior to January 1, 2014). The process was nothing more than a quick signature on the form that showed the child’s name and date of birth. Couldn’t have been easier. But any change, ANY CHANGE, on the exchange requires a whole new application. You may remember that ridiculous series of questions about whether or not you were a US citizen and what ethnic heritage you chose to acknowledge. And of course you also had the opportunity to verify that each of your children were not only your children but the actual brothers and/or sisters of your other children. This mind numbing experience is also a mine field. Every single entry is the portal to another site crash. On a perfect day, with a tiny family, this may take only an hour.
But not every family is tiny. And there are no perfect days with healthcare.gov.
The client and I thought that this was going to be a simple process. After all, the exchange had plenty of time to prepare for the Special Enrollment Period that began in earnest when the Open Enrollment Period ended. He thought that it would take 10 minutes. I guessed an hour. After an hour and a half, I had not only failed to add the baby to the policy, I had also lost the subsidy for the mother. Yes, the exchange had sent another woman to Medicaid even though her income was nowhere near the required amount.
Both the client and I had had enough for one day. We got back together at his office this morning. We began the process at 11 AM. Two representatives, two specialists, and three documented system failures later, we were told that there was nothing else we could do today. It was exactly 2:30 PM. I had been chained to the phone and computer in his office for three and a half hours. The client’s wife is no longer being shipped out to Medicaid. Our problem, the government’s inability to simply add a newborn, has now been “escalated” (official term!). The client has been promised a call in 3 – 5 business days from a different office.
The baby is still not covered.
What once took moments may now require an act of Congress.
DAVE