by Lila Bricklin
I campaigned and voted for Barack Obama twice. In 2008 and 2012, Obama used every bit of available technology to get elected, but when it came to his signature piece of legislation — the Affordable Care Act (ACA) — his smarts and technological savvy eluded him.
The implementation of what’s become known as Obamacare is totally dysfunctional. Signed into law in 2010, no public education campaign was ever implemented to inform citizens how the greatest change to U.S. healthcare policy, since Medicare in 1966, was going to work. Its rollout in fall 2013 was a disaster.
One year later, improvements were supposed to right the ship. But then, incorrect 2014 tax information was distributed to about 1 million enrollees in January, 2015, causing massive problems for both consumers and the IRS. I had to file an amended return and only after over three months did I finally receive my refund in early May.
The saga continued in mid-March when many had their tax subsidies reduced due to more mistakes by the federal Marketplace, where the ACA is implemented to states that don’t have their own exchanges (most), resulting in consumers scurrying to reclaim the premiums they were quoted during open enrollment late last year. Mine was reduced $260, making my policy unaffordable after 20 months of being unemployed.
It’s like they changed the rules of the game in the third inning.
Hours, days, weeks and months were devoted to applying, enrolling and maintaining my health insurance and dealing with the IRS, including filing an appeal to the Marketplace and a hearing with their Appeals Center.
The Appeals Center decision in late April only convoluted my situation further, giving me back some of my tax credit but not fully restoring it, so I sought legal counsel from the Pennsylvania Health Law Project (PHLP). How was it possible that my monthly tax credit was less in 2015 when my income was less than it was in 2014 due to extended unemployment?
Did the Marketplace change the formula? The Appeals Center didn’t provide an explanation on how it calculated its decision, but said it was final!
And when I called the Marketplace on April 30 to inform them that I’m now a Medicaid recipient and to terminate my insurance policy, effective May 1, I was told it would take two weeks, and, further, I was responsible for the premium in the interim. The PHLP lawyer informed me that a federal regulation stipulates, “A new Medicaid enrollee should be able to cancel their Marketplace plan immediately.” Otherwise regulations do require two weeks notice.
Then, the Appeals Center called me on May 6 to tell me that my hearing officer thinks she made a mistake and that I may be entitled to additional tax credits. I learned a week later that my monthly tax credit is now more than it was in the first place. Meanwhile, extricating myself from the Marketplace is as difficult as enrolling. So, I contacted Sen. Casey’s Office for help and this time, Casey did not strike out!
I last wrote about accessing healthcare in America in January and concluded, “I wonder what other surprises await.”
Lila Bricklin lives in Mt. Airy