News Americas, NEW YORK, NY, Mon. Feb. 17, 2014: While the White House and Democrats this past week were quick to tout the news that 3.3 million Americans have enrolled in plans in the Affordable Care Act’s health insurance marketplaces since October last year, the reality is that the ACA has become a nightmare for millions of others, including this writer.
As the media, including the New York Times, were quick to repeat the spiel and the White House rolled out celebrities like Lance Bass, Taye Diggs, Kerry Washington, Pharrell Williams and Julia Dreyfus and its own Valerie Jarrett holding up silly signs touting the virtues of a plan they have not signed up for nor need, millions of Americans are in a bind over how to proceed.
Unlike the joke that is the PR stunt, millions of Americans are battling a new reality. They are ineligible for the government expanded Medicaid portion of the ACA but cannot afford the supposed ‘care’ offered in the plans that are so very “good,” even Washington lawmakers have excluded themselves.
Let me be clear – I’m no right winger who hated the ACA or the President. On the contrary, I was all for the ACA and the President until reality kicked me in the teeth and I was told by my insurance carrier that December 31, 2013 would be the last day the self-employed health plan I had, would cover me. So much for the President’s promise that if you like your health care plan you could keep it!
My option I was told was to sign up for the ACA. And so as the Market Place in New York State opened in October, I tried to sign up for the much publicized ACA. But in the nightmare of technical glitches I could not.
So I called the heavily advertised number and was told a paper application would be sent to me because not even the staff at the Exchange could fix my application in the system at the time. About a month later, a paper application arrived and I immediately filled it out and mailed it back to the State.
By December 2013, with no response and a day away from landing back among the uninsured, I tried to complete the online application again. This time at weird hours of the morning and night!
Failing, I decided it was best to create a new application and so I did. This took me to a portion that asked me to upload income verification, which I did. By Dec. 30, still hearing nothing, I called again.
After more than an hour on hold, I was told I needed to submit an income and expenditure account for the past three months. Again I complied. By then December 31, 2013 had come and my health insurance plan was gone with the thrashed confetti that floated down in Times Square once the clock struck midnight.
So in week one of January 2014, I called again and again. After much holding for a live operator, I was told I needed to be patient because there was a backlog in the system on income verifications and I was among the unfortunate suckers.
And so the dance continued, with me calling every week since the beginning of the year, sometimes twice a day in order to get a live person, because the first time around the wait time was simply too much and the automated messages like “You may qualify for health insurance, please stay on the line to get more information; Please stay on the line to determine if you qualify for help with the cost of health insurance. Please continue to hold for more information and Not sure how to apply or purchase health insurance, please stay on the line to get more information,’ were simply too much to bear.
Maybe they were hoping if I stayed on the line on enough I would die of old age before they had to tell me anything.
Finally, sick as a dog in the first week of February of 2014, a day after the State of the Union where ACA was again touted as the greatest thing since slice bread, I decided I needed to stay on the phone until I got some real answers from the New York State Health Exchange. This time I was really upset and asked the woman on the other line whether I will have to die before I got an answer?
Her response was to apologize for what she said was a ‘backlog” and to insist she would kick it up to a supervisor in order for it to be fast tracked in 7-10 days. In 10 days I was sent an email claiming my income did not match the 2012 tax returns. But how could it when I was asked for three months of income and expenditure for 2013?
So I hit the phone again. A good 45 minutes later and months after being on hold because of technical glitches and income verification claims, I was simply told my monthly earnings were above the $1,273 needed to qualify under the new government expanded Medicaid portion of the ACS law.
As such my only option was to sign up for one of the plans. But this is where it gets even ‘uglier.’
The lowest costing plans in the Bronze level in New York State starts at $307 and goes up to $359,87 per month. But here’s where it gets tricky. The lowest is for a new plan called the Health Republic Insurance of New York, a Consumer Operated and Oriented Plan (CO-OP) Option, that has a deductible of $3,000 per year per individual and a 50 percent co-pay on every medical service, including primary care visits, lab tests and hospitalization. The other choices that range between low ranked insurance carriers like Emblem Health, Fidelis and Metro Plus range between $308, $332 and $334 per month, respectively, with the same 50 percent co-pay option.
The highest under the Bronze plan scale is the more renowned Empire Blue Cross Blue Shield with a deductible at $5,800 and a 20 percent co-pay on most services. But now the co-pay before the deductible for the first 2 office visits would be $45, up from $20 on my last insurance plan under Blue Cross, Blue Shield.
That’s an annual cost of over $4,300 plus co-pays on each doctor’s visit that could range between 20 to 50 percent of the doctor or lab fees; costs that can no doubt sink the average American further into debt.
So what’s my next step you ask? The only one I can muster – medical tourism. Fine away Mr. President; the 1 percent or $95 per person per year fine will be much cheaper than the ‘Un’ Affordable Care Act that’s been rammed down our throats under the guise of real health care reform
So much for ‘change we can believe in!’
EDITOR’S NOTE: Felicia Persaud was last seen trying to find a flight to Jamaica, where a sonogram costs US$55 out of pocket compared to US$120 in New York City.