I am one of the privileged few who has been
able to log on to Healthcare.Gov and complete the process. I even chose a plan.
I am writing this short entry in the hopes that anyone considering signing up
for Obamacare can have an honest evaluation of the process and not have to
depend on what the politicians and talking heads say about it.
I began with the infamous website. The design
of the website was encouraging. It wasn't stiff or overtly bureaucratic as one
might expect a government portal to be. The colors were bright, the images
crisp and modern, and the introductory video helpful in terms of defining what
I could expect from the “marketplace” experience. The video- also draped in
sleek modern graphics- told me that I could expect to compare different plans
in the virtual marketplace; find "clear information” about
prices/benefits; and search for definitions of what medical words like premiums,
deductibles, or co-pays meant.
Every plan- a sweet soothing voice told me- would offer “comprehensive benefits”
and no one could be turned down. It took me about two hours from sign up to
enrollment.
When I arrived at the launch page I immediately
set up an account. The information required was pretty basic and streamlined.
Name, address, phone number, etc. So far, so good.
In terms of who
qualifies? I noticed that there were specific groups that were purposefully
left out, such as undocumented immigrants and incarcerated individuals. I will
not make a judgment of these barriers here, but I do feel it necessary to point
out that this program was not designed for all Americans.
Once I arrived at the privacy statement I
slowed down a bit to read the fine print. Part of the terms and conditions
state that if any of the information I entered, such as income or residency, did
not match the information in the Heatlchare.Gov database[1]
then I would have to provide "proof" of the changes. This proof could
include information from inaccessible bureaucratic labyrinths like the Internal
Revenue Service, Social Security Administration, and Department of Homeland
Security, among several others. I worry about the accessibility of such information
for a large cross section of the population who aren’t used to navigating
government red tape. Even my "Eligibility Notice"-- which is a sort
of what’s next kind of jawn—doesn’t
make it clear how to obtain the information.
After entering my personal information the
website asked me whether I wanted to
enter my income to apply for a tax credit. I find this question to be of
supreme importance for a number of reasons. Firstly, it was an option.
Unless I am mistaken the Affordable Healthcare Act was designed so that folks
who have typically not been able to afford or have access to health
insurance can. Why is it an option? What if I had missed the significance of
the question and pushed "no”? Then none of my potential plans would have
included the subsidy that I qualified for and I consequently would not have known
that the price I was quoted could have been significantly cheaper. Secondly,
the language of the site offered me a "tax credit toward my monthly
premiums". Thankfully, I understand what tax credits and premiums are, but
I do worry about the accessibility of such language to people who aren’t as
familiar with what they mean.
The tax credit itself turned out to be the most
important part of the process for me. I entered my expected income for the year
and was provided with an amount: $2,724. That amount was based on my income and
basically covered the cost of my monthly premium for a year because I live
under the poverty line.
Then I was presented with options for how I would like to receive that tax
credit. Basically, I could either put all or part of the $227/mo. subsidy
toward my monthly premiums or receive it all in one lump sum with my federal
tax refund. The website did offer very helpful color-coded graphics to help
understand these options as well.
I was a little disappointed that I had to
choose how to use my tax credits before
I saw the actual plans. I chose the use
all of it every month option so when I was presented with my options in the
marketplace section my monthly
premiums were $227 less.
When I arrived at the marketplace itself I was
offered a few different options for the types of plans I wanted: bronze,
silver, gold, and platinum. They basically varied in deductibles, out of pocket
maximums, co-pays, etc. I chose silver because I wanted low premiums (monthly
fees) and cheap doctor visits.
When I went to choose my plan the confusion
began. I think the goals of the website were met in terms of presenting my range
of options in plans, providers, and costs, but it did not help explain what
these costs were. My monthly costs and co-payments were clear, but I still
don't quite understand what a deductible is or when I have to pay an out of pocket maximum.
I tried to use the "live chat" option
as well. I was quickly connected to a representative, but it did not prove very
helpful for me. I asked a lot of the same questions that I have presented here:
What is the difference between a deductible and an out of pocket maximum? What
am I going to be billed for? The reps’ answers sounded more like scripted responses
when I could’ve more used a more free flowing dialogue. I finally searched the
website for the definition of a lot of these terms, but again they sounded more
like entries in an textbook for medical billing than a helpful one-stop-shop explanation
of healthcare costs. Again, I imagine that this could get especially difficult
for those not familiar with navigating the Internet or making sense of medical
terms.
In the end I chose a plan that would provide me
with $5 doctor visits, $25 emergency room visits, $4 generic prescription, $10
x-rays, $0 deductible (whatever the hell that means), and a $2,250 out of
pocket maximum (see: Previous Parenthesis) for $0.13/mo. thanks to the $227/mo.
subsidy/tax credit for which I qualified. My Eligibility Notice said that I am still required to send proof of
my income to the Health Insurance Marketplace before I can be approved. It's
not a done deal yet, but I am hopeful.
Overall, I am satisfied with my experience of Obamacare and
Healthcare.Gov, but I am not sure that it quite meets its stated goals. I am a
young College-educated person who is familiar with the Internet, kind of knows
some health insurance lingo, and can easily access information from government
records. However, it seems to me that the rhetoric of Obamacare has been that
it will offer millions of Americans easy access to health coverage for the first
time. It is easy, but it’s not that easy.
If I did not have the education I have then I may have had some trouble
navigating the bureaucracy and language.
UPDATE 12/5: After a bit of searching I finally found the submit proof of your income portal. Again, the live chat option was no help at all, but after a bit of digging around my profile I finally found it. I uploaded a pay stub electronically. It was relatively simplae and there are a myriad of options for the type of documents that are accepted. All that should be left now is the insurance company contacting me. I'll update everyone when I have news.
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