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Our Less-Than-Excellent ACA Adventure

Mrs. Tiger and I are Affordable Care Act outliers. We can afford to pay more for lousier coverage. And we’re selfish and whiny, and repeating Republican talking points to boot. At least that’s how the pro-ACA cheerleaders characterize us.

Perhaps they’ve had better luck with ACA than we have.

For more than 30 years, we’ve been insured by Blue Cross and Blue Shield of Michigan. The plan is called Traditional Blue. I’ll refer to it as True Blue. It costs quite a bit, and being self-employed, we’ve had to pay for it out of our own pocket. However, True Blue hardly fits the definition of “junk.” There is no deductible, the maximum out-of-pocket is $1,000 per year, and there’s no distinction between in-network and out-of-network providers. True Blue paid the proverbial lion’s share of the cost of my skin cancer surgery, which took place last year at a well-respected local hospital system.

Good thing I had my diagnosis when I did. I should have scheduled a heart attack for that year as well.

Several months ago, the Blues notified us that True Blue would terminate at the end of the year. They blamed the ACA for having to make that decision. The ACA-compliant replacement policy the Blues offered us has a $12,000 deductible, twice that amount for out-of-network coverage. I’ll refer to that policy as Blue Very Light.

The Blues’ decision left us with three alternatives:

(1) Use the handy, postage-paid envelope the Blues provided us, sign up for Blue Very Light, and cross our fingers that we don’t get sick next year. Did I mention that I’m 62 and Mrs. Tiger is 57?
(2) Call the friendly folks at the Blues, buy a policy other than Blue Very Light (e.g., the top-of-the line Royal Blue), pay a substantially higher premium, and face substantially higher co-pays and deductibles.
(3) Go on the website and buy coverage there. Just like the attractive young actors in those obnoxious “I’m covered!” commercials.

We chose door number (3) because now that we’re edging into retirement, we’re eligible for an ACA premium tax credit. (Aside: Mrs. Tiger discovered that the credit gets bigger if you don’t apply all it immediately to your premiums. This makes absolutely no sense. However, Mrs. Tiger read the IRS rules concerning the credit, all 24 pages of them, and found out that this is indeed a feature, not a bug.)

To put it mildly, our experience with the website, which I’ve taken to calling, has been a nightmare. Actually, it’s been worse; nightmares are limited in duration.

So far, Mrs. Tiger has spent 60 hours–and counting–on HealthKludge in an effort to set up an account and shop for coverage. She has experienced numerous and serious technical problems with the website. The site’s chat function is worthless, and people staffing the exchanges’ 800 number are unable to resolve problems. At least no one has sent malware to her computer or redirected her to porn sites.

Contrary to the propaganda from the Department of Health and Human Services, the problems with the website aren’t being resolved. If anything, they’re becoming more intractable. The excuses and reassurances the people at and DHHS offer beleaguered users are laughable. No Amazon or Kayak customer would put up with this.

The problems with shopping for coverage on the exchanges don’t end with the website. To begin with, the policies on the exchanges are awful. Even at the Silver level, they carry substantially higher premiums, and have much bigger deductibles, than True Blue. They also have narrower networks of providers–an important consideration because uncovered out-of-network bills can send you straight to bankruptcy court.

Despite the importance of knowing who’s in network, HealthKludge doesn’t give you that information. And the insurance companies don’t seem eager to tell you who’s a particular plan’s network. (Yes, networks vary from plan to plan.) The friendly lady at the Blues told Mrs. Tiger to buy a policy, then the Blues would tell us who’s in-network. Buy now, pay later.

As of this evening, here’s how things stand. We’re still plowing through the Blues’ website to figure out who’s in-network. HealthKludge won’t process our request for a subsidy or let us buy insurance because of an abstruse error message. Twice last week, Mrs. Tiger reported it on HealthKludge’s 800 number. Both times, the friendly HealthKludge lady told her to “try again.” She did. As of this hour, the error message is still there. And the clock continues to tick on our current policy.

The ACA cheering section asks us not to judge the law by the botched rollout of HealthKludge. I beg to differ. HealthKludge epitomizes everything wrong with the law. It grafts an unfriendly government bureaucracy (and whose bright idea was it to put credit reporting agencies in the loop?) on top of an even unfriendlier insurance bureaucracy. It mires customers in a war of attrition with insurers. And, contrary to what ACA stands for, it doesn’t make care more affordable.

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Tammany Tiger

Tammany Tiger