No? Did You Say No? Thank You!


February 11th.  The young family applied for health insurance on the government’s exchange on February 11, 2014.  It was a frustrating experience that resulted in the young husband and his child being invited to apply for health insurance.  They were even offered financial assistance.  The 22 year old mom?  The feds thought that she’d be better off with Medicaid.

We tried to fix this.  No luck.  Nothing could be done about this error until the State of Ohio reviewed her case and ruled that she was not eligible for Medicaid.  We applied for the subsidized health policy for the father and son.  We kept the woman on her existing coverage.

The notice was dated Sunday, May 4, 2014.  Ohio, swamped with over 300,000 new Medicaid enrollments since last fall, finally got to my client’s paperwork and declined her.   She is now officially eligible for the subsidized health insurance that she should have been able to purchase months ago.

No, for once, is the answer you want to hear. 

My clients are responsible people who have always had insurance and always will.  They found a way to put the monthly premium into their budget.  But what if they couldn’t?  This is a huge problem that has not been resolved.  I am still having clients incorrectly shipped off to Medicaid.  And what if the client has any ongoing health or financial problems?  Then he is screwed.

In the last month I have had numerous conversations with CMS and federal exchange employees, Senator Brown’s staff, and our elected officials in Columbus.  Our main topic was how to make The Patient Protection and Affordable Care Act (PPACA) work better.  Some of what I’ve learned was told to me in whispers.  Some of what I’ve learned from experience has been grudgingly confirmed.  And of course, there are glitches and problems that no one will acknowledge.

  • works best when using all capital letters and your Chrome browser.
  • Do not show a husband and wife earning the same exact monthly income.  It throws the system.
  • has a big problem with large families.
  • Ditto newborns.
  • Unofficially, part of’s problem is that there was this assumption that it would be serving the uninsured.  The government’s exchange defaults to Medicaid.  You must qualify OUT of total assistance to earn a subsidy.
  • Undertrained, unprepared, and overworked, the call center workers shouldered a huge part of the burden.  They are now fielding fewer, but more intense calls.  Sitting in a cubicle, forbidden to use paper or pen to take notes, and unable to email for help, the call center assisters are totally overwhelmed by service issues.  I have talked with veterans (8 months!) who are willing to try trial and error to solve problems.  I’ve also had them hang up on me.

This is my work environment.  The State of Ohio has just about cleared its back log of Medicaid applicants.  Many of our citizens have recently learned that they will now have access to the health care that they need.

And a few of my clients will get the letter they really want.  They will be declined for Medicaid and will now be able to buy an affordable policy.

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One Response to No? Did You Say No? Thank You!

  1. Michael J. Saltzman says:

    I once worked in a kitchen cubicle and I was forbidden to take notes, follow recipes or ask for help. Nothing ever came out the same. I quickly learned what the word “uneven” meant. The food was affordable and no one complained. No one blamed the previous owner nor the current owner of the cafe. It was called the student union and everyone had to pay dues.
    Aside to David: If you ever turn your Blog Posts into a book, please give me a mention as your inspiration.

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