Former ACA success story not so much a success story...

[y4m]

I thought Washington State was one of the ones that was working better than average…  Sounds like it's allowing signups, but then the underlying data is wrong?



Woman cited by President as Obamacare success story frustrated by sign up process


(CNN)– Washington state resident Jessica Sanford was bursting with pride when President Obama mentioned her story during a Rose Garden event on health care reform last month at the White House.

"Who wouldn't?" Sanford asks. "I'm a nobody really to have him mention my story."

Back in October, Sanford had written a letter to the White House to share her good news. The 48-year-old single mother of a teenage son diagnosed with ADHD had just purchased what she considered to be affordable insurance on the Washington state exchange.

"I was ecstatic. I couldn't wait to call the doctor for an appointment on January 2nd," Sanford told CNN about the feeling she had when she first enrolled.

Her heartfelt letter made it to the President's hands and then into his October 21 speech.

"'I was crying the other day when I signed up. So much stress lifted.'" Obama said, reading from Sanford's letter.

The president said Sanford's story was proof, despite the technical problems with the healthcare.gov website, that the Affordable Care Act was working.

"That's what the Affordable Care Act is all about. The point is, the essence of the law - the health insurance that's available to people - is working just fine," Obama said.

But then, after Obama mentioned her story, Sanford started having problems. Sanford said she received another letter informing her the Washington state health exchange had miscalculated her eligibility for a tax credit.

In other words, her monthly insurance bill had shot up from $198 a month (she had initially said $169 a month to the White House but she switched plans) to $280 a month for the same "gold" plan offered by the state exchange.

Sanford said she was frustrated with the state's error. But she decided to purchase the new plan and thought everything was fine.

It wasn't fine. Last week, Sanford received another letter from the Washington state exchange, stating there had been another problem, a "system error" that resulted in some "applicants to qualify for higher than allowed health insurance premium tax credits."

The letter said the state exchange was "disappointed to have discovered this issue" and apologized.

The result was a higher quote, which Sanford said was for $390 per month for a "silver" plan with a higher deductible. Still too expensive

A cheaper "bronze" plan, Sanford said, came in at $324 per month, but also with a high deductible - also not in her budget.

Then another letter from the state exchange with even worse news.

"Your household has been determined eligible for a Federal Tax Credit of $0.00 to help cover the cost of your monthly health insurance premium payments," the latest letter said.

"I had a good cry," Sanford said about her reaction to the latest news from the state.

As a self-employed court reporter, the new quote was simply out of her range.

"This is it. I'm not getting insurance," Sanford told CNN. "That's where it stands right now unless they fix it."

Sanford, an Obama supporter who voted for the president twice, is careful to say she blames the state of Washington's online marketplace for the mixed signals and not the White House.

She is sorry Obama mentioned her during the October 21 speech.

"I feel awful about it. I support (the Affordable Care Act)," Sanford said.

But the messy rollout in the other Washington, the nation's capital, was not far from her mind.

"What the hell? Why is it the same story as the federal government?" Sanford says in disgust with the Washington state exchange. "They didn't have it ready."

"They screwed up," she added.

Sanford reiterated her frustration in a post to the Washington HealthPlanFinder's Facebook page last Friday.

"Wow. You guys really screwed me over," Sanford wrote. "Now I have been priced out and will not be able to afford the plans you offer. But, I get to pay $95 and up for not having health insurance. I am so incredibly disappointed and saddened. You majorly screwed up."

In response, a HealthplanFinder posting tried to direct Sanford to a broker for help.

"Jessica, we are very sad and disappointed that the tax credit miscalculation affected you so heavily," the comment read, suggesting she try to find a new plan on the site. Sanford responded on Facebook the issue was affordability.

Bethany Frey, a spokeswoman for Washington HealthPlanFinder told CNN on Monday night, "I'm already looking into this with our client specialist team. I'll let you know what I hear."

politicalticker.blogs.cnn.com/2013/11/19/woman-cited-by-president-as-obamacare-success-story-frustrated-by-sign-up-process/

[eclaires]

The response from healthplanfinder is hilarious.

"Jessica, we are very sad and disappointed that the tax credit miscalculation affected you so heavily," the comment read, suggesting she try to find a new plan on the site.

[KateAggie]

[Deleted]

[IIOY]

[cookiemdough]

Lol KA is that a dog sniffing another dog's butt??

[ttt]

So wait, she's not eligible for ANY federal tax credits??

[Bad Dingo]

Nov 20, 2013 9:38:14 GMT -5 ttt said:

So wait, she's not eligible for ANY federal tax credits??

If she's not eligible for any tax credits it means that she makes more than 400% of the poverty level (so over $62k).  If she doesn't like what she's seeing on the exchange she can look into individual coverage in the private market.  I think (I could be way off) that the issue with her thinking that she was eligible for a subsidy could have been that if she put in the wrong amount for her annual income and then it was verified through the federal hub she would have initially been told she was receiving a subsidy but then when the accurate info came through from the IRS it was revoked.

[ttt]

So basically her complaint is that the government isn't giving her enough money.

ETA: I do think it's a legit complaint that the website told her she was getting $X but actually she's not. 

[y4m]

This story from IBD has more info:

1. She makes just under $50K as a court reporter
2. Washington State apparently programmed their system to ask for Monthly income, but the federal site was checking against Annual, so everyone who applied from Washington before October 23 got quoted a lower rater than they actually qualified for. So the first letter she got was fixing that.
3. Then she gets another letter for a second screw up in the calculation not detailed in either article. (maybe that was for misreporting her income?)
4. The website also said her kid qualified for state Medicaid, but he doesn't.

news.investors.com/ibd-editorials-obama-care/111913-679855-jessica-sanford-can-not-afford-obamacare-policy.htm

[tef]

[tef]

[y4m]

[ttt]

Nov 20, 2013 10:48:09 GMT -5 y4m said:

This is awesome

[downtoearth]

This is terrible! I guess the only win here is that WA is coordinating with those who signed up A LOT. J/K

So she makes $50,000/yr and doesn't want to spent $3,888 on a bronze plan for health care for herself and her child? That doesn't seem like much to spend annually on health insurance, but I'm not sure what the bronze plans cover - well visits and then they are like a high deductible plan, right? Isn't the penalty either $95 or 1% of your income, so it's still only $500 if/when she goes to the doctor, right? Who fines you? The doctor doing the service?

Sorry for all the questions. I guess I'm still trying to figure out the ACA.

[ttt]

Nov 20, 2013 11:07:30 GMT -5 downtoearth said:

This is terrible! I guess the only win here is that WA is coordinating with those who signed up A LOT. J/K

So she makes $50,000/yr and doesn't want to spent $3,888 on a bronze plan for health care for herself and her child? That doesn't seem like much to spend annually on health insurance, but I'm not sure what the bronze plans cover - well visits and then they are like a high deductible plan, right? Isn't the penalty either $95 or 1% of your income, so it's still only $500 if/when she goes to the doctor, right? Who fines you? The doctor doing the service?

Sorry for all the questions. I guess I'm still trying to figure out the ACA.

For $4,680 a year she can have the silver plan, with a much lower deductible. I mean, that's still a lot of money but it doesn't seem like an obscene amount of money. The average cost of a health insurance plan is $16,000 a year: www.nbcnews.com/health/health-insurance-now-costs-16-000-average-family-6C10960584 

[ESF]

Nov 20, 2013 11:07:30 GMT -5 downtoearth said:

This is terrible! I guess the only win here is that WA is coordinating with those who signed up A LOT. J/K

So she makes $50,000/yr and doesn't want to spent $3,888 on a bronze plan for health care for herself and her child? That doesn't seem like much to spend annually on health insurance, but I'm not sure what the bronze plans cover - well visits and then they are like a high deductible plan, right? Isn't the penalty either $95 or 1% of your income, so it's still only $500 if/when she goes to the doctor, right? Who fines you? The doctor doing the service?

Sorry for all the questions. I guess I'm still trying to figure out the ACA.

This is where I am.  I mean, the Washington State fuckup is ridiculous, so major eyerolls on that.  But I'm not really horrified at the ultimate rates she's being charged.  Are we supposed to be?  They seem reasonable.  

I'm also not bothered by the fact that she's being assessed a penalty for not wanting to pay that amount.  Her choice to be uninsured affects everyone because if she gets rushed to the emergency room and can't pay the five or six figure bill, that cost is born by people who are paying for insurance.

My understanding is that the penalty is assessed when you do your taxes, on your 1090.  

[downtoearth]

Nov 20, 2013 11:11:31 GMT -5 ttt said:

Nov 20, 2013 11:07:30 GMT -5 downtoearth said:

This is terrible! I guess the only win here is that WA is coordinating with those who signed up A LOT. J/K

So she makes $50,000/yr and doesn't want to spent $3,888 on a bronze plan for health care for herself and her child? That doesn't seem like much to spend annually on health insurance, but I'm not sure what the bronze plans cover - well visits and then they are like a high deductible plan, right? Isn't the penalty either $95 or 1% of your income, so it's still only $500 if/when she goes to the doctor, right? Who fines you? The doctor doing the service?

Sorry for all the questions. I guess I'm still trying to figure out the ACA.

For $4,680 a year she can have the silver plan, with a much lower deductible. I mean, that's still a lot of money but it doesn't seem like an obscene amount of money. The average cost of a health insurance plan is $16,000 a year: www.nbcnews.com/health/health-insurance-now-costs-16-000-average-family-6C10960584 

See, that is what I was thinking - it doesn't sound like much, but I guess I have been paying for my kids health insurance for 7+ years now and so it seems reasonable to spend $4k/yr on health insurance. Then again, she might be looking at it that she spends $3k on doctor's visits already, so if she get's this plan for $4k and still has to pay $2k in bills for a crap plan, then she's now doubling what she's used to paying.  I'm not saying that isn't reasonable, just a shock.

I looked at the exchanges and, without any subsidies, I could get a gold plan (100% coverage with no deductible) for the family for $11k/yr.  That seemed like a deal since now our employers pay way more than that and we still add another $3k and our deductible is still $2,500. Can you imagine paying a flat fee of $850/month and just going to the doctor or any hospital for anything and knowing it would cost you nothing?

[KateAggie]