The state, as multiple news
stories attest, even drops a ball impacting Medicaid signup
Subsections below:
What I found in inquiring about my own application
Four phone calls a charm?
Recent news about another loss of an opportunity by the state
Addendum, regarding a column by Michael Reagan: “Trickle down” is back
[Edit 2/24/14. Edits 3/13/14. Edit 3/18/14.]
First, here is part of what I
said in Part 1, to orient you:
I don’t really
want to go into a lot of depth about my small part in the signup under the
Affordable Care Act. I did go on the federal “marketplace” Web site in December
(I’m in New Jersey,
and we don’t have a state site for this). I filled out the application in what
seemed for me the right way. And I haven’t heard or gotten anything since: no
e-mail, and no letter or application package in the mail. (There was a
perfunctory pdf of a letter that came at the end of the process of applying on
the federal site. It was slightly erratic, stuffed with various info, and
overall not too bad.)
What I found in inquiring about my own application
Now, what I found out within recent
weeks is, let’s say, consistent with my personal assessment that the Affordable
Care Act is the worst piece of federal legislation, which has the effect on me
(and everyone else) that it does, that I have seen in my lifetime. (And I say
this as a Democrat who has voted for a Democrat for president in every election
since 1984, and did not vote for Reagan in 1980 but voted for Anderson, and if
I could have done it over, would have voted for Carter.)
Another “bottom line” is more
constructive: In absence of my having health insurance through this program
(assuming my Medicaid coverage doesn’t come through), with my family’s history
of heart disease, at least I can count on the following measures, which are
also pretty cheap: eating a salad every day, and taking regular aspirin every
day. They also say laughter is the best medicine, and I can get causes for
this; but the ACA is not among them.
Anyway, I first, on February 14,
went on the federal marketplace Web site and signed in to my account. It said
my application is “complete” and gave an ID number. But when I clicked on a
link that said “Find my application,” I got a message saying “File not found,”
or such.
Next idea was to talk to someone
at the 800 number given, by the letter pdf that had accompanied the initial
filing of my application in December, and try to talk to someone there. This is
the number for the office for NJ [New Jersey] FamilyCare, which administers
Medicaid applications in the state.
Four phone calls a charm?
On February 18, I phoned no
fewer than four times in a row. In their system, you press different options
offered on the phone, which are not
numbered consecutively and, well…
On the first call, I got to a message giving some general information
regarding NJ FamilyCare, and then you get options, including a #2 (I won’t list
all buttons I pressed, in this
overall account), which when I pressed it led to an impersonal phone-company
type message, “Your call cannot be completed as dialed,” and then a sound as if
I was disconnected, or close to it.
Second call: I got to an option (another #2) which would allow me “to
apply or…” and when I pressed this, and heard options, one of which was “to
talk to….” I pressed this option, and got “…Your call cannot be completed as
dialed.”
Third call: I pressed another series of options, and got to where I
actually was told (mechanically) a policy number for my own “household.” I
wrote this number down; I even got a phone-option chance to hear the number
again. Then when I tried to go to another option giving info on application
status, I heard a message, “This option is currently not available to you.”
Fourth call: I tried to press options including for what I could
find out about an “ongoing application,” and I got an option where I could
enter my policy number and my ZIP code for verification. Then I heard something
I heard on the previous call: “This option is currently not available to you.”
So—I found there is a policy
number for my case. But I can’t get any information on it. (And certainly I’ve
never received anything in the mail, even an invitation to appear in a county
social services office to further proceed through the application in a more
formal capacity, showing proof of x, y, z, etc., as some of the
Medicaid-related boilerplate I’ve seen seems to suggest the state office needs
to see.)
On February 18, I gave up,
confident—in having done what I could at this point. I also knew, as I’d
considered for months, that I could always pay the $95 penalty on my 1040 form that
is filed in 2015 (for tax year 2014), regarding whether I’d gotten insurance
per the ACA. [Update 3/13/14: Yesterday, I tried the NJ FamilyCare number again; after trying the options (apparently from the same broader array of options) that were most suitable to my situation, I got the same result as with the "Fourth call" description given above. I also found that the general info stated at the beginning of the call included the note that, due to the tremendous volume of calls, a caller may end up encountering a message that said that the call was disconnected, or such. Lastly, today The Star-Ledger, the main newspaper of New Jersey, had an article on the hideously huge backlog of ACA cases--and consumers' lacking something in hand--on both the level of private insurance and the level of the Medicaid expansion (the NJ FamilyCare route).]
One test of good government is
the confidence it gives you.
Recent news about another loss of an opportunity by the state
Strangely to me, the state
newspaper, and even local newspapers, have not been covering the deficient
Medicaid-application situation under the ACA. It’s not for lack of people this
is relevant to; a recent report there were tens of thousands (was it?) who
signed up for ACA Medicaid-extension coverage in the state. But where, when,
were all these people processed? Did they get by now a Medicaid card showing
they were in the system? Or were the statistics merely reported by some
federal-level or general state-level entity who reported only the number of
people whose info from the federal ACA Web site were transferred over to the
state, without the applications fully being processed yet? On the evidence of
what I’ve found through numerous phone calls, on January 6 and February 18
(especially the latter), I find it hard to believe the state even processed hundreds of people, never mind
thousands, if their phone system, which can’t even give me the status of my
policy, is so rinky-dink.
Recent news seems to support my
skeptical view.
On Friday, February 21, it was
reported in the state’s Star-Ledger
(pg. 22) that the state was at risk of losing a grant of federal money that was
received in 2012 tied to the original issue of whether the state would set up
its own marketplace Web site (which it, of course, did not do). The $7.6
million grant was subject to the state’s submitting a subsequent plan for how
it would use the money, in absence of erecting a state marketplace site.
As it happened, the state
submitted a proposal, but this was not accepted by the federal department of
Health and Human Services. State Insurance Commissioner Ken Kobylowski,
according to the Star-Ledger article,
had “asked to use the majority of funds, or $4.86 million, to staff the NJ
FamilyCare hotline for state Medicaid recipients that he said has faced an
‘unprecedented rate’ of calls about the health care law.”
That sounds like calls from such
people as myself. Except multiplied thousands of times.
So I wasn’t just finding a fluke
tied uniquely to me, in having a totally deficient “phone experience” on
February 18.
The state did not submit another
plan, after HHS had rejected its plan with the FamilyCare component. The
February 21 news article suggested the deadline was approaching and the
Christie Administration was on the brink of missing it.
And it missed it.
Headline in the next issue of The Star-Ledger (February 22, pg. 3):
“State loses federal health care grant worth $7.6 million.”
Lead paragraph: “New Jersey has been
stripped of a $7.6 million grant toward a health insurance overhaul after Gov.
Chris Christie’s administration failed to submit a plan for using the money to
steer uninsured residents to health plans, federal health officials said in a
statement yesterday.”
I think, as far as I read the
situation that I have approached “journalistically” from direct and indirect
angles, the largest problem represented by loss of the $7.6 million is proper administration of the Medicaid
component of the ACA in this state. And this implies not merely state
employees’ answering frivolous informational questions but properly processing
the applications.
Now NJ FamilyCare also helps the
poor (but not too poor) to sign up
for private insurance, if they can
afford it (though, under the ACA, depending on income level, there would be
federal subsidies). There already was a
working Web site (under NJ FamilyCare) for
this in the state last fall, which I encountered, and which I found
decidedly didn’t square with my needs as someone who needed to sign up for Medicaid under the ACA’s Medicaid-expansion
component.
Clarification
on a point, from the get-go: Someone writing in the letters to the
editor section of the February 23 New
Jersey Sunday Herald relates a personal story of difficulty she found in
signing up for individual insurance through what was apparently the NJ
FamilyCare program. She speaks about starting to enroll in private insurance,
and found subsequently, among other disappointing features, that she was
disallowed under her new plan to see her doctor in what had been her old
network or arrangement. This is a typical consequence of Obamacare (not that
individuals don’t have a right to complain about it). And her story is worth
presenting in general, because with a federal program like this, as much as
sundry public figures (media professionals or not) promote it, the major flaws
in the ACA—so important to heed (to judge the soundness of the legislation)—are
revealed in the stories of disserved individuals. Anyway, I think this woman is
mistaken on one point: she talks about her private plan being a version of
Medicaid, apparently due to federal subsidies involved. Whether she meant this
metaphorically or not, I don’t know. Important:
PRIVATE PLANS THAT ARE PARTLY SUBSIDIZED ARE NOT FORMS OF MEDICAID. Medicaid is
very much an all-government-subsidized plan, and a bare-bones one at that, for
the poorest citizens. (This also limits quite a bit how useful it is, in
getting acceptance from health-care professionals for care.) IT IS IMPORTANT TO
UNDERSTAND THIS DISTINCTION SO THAT WHEN WE SAY THE NJ FamilyCare SERVICE IS
FUMBLING WITH SIGNUPS FOR MEDICAID,
IT IS FUMBLING WITH THIS PROGRAM AND
NOT WITH THE PRIVATE PLANS, which NJ FamilyCare was apparently working smoothly
with last fall, unlike with the Medicaid-expansion signups.
I’m sure a lot of poor who need Medicaid and could have benefited from
the ACA-directed signup for it will find this situation a kick in the ass.
Maybe we all will find our applications processed, in dribs and drabs, by the
summer. (And this state’s loss of filing an application properly for the $7.6
million grant pales compared to the many-multi-million dollar opportunity lost
by the state, of 2011 [I think], in failing to properly fill out an application
for qualifying for federal educational aid, or whatever it was.)
Myself—and I will outline my
thoughts on this a little further in the subsection below, on Michael Reagan—I
am not terribly concerned about signing up for Medicaid this year. I have
thought on this numerous times, and as someone who has paid for his own health
care the vast majority of the time as an adult, and rarely having insurance
(from an employer or not), I will not feel heartbroken over not getting
Medicaid this year. And if in fact my application is not processed in 2014, I
will look into the matter again with the next open-enrollment period in the
fall. Further, the penalty for not signing up this year is only $95 (more thoughts on which are offered below).
The irony of all this is, with
Medicaid, you’re supposed to requalify every year anyway, though I’m sure
subsequent reviews for this aren’t as complex as the initial signup and requisite
review of your case.
But if I find the NJ FamilyCare
system’s ability to accept Medicaid applications to be a slovenly mess next
fall, then I will really feel this ACA thing is a total disaster, not just at
federal hands, but at the Christie Administration’s hands, too. (This is
assuming I try to sign up again in New Jersey.)
I hope to say no more about this
ACA situation on this blog, but we’ll see what arises, whether in my life or in
the newspaper.
Addendum, regarding a column by Michael Reagan: “Trickle down” is back
I read in a local paper (not The Star-Ledger), which has a generally
conservative editorial slant, a subscription-service editorial column by
Michael Reagan, on the ACA. He proposes the gripe, becoming common among
conservatives now, that the ACA is lamentable because it is allowing people
“not to work” and meanwhile to collect health insurance as subsidized by the
federal government. Allow me to slip on my Democratic hat for a moment.
I try not to get into a lot of
stock-political discussion, since life is more complex than a lot of
hack-political phrases tend to imply, and certainly a lot of Democratic lines
of discussion are tailored to the union mentality. But it’s not quite amusing,
in fact it’s annoying (at best), to see this son of a former president whom I
never cared for spewing out a bit of conservative dogma. Yes, the ACA is
severely flawed; yes, I would be among the first to make strong criticisms
about it, as I suggest above and will do again below. But idiot conservative
dogma in this time of the many problems posed by the ACA is NOT what is needed.
I remember about 20 or more
years ago, one of the stock conservative/Republican economic lines was “free
market”—when we were still in competition with the Soviets, and a position
against command-economy economics seemed “as right as rain,” and hence so vague
a concept as “free market” could seem like a can’t-miss battle standard for the
conservatives. Nowadays, that simplistic battle standard as been replaced by
something even more uncritical, simple pro-business dogma—as if business, any kind of business, can do no wrong,
and is almost always a preferable alternative to government patriarchalism, or
whatever you want to call conservatives’ ultimate bugbear.
The idea that the ACA promotes
“not getting a job” because “now it allows you to get insurance without one”
(not a direct quote, but summing the apparent assumptions) seems, to me, to
carry some racist baggage also. As if all those going on government-aided ACA
coverage are almost exactly the same who hopped on the food-stamps and welfare
bandwagons about 40 years ago. But leave that line of criticism aside.
The fact is that businesses have
found ways not to give health insurance coverage to employees for DECADES. In
fact, this is one main reason for the ACA. If people didn’t have health
insurance, and couldn’t get it from employers, how else were they going to get
it, if suddenly the overriding Democratic policy-notion was that “all must be
covered, to bring down health-care costs” (to me an assumption begging for
criticism in its own right)?
Since 1978, I have worked for
dozens of employers, and I could probably count on one hand the number that offered any sort of health insurance
that you didn’t have to partially pay for, and several instances of this were
temporary insurance (because the job was temporary, including a VISTA stint).
In the print-media industry, it is a notorious fact that employers will find
every way they can not to give you a
raft of benefits, health insurance chief among them. You say, “But this was
pre-ACA; the ACA requires employers…” But as we know, employers are now finding
ways to make some employees part-time (< 30 hours/week) in order to elude
giving all their employees insurance.
The way employers have sought
not to provide health insurance, because of its costs, has been such an engrained
fact of life in the U.S., for so long, that I would think a Democrat would have
to be mighty stupid indeed to think that ALL employers must now give ALL
employees a full health-insurance policy, just as it would be a STUPID
Republican who would feel almost the same thing in their criticisms of the ACA
like Michael Reagan’s.
Reagan, like his father, seems
to believe in “trickle-down” economics, where if you kiss up to the business
world in every way (as a rank-and-file worker or business leader), eventually
wealth will trickle down into your pocket. This was a philosophy I couldn’t
agree with in the 1980s, when Ronald Reagan was in office (not on any vote of
mine), and gets toted out now, as if Mini Me had nothing more intelligent to
offer than a stale version of the same plain-Jane bread his father peddled 30
years before—making him as dynamic and equal to current challenges as a
half-senile fool reeking of old-fart BO and pain-relief ointment.
Sidebar:
The “privilege”/hard work issue. Reagan points out a number of times
that his being a son of a Hollywood actor family didn’t earn him special
privileges in his family (he even refers tongue-in-cheek to the “Beverly Hills welfare”
that his mother didn’t believe in). His family enforced his need to learn to
work toward where he wanted to go, etc. OK, laudable. But didn’t his father’s famous name help him in some
ways, at one point or another, along the winding road of his life? Might it not
have helped him when he got a radio show that he notes he traveled 262 miles at
a time (round-trip) to perform? Michael Reagan might say: “Well, my father’s
good name meant less than you think. He was a yutz of a B-movie actor (I mean, Bedtime for Bonzo??), and was joked
about as presidential material in about 1970 on Rowan & Martin’s Laugh-In. He was one of the more overrated
presidents in our history, and the credit he gets for the fall of East Bloc
communism is vastly overblown. His ‘catsup is a vegetable’ social-policy ideas
and foreign-policy gaffes (“Russia’s
been outlawed; we begin bombing in five minutes”) are legend. Iran-contra was
a true stain on his presidency. Do you think all that provided a red carpet for me all along the way?” If this
is what you argue, OK, Mr. Reagan, I see your point. Quite well. But my own winding road of a life didn’t even have a
second-rate president in my family tree to help me out.
Now let’s see in a specific case
how much the “pro-business” philosophy squares with the realities of our
current world and the ACA. I use my own droll example. As Mr. Reagan might
approve, I am “employed”—I am self-employed. But based on my income for the
past three years, I qualify for Medicaid this year under the ACA. Do I relish
this? Not a bit. In fact, if some doctors I saw didn’t take Medicaid, that’s
OK, because I’ve been paying out of pocket for my own health-care costs for
many years anyway.
But a glitch has arisen on the
state level with my ACA application. Though I have a policy number, according
to the NJ FamilyCare phone line, I still don’t know if I have Medicaid
coverage. So I may need to pay the $95 penalty at tax time next year. This I’ve
been willing to do for many months, in considering my options under the ACA
situation.
I would consider the $95 penalty
to be a “cost of doing business,” so to speak. [Update 2/24/14: See update note two paragraphs below.]
Now let’s say I retry to get
Medicaid (or even private insurance, but probably subsidized to some extent,
because of likely income level) in the open-enrollment period starting next
fall. Say it doesn’t work out (because of such wonders of the federal Web site,
or the state FamilyCare service, as I encountered in recent months).
Then I would have to pay a $695
penalty (I think it is) in early 2016, for the 2015 tax year, for failure to
sign up for insurance. [Update 2/24/14: $695 is the figure that has been in the press for the penalty payable in 2016, but what has also been noted regarding both the $95/2015 penalty and the $695 is that, depending on level of reported income, the amount you owe could either be those figures or 2.5% of income (whether adjusted gross or taxable income, I don't know). Whether the idea is "the smaller of $695 or 2.5%"--which would be helpful to lower-income people--I don't know. It would make sense if it was this. Update 3/18/14: It appears that the logical pattern of the penalty is the other way than I had thought: for the first year, the minimum penalty is $95 per individual, and above a certain income level, the penalty is a percentage of adjusted gross income (resulting in a higher dollar amount). An article in the March 16 Star-Ledger of New Jersey (p. 1) has a headline giving the nature of the concern: "Not buying a health plan could cost you[:] Fines are steeper than many realize." I'm surprised that, regarding the ACA, with all the media cheerleading, coverage of Web site gaffes, and so on that have been done (in many newspapers) in the past five or so months, a definitive, clear, and thorough focus on the penalty aspect, just to inform the focus on practical realities it faces, hasn't been done until very recently, just a few weeks before the open enrollment period ends.]
Now this is a lot harder to
swallow for me (as it would in some sense for most other taxpayers). For me, if
my income—as a self-employed person—stayed about the same as the past few
years, I would actually have to set aside
MORE money (as estimated tax payments) to cover the ACA fee than I would have
to for regular self-employment tax.
How’s that for someone “sucking
up to” the culture of “doing business”?
If I was to say, “As an employer
I can’t afford to insure my employee,” I would be close to accurate, or exactly
so. The cost—and, in the penalty, this doesn’t even get me insurance—would be
more than self-employment tax would be. That would put me in some kind of
league with the many big employers who have tried to find ways not to offer
fully-paid insurance—like my own college, GWU, with me in 1984, which was one
year of Reaganella’s presidency. (By the way, I have filed tax returns every
year since 1979. And I repaid about eight months of Social Security survivors’
benefits in 1984 because of a Reagan policy demanding a scale-back of such
benefits.)
How about them apples, Mr. Son
of Trickle-Down?
