(In given blog entries, this could run concurrently with
another, ongoing series.)
Case today: Dealing with Affordable Care Act “tail ends”
[Edits 1/17/15. Edit 1/19/15.]
Introduction
This series, along with covering other subjects (which
actually may be more interesting), will continue in some sense the “OFAD”
series. It will look at everyday business (and laughs) associated with the
implementation, on the jerk-on-the-street level, of the Affordable Care Act (usually
and specifically, as I can best discuss, the Medicaid expansion in New Jersey).
But it will do more than that.
The more interesting topics under this heading will
illustrate how we (as jerks on the street) develop competence to deal with practical
problems (which may often seem stupid and needless), as often arise in pursuing
a middle-class life in a state (such as New Jersey) with a high cost of living,
and when paradoxical issues arise regarding (among other things) your health,
your insurance status, and/or your status as viewed by others (ludicrously or
not).
This series will look at everyday tactics as well as
longer-range “principles of your personal philosophy” that you develop as sum
up what it means to pursue your life, and which may constitute a theory (small-purpose
or otherwise) that you can improve, adapt, or supersede you develop better
skills in life.
(For instance, when you’re young, you may opt not to go to
the doctor for very much, especially when you don’t have health insurance. What
about when you’re older middle-age? Going to the doctor, then, seems wiser. Do
you [at that stage] have health insurance? Maybe bare-bones. How do you, then, choose
when to go to the doctor on a somewhat more frequent basis?)
As one example that used to be a bit of a bear for me, I
found that, very generally and quite predictably, working in the editorial
field—whether at a staff job or as a freelancer with a lot of work per year—means
decreased sleep. On average, during roughly 1990-2010, my sleep was about 6 ½
hours a day, with some days less (it could be a lot less), and some days more.
It’s beside the point what physiological mechanism and/or predictable set of
factors was behind this (much less whether there was much I could have done to
mitigate the problem).
“Stress” as a vague idea is a good candidate as an
explanation; but it was a fact of life for me (as it might be for you if you
had a similar career), and what problems did it potentiate? What passing
solutions were there?
For an instance that may be more familiar to you, if you
have a demanding job, or an unreasonable boss or project, how do you handle
sleep problems that arise as an obvious enough result of the emergent stressors
(especially when, acutely, your sleep may get starkly worst with clearly
increased, not-terribly-fair work problems going on)? This is one kind of
“Getting the Knack” issue.
##
Now I don’t want to go marching into a thicket of
specifically, and anger-inducing (for me), work “war stories” as I did last
winter with the “Dollars and sense” and “Running with the bulls” mini-series
(which ended up as two shorter series than I expected, by emerging preference).
I want to look at more constructive angles, such as stratagems, methods for
resolving difficulties (objective problems and not, and successful resolutions or
not-so), and conclusions that you draw about areas of challenge in life (such
as may lead you to start pursuing a different line of work or industry).
And I will seek chances for humor among the “friendlier war
stories” and “bits of practical wisdom.”
Catching up with the
OFAD details
Let’s wrap up quick my goofy odyssey of 2014.
In November, after I tracked down the right person to talk
to about getting my Medicaid coverage set up (see this entry for details), my general Medicaid card came in
the mail (as I noted here),
just before the “seven to 10 business days” I was told it would take for me to
get something.
Then I had a standing doctor’s appointment in mid-December.
This was a general practitioner I’ve seen for many years, for regular
follow-ups. (I did not need to be told by any ACA palaver to see him.) But the
question for me: how would my Medicaid coverage affect seeing him? Would I be
advised to change practitioners? I strongly did not want to.
Long story short: I saw him, and discussed the insurance situation
with workers in his office. They did take Medicaid, but they did not take the
specific Medicaid-serving insurance company that I had been automatically
signed up with by the state (Amerigroup). If I could change the insurer, they
said, they could bill the insurer they wanted, United Healthcare.
Well, I phoned the Medicaid office that I had a number for,
and got the ball rolling on changing the insurer. But the new arrangement
wouldn’t be effective until Jan. 1. So this could not cover the doc visit. Then
I returned to the doc’s office to pay the bill “out of pocket,” which I had
been prepared to do on the day of the appointment (and had long done with his
office) anyway.
Somewhere in the midst of the later-December jazz, there was
an online questionnaire I was invited to partake in, from Amerigroup. I did
this, I think before I was signed up with United Healthcare. As a reward for
taking the questionnaire, I was offered a choice of gifts (one, a hat, had the
Spanish translation—and just about all the Medicaid-related mailings I’ve
gotten have had Spanish translations—of sombrero;
I chose a water bottle [I forget what the Spanish term was for this]).
##
Well, when I got my United Healthcare card (an insurance ID
card in addition to the Medicaid one I’d already gotten), it said my new GP was
Dr. ____. I didn’t want this; I phoned the number for them and changed my GP to
the one I’d long had, which they allowed. I was to get a new card in the mail,
which came days ago.
Also in recent days, a bill came from my doctor’s office for
the appointment I’d already paid for by debit card. This has happened with them
before. I was a bit angered, but last Saturday I put together a mailing,
including a copy of a bank statement reflecting the charge by the doc’s office,
to show I’d already paid the bill.
This may all sound like an annoying load of business, but
another matter has downright angered me a lot. And to this we turn.
The ACA Web site’s
harassing e-mails
Starting last fall, I was getting ACA Marketplace–generated
e-mails inviting me to come back, to sign up, hey hey. There was quite a flurry
of these over some days or weeks. The general assumption in them was that I
qualified for privately gotten individual insurance, for which I would likely
get a subsidy, and I hadn’t signed up for 2014 yet.
This was bullshit. I’d been in the process of getting my
Medicaid coverage going (as I’ve said in previous OFAD entries, and as
newspaper coverage for New Jersey has made plain, the Medicaid expansion in
this state for 2013-14 was in the state’s
hands after people had signed up on the federal Marketplace site in late 2013;
and you could not sign up directly, within any state system in New Jersey, for
Medicaid-expansion insurance in late 2013). Then, once the state entity
handling the Medicaid expansion, NJ FamilyCare, had the info from the feds,
there was a backlog, fumbling….
I’d found as long ago as last February (see here) that I had an insurance policy number, but
nothing came to me (in the mail or otherwise) showing I had insurance. I would
not find out that a Medicaid card had been prepared to me (and mailed out, but
to the wrong address) until November 2014
(as I related in OFAD 7).
Well, I did get onto my federal Marketplace page (after
trouble dealing with the need for a password change, which was angering in
itself) eventually, in December. I saw there was nothing I need do there, but
it was good to know I could get on, in case I had to.
The latest problems
Well, just in the past few days, there was a big spate of
e-mails from the federal ACA people, haranguing me about signing up, the
deadline was coming (Jan. 15), etc., etc. There were three initial e-mails,
within hours of each other. Yesterday (Jan. 15) I printed out two. Then, over
the past 24 hours or so, there were at least two more. One portentously had in
its subject line something about an individual person making a statement.
After becoming aware of these, I was quite angered. I
thought in terms of stalking, harassment, tax-fraud case—meaning I saw the ACA
people as guilty of all these.
I looked at my printouts of the two ACA e-mails I’d gotten
the day before. Yes, there was a way (via a URL) you could “stop receiving
messages from the Marketplace.”
Plan for a solution
This morning I was getting ready for my day and went about
reviewing what to do to be efficient, and not merely write a ranting blog entry
about this situation. Do I cancel the ACA’s sending me e-mails, or not? I had
left them coming in the fall because I thought there might be important,
relevant info they could tell me. Not so now.
But also, they came to me on the assumption I had yet to
sign up for (subsidized) individual insurance. This was the source of the most
anger. I was already signed up for Medicaid. Clearly there was some
“disconnect” within the ACA system (even after its vaunted improvements
following the debacle of fall 2013) for it to be approaching me as if I still
needed to sign up, when I didn’t, and when it assumed I had an income level
that qualified me for individual insurance, when I don’t. The satirist in me
looked at this importunate haranguing as like the insurance salesman in Woody
Allen’s Take the Money and Run
(1969), in the prison sweat box with Virgil Starkwell, assigned to apply severe
punishment to Starkwell for his attempt to escape.
Aside from the subjective issue of the ACA people seeming
intent on drumming up business for private insurance companies from the wrong
constituents, like an implacable insurance salesman, there was the possibility
that, when I filed for my taxes, the blessed bureaucratic monstrosity in play could
have in its files that “I hadn’t signed up for insurance” when I had. I could
only find out if they were wrong on this once I filed my tax return.
Then, not entirely an academic matter, there’s the issue of
stalking. I’m not one to claim being subjected to this, at the drop of a hat,
but look here: there is definitely a solid subjective basis. New Jersey state
law on criminal stalking has this provision (in N.J.S.A. 2C:12-10):
“(1)…repeatedly
maintaining a visual or physical proximity to a person; directly, indirectly,
or through third parties, by any
action, method, device, or means, following, monitoring, observing,
surveilling, threatening, or communicating
to or about, a person, or interfering
with a person’s property; repeatedly
committing harassment against a person; or repeatedly conveying, or causing
to be conveyed, verbal or written threats or threats conveyed by any other
means of communication or threats implied by conduct or a combination thereof
directed at or toward a person.” [p. 686
of the 2012 Compact Edition of West’s New Jersey Statutes]
I boldfaced possibly relevant language. Now, it does not
cause me to fear, when the ACA
e-mails come in to me like a snowstorm with “advisories” based on no reality.
But the sort of interference in a person’s life that may cause fear to more naïve people could cause anger and indignation to older, more
experienced people. And definitely, it angers me that I get e-mails suggesting
I have not complied with the ACA law, when I have, and when I contemplate
filing my taxes and wonder if the IRS will have in records somehow connected to
an ACA database the false info that I have not signed up.
If the ACA people were fully within their rights approaching
me with their e-mails, I might not have a case; but I have been complying, as
my OFAD series has shown; so for me to get “delusional” ACA e-mails that seem
insistent on assuming I still need to sign up, and that for individual insurance, is to me rather
like stalking and harassment.
But I won’t pursue a case for that at this point. I have
relevant printouts, against their possible future need. But for now, I will
apply through an ACA e-mail, as their copy allows, to have them stop e-mailing
me messages. Which [after writing the foregoing] I did.
I also went into my account on the ACA Marketplace site
and checked there; the only thing specific for me was a “statement of eligibility,”
which I found was the same December 2013 letter (a pdf) I had already
downloaded twice before in the past.
And I will hope for the best regarding filing for taxes.
##
Hopefully my next “Getting the Knack” entry will be on
something far different and more fun.
