January 7 2014

ObamaCare: Gee, It's Hard to Tell if You're Actually Enrolled...

Patrice J. Lee

Stories are filing in about sick people who thought they had enrolled for ObamaCare but are finding themselves in coverage limbo and responsible for expensive medical bills. We speculated that this would happen and, unfortunately, we were right.

The Administration is touting the 2.1 million Americans who have supposedly “enrolled “in ObamaCare. The problem with their loose definition of enrollment as anyone who has merely selected a plan is that it doesn’t align with the actual enrollment processes. Delaying the requirement that enrollees submit their first premium to their insurer for up to 90 days –another sneaky tactic from last month- is just window dressing to boost enrollment figures.

The harmfulness  of this practice shows up when patients try to get care and learn that they aren’t covered at all. They find themselves on the hook for bills they expected their new ObamaCare insurance plan to pick up.

Leave it to MailOnline, a British newspaper, to report on this:

Hospital staff in Northern Virginia are turning away sick people on a frigid Thursday morning because they can't determine whether their Obamacare insurance plans are in effect.

Patients in a close-in DC suburb who think they've signed up for new insurance plans are struggling to show their December enrollments are in force, and health care administrators aren't taking their word for it.

In place of quick service and painless billing, these Virginians are now facing the threat of sticker-shock that comes with bills they can't afford.

'They had no idea if my insurance was active or not!' a coughing Maria Galvez told MailOnline outside the Inova Healthplex facility in the town of Springfield.…

Health and Human Services Secretary Kathleen Sebelius testified in a December 11 congressional hearing that the federal government can't say how many new enrollees have written checks for their first month's premiums.…

Given the Obama administration's latest claim that 2.1 million have signed up nationwide, that means as many as 700,000 Americans might falsely believe they have a current health insurance policy.

Mary and others like her, who took the time to enroll but may not follow the daily flood of news about Obamacare, likely don't know one way or the other.

In the two other cases profiled by the MailOnline, two women enrolled but had not yet heard from their insurers confirming their coverage. One woman, a black business owner, decided to forgo emergency services to check out her chest pains after being advised by hospital staff that she would be on the hook for more than $3,000 if she wasn’t covered.

Isn’t this exactly what ObamaCare was supposed to curb?

The White House response to this problem back in December was that enrollees should call their insurer directly if they are uncertain about their plans. That’s a sly way of wiping their hands of the situation and pushing responsibility off to the patient and insurer to complete. That’s fine, but it’s disingenuous for the Administration to call that enrollment and a win.

To put it another way, like me, you’ve probably “shopped” online by adding items to your virtual shopping cart. However, my purchase was not complete until I checked out (i.e., submitted payment) and received a receipt.  I can’t call the retailer asking for my order if I didn’t pay or if the transaction wasn’t processed. Unfortunately, that is what’s happening here and will continue to happen as the Administration changes the rules to their benefit.

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