In addition to being experts on health and dental insurance, Certified Agents and Certified Enrollment Counselors are expected to be an authority on immigration status, accounting, and taxes. We are being asked to have all this subject matter knowledge, with no assistance from Covered California, and be accurate when working with Californians where English is a rough second language.
Agents asked to specialize in immigration, taxes, accounting
As much as I love the fact of reforming the health insurance system in America, I am deeply distressed that insurance agents and enrollment counselors must now become tax specialists, CPAs, immigration experts and computer geeks. Agents and counselors helping enroll Californians into new health plans have been asked to radically transform their services to help people enroll with very little training relative to the scale of the task.
Covered California fails at foreign language support
At one public enrollment event I worked the families’ primary language, written and spoken, were, Chinese, Vietnamese and Urdu. Do you know how hard it is to ascertain if the son away at school will be declared as a dependent in 2014 or if the revenue from the new part-time self-employment of mowing lawns will be declared as income? The first time I had seen a Permanent Resident Card was at an enrollment event and I had no idea which numbers I was suppose to plug into the online application. Covered California has failed to provide language assistance at the public enrollment events.
Sorry, Mom doesn’t get health insurance
Therapist is another skill agents and counselors are suppose to have when explaining how the ACA rips the family apart and ensures that some spouses can’t afford health insurance. The scenario is a parent who has employer sponsored health insurance, household income automatically places children in Medi-Cal kids, but the spouse is cut out of premium assistance because of the availability of the partners group health plan. How do you explain the mother is not worthy of affordable health insurance under the ACA?
How much will you owe the IRS?
Even with my above average knowledge of bookkeeping, taxes, and computers, I know I have made mistakes because I have had to go back and fix them. The volume of phone calls and emails I get from other agents who think I am an expert because I blog about the application questions indicates that I am not the only agent struggling to get the ACA right. See “Discrimination practiced at Covered California enrollment events“. I can only imagine how the general public, attempting to navigate through the enrollment, may have set themselves up for an IRS shock in 2015.
Determining ACA income is no easy task
It is the IRS that will have the final say as to whether a household income was too high or low for the premium assistance awarded. How many Americans will have over estimated their income triggering a massive pay back of excess premium assistance? How many agents like me might be sued by a family I helped enroll with bad income information leading to a large bill in 2015? Sometimes I feel like the ACA is making me practice immigration, tax law and accounting without a license. See “What type of income counts for Covered California”
Families appreciative of affordable health insurance
It is the pinnacle of professional pride when, as an agent, I am able to assist a family with navigating through the labyrinth of application queries to the final passage where they enroll in a health plan with premium assistance. The families I have been working with are the foundation of our communities. They are mothers and fathers working multiple jobs and long hours to keep their families afloat. They absolutely value the ACA for bringing affordable health insurance within their reach. These families are excited to have their children covered under Medi-Cal because they know it will keep them healthy.
Upper income families look to avoid penalties
On the other side of the spectrum I’ve had to deal with some spoiled families with an exaggerated sense of entitlement. These are families with incomes too high for premium assistance and have balked at the increased premiums for plans complying with the ACA. I was dumbstruck when the mother of one family whose household income is $134,000 per year was quizzing me on how they could avoid the penalty associated with the individual mandate. She was hoping that I could figure out how to make their income low enough so the insurance premiums were more than 8% which triggers an exemption. The parents of this upper income family were seriously considering not providing health insurance to their children. That is just so irresponsible.
Only God can save us
Of course, since her family was Christian, she was hoping they might qualify for a religious exemption. This upper middle-class family hated the ACA so much for raising their premiums they were contemplating having no health insurance at all. Christian health sharing ministries have become popular topics as some people think membership will help them avoid the individual mandate penalty. These Christian health sharing ministries are not insurance and don’t cover the minimum essential benefits like ACA plans. They can be attractive for Christians who loath the fact that their health insurance premiums dollars may go to help Jews or a Muslims pay for health care.
I’m leaning toward single-payer
The implementation of the ACA is overly complicated. There will be a second round of dissatisfaction with the law when people get bills from the IRS for receiving too much premium assistance for their income. All of this will snow ball and pave the way for a single payer of health insurance in the U.S. Americans love the fact that most people will have health insurance, but they are angry at the unnecessarily complex nature of eligibility, tax credits, and the enrollment process.