The Affordable Care Act has helped provide health insurance to millions of America’s citizens and residents. The accompanying bureaucracy has also created mental health meltdowns for thousands of individuals and families. Through a series of website glitches, bureaucratic rules and purposely designed narrow provider networks, the ACA is delivering unparalleled amounts of stress, anxiety, and for some, thoughts of suicide for many people who thought health care reform was supposed to help them.
ACA health insurance frustrations
Over the past year I’ve heard from numerous individuals and families wrestling with a variety of problems induced by the ACA and the common refrain from all of them is, “I didn’t sign up for this”. What they didn’t sign up for were enrollment website errors that exploded a simple error into nightmare that takes hours on the phone to untangle. They didn’t sign up for the bureaucracies adjusting their ACA accounts and busting them into Medicaid or Medi-Cal health plans. They didn’t sign up for out-of-network hospital and doctor bills because the health insurance companies designed narrow networks.
Mental health crisis
The overwhelming majority of my clients, and I suspect most ACA households overall, have had no problems with their new health insurance or the Advance Premium Tax Credits to lower their monthly premiums. But for a small percentage, the issues created by the new health insurance landscape have brought many people to tears and created a mental health crisis for some. I write this from firsthand knowledge from people calling me with the hopes that I can solve the nightmare they are living. As one person said, “I feel like I’ve been ground down to nothing”.
Blue Shield billing nightmares
The largest source of frustration has come from the horrendous billing system of Blue Shield of California. It has been a constant battle for many Blue Shield members to get their accounts straight. A common theme is Blue Shield having multiple active accounts for a family. They apply payments to one account that invariably is not the active account. People only learn they have no active insurance until they go to use it. Blue Shield blames Covered California. Covered California bounces us back to Blue Shield to resolve the issue. No one at either organization will take ownership for errors.
Bureaucracies shrug off problems
While the service center representatives at Blue Shield and Covered California shrug their shoulders in the “it’s-not-my-problem” reflex, a mother wonders why her children don’t have health insurance. The standard answer is they’ll escalate the issue and it will take two to four weeks to fix. Of course we heard the same answer two to four weeks earlier after hours on the phone. The level of stress by not having health insurance is unfathomable for all the employees at Covered California and the health plans who have group health insurance.
A comment from Beth on my blog post Covered California sours liberals on health care reform says it all –
I am one of those liberals who was excited about the ACA only to have been soured on the whole experience because of Covered CA. Only today did I go though the exact bureaucratic nightmare you describe — again. Everything described in this article is 100 percent accurate and almost every part of it has happened to me and my husband. We are middle class and both self-employed. No kids, but we were assigned to Medi-Cal, even though Covered CA has said repeatedly that our incomes are too high. So far, we have kept our regular insurance because I have simply ignored all the Medi-Cal information requests. Apart from this, I am the ping pong ball you describe. Every time I call my insurance carrier about an issue they refer me to Covered CA. Every time I call Covered CA I end up in tears of frustration because they say I have to call the carrier. when Covered CA does “fix” an issue it isn’t fixed…the same issue crops up over and over. I called a broker for help and they have made it worse. I have had multiple applications submitted to the same carrier, my coverage teminated without notification or my permission (resulting in me being completely without coverage for as long as a month at a time — twice) and much more. The Covered CA website is confusing (and I am computer savvy) or just inexplicably will not work. I am so desperate to get out that even though I love being self employed I am interviewing hard for a full time job again simply to get the health coverage.
Medi-Cal meddles without authorization
Another sort of soul crushing experience is sparing with a county social services case worker over why the family was busted into a Medi-Cal health plan. The counties who administer Medi-Cal have access to Covered California accounts and without notice or consent can knock an individual or family off a tax subsidized health plan and into the Medicaid system. Covered California seems to be powerless to prevent this because of the rules and regulations governing the ACA. People must spend hours on the phone trying to claw their way out of Medi-Cal. They have to spend their limited time and energy because they are usually in the middle of health care treatment and their current doctors don’t accept Medi-Cal.
Surprise, your insurance is cancelled
As an agent, I can’t really advocate on behalf of clients who have been demoted into Medi-Cal. These folks are left to fend for themselves against county bureaucracies that are experiencing enrollments far beyond their resources to properly service them. The stress, anxiety and subsequent depression this leads to is overwhelming for individuals who must now rush to re-schedule doctor appointments for chronic health challenges. The additional slap in the face is the two to three months wait to see a Medi-Cal doctor. Can you even fathom being told that your private health insurance plan has been cancelled and you have to switch to a doctor you’ve never met?
San Diego County Medi-Cal mystery
The insults of the Medi-Cal system never seem to abate. One woman, who had successfully navigated the Medi-Cal system in January, was abruptly told by her Medi-Cal doctor that San Diego County had dis-enrolled her from Medi-Cal. San Diego county could give her no reason as to why she was dropped out of her Medi-Cal plan. Covered California wasn’t offering her tax credits to purchase a private plan because her income was too low. As of February 2015 she had no health insurance to cover her scheduled appointments.
Suicide looms without health insurance
The fear and frustration is palpable in the voices of so many people I talk to who are facing these unintended consequences of health care reform. One person told me that the overall stress of fighting with Covered California and the different bureaucracies had driven him to contemplate suicide. In his mind, the combination of his health challenges, feverishly trying to find employment, and now the utter futility of fighting the new ACA system made suicide look like a viable alternative to the constant struggles he was facing. The irony, not lost on either of us, was that since his health insurance wasn’t active because of various ACA problems, he couldn’t even make an appointment with doctor to discuss his depression and thoughts of suicide.
Covered California Suicide Hotline
I know many of you will scoff and declare that one anecdote of an individual contemplating suicide because of ACA glitches can’t be extrapolated to conclude that there is a significant population suffering from the same effects. On this point I agree. However, the volume of calls I get and the tales of frustration I hear is fairly solid evidence that suggests that the problems with the ACA are inducing high levels of stress and anxiety for thousands of individuals. These people didn’t sign up for the type of mental harassment and abandonment they are experiencing from numerous bureaucracies involved with implementing the ACA. Perhaps Covered California should post the Suicide Hotline next to their telephone number as an acknowledgment that they are failing some people in the new ACA system.