Obamacare/Trumpcare Horror Stories

[Jay]

http://news.investors.com/politics-obamacare/081114-712602-obamacare-enrollment-falling-aetna-says.htm

 

ObamaCare Enrollment Is Shrinking, Top Insurers Say

 

The nation's third-largest health insurer had 720,000 people sign up for exchange coverage as of May 20, a spokesman confirmed to IBD. At the end of June, it had fewer than 600,000 paying customers. Aetna expects that to fall to "just over 500,000" by the end of the year.

[fan_since79]

looking forward to more posts from fansince79.

 

poor guy.

 

I had to change my Primary Care Physician because the one I had moved to San Bernardino. I called Anthem and they promised to get it done.

Never got done. No record of my phone call. So I had to make another call a month later, and luckily, this time they put the change through.

 

Then I actually used my new policy and had a mole removed by my dermatologist (needed approval first because he's a 'specialist'). That was three weeks ago. Still no record of my doctor visit on Anthem's site. There should be an Explanation of Benefits there, and it should have been processed in a matter of days.

 

No horror story here, just the same old bureaucratic irritation.

 

You still have to journey through the maze of the automated call system when you do try to reach a human being at this company. It takes a long time to actually speak to a person and you have to enter your personal information several times along the way.

[nate]

CMS is more than a month late releasing their guidance for how renewal will work.

 

Open enrollment opens on 11/15/14.  They are a complete mess.

 

Also hearing that rates are going up substantially.

[AngelsLongBall]

But but but...affordable!!!

[fan_since79]

Several horror stories here:

 

http://www.ndtv.com/article/world/after-surgery-117-000-bill-from-doctor-he-never-saw-595458

 

A man was billed $117,000 from an "assistant surgeon" that he never met who just happened to show up during the operation. $117,000?!!

 

A woman was billed $250,000 (!!!) by two plastic surgeons who did nothing more than sew up an incision that a resident normally would do.

 

What the heck is going on here?!

 

By the way, the cost of health care in America annually is $2.8 TRILLION. Wrap your hear around that figure!

[Amazing Larry]

So far the bill for the website is over $2.1 billion so we've got going for us, which is nice.

 

http://www.bloomberg.com/news/2014-09-24/obamacare-website-costs-exceed-2-billion-study-finds.html

[nate]

You guys think last year was bad, wait til you hear the horror stories this year.

[Taylor]

You guys think last year was bad, wait til you hear the horror stories this year.

 

But it's all good because like 1 million people have insurance and they didn't before.

[Tank]

tell me again how many people were supposed to benefit from having obamacare? 

 

and for accuracies sake, let's not include senators who had their hands out prior to the vote or any healthcare CEO's.

[fan_since79]

Obamacare architect admits the administration lied to the "stupid" American people to get the law passed.

 

"In terms of risk rated subsidies, if you had a law which said that healthy people are going to pay in, you made explicit healthy people pay in and sick people get money, it would not have passed. Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter or whatever, but basically that was really really critical to get for the thing to pass."

 

http://townhall.com/tipsheet/katiepavlich/2014/11/10/obamacare-architect-yeah-we-lied-to-the-stupid-american-people-n1916605

[arch stanton]

I don't know how it wasn't obvious to anyone. People who don't have money can't pay for stuff. People who have lots of money can always find a loophole. That leaves those with some money but not enough to buy a member of Congress. Simple process of elimination.

[gotbeer]

Breaking: Obamacare architect admits Obama lied about his signature law 

 

/sigh

[Tank]

i really like it when our gov't lies to us and misleads us. it's very comforting as a citizen.

[DowningRules]

Obama had to get the bill passed through Congress and Senate which therefore makes them dumb and dumber to.  I semi-believed the FIC when he said that if I liked my insurance I could keep it.  Surely, no president, especially one as politically gifted as the FIC would establish such a lie.  

 

I was wrong.  Half wrong, anyway.

[Jay]

Breaking: Obamacare architect admits Obama lied about his signature law

 

/sigh

If Obama had a shred of credibiliy left it's gone now. And this Pelosi, what a lying sack of shit, or just stupid, or both.

[Blarg]

I think she is politically ambidextrous or simply put, both.

Edited November 14, 2014 by notti

[Adam]

We can get angry and say "See. See! He lied! She lied." Doesn't matter. They can do whatever they want. 

[fan_since79]

We can get angry and say "See. See! He lied! She lied." Doesn't matter. They can do whatever they want. 

 

Yep. The sad truth. Nobody's going to stop Obama from doing pretty much anything he wants.

 

The recent election had the smallest turnout ever in California. Only 23% in L.A. County. Even the voters don't care anymore.

[Tank]

called to make an appointment with a urologist for my kidney stones. here's how it went with the receptionist:

 

me: i need to make an appointment.

her: do you have insurance?

me: yes.

her: is it covered california?

me: no.

her: thank goodness!

[Angel Oracle]

Obama had to get the bill passed through Congress and Senate which therefore makes them dumb and dumber to.  I semi-believed the FIC when he said that if I liked my insurance I could keep it.  Surely, no president, especially one as politically gifted as the FIC would establish such a lie.  

 

I was wrong.  Half wrong, anyway.

You mean you don't like people reading bills AFTER they passed?

If you like your politicians reading bills after passage, you can keep your politicians.

 

Even the original female model for the Obamacare site wanted her likeness removed from it after a short time. 

 

I guess that the healthcare system was broken to an extent.

Obamacare though was a textbook in how NOT to fix it.

Edited November 14, 2014 by Angel Oracle

[IEAngelsfan]

i really like it when our gov't lies to us and misleads us. it's very comforting as a citizen.

You must really like our gov't a lot.

[nate]

FML

[2002_halos_II]

Here's my secure message from Covered California dated 11/15 about my new coverage? Only partial C&P.

 

springframework.web.portlet.DispatcherPortlet.render(DispatcherPortlet.java:1093)
at org.springframework.web.portlet.DispatcherPortlet.doRenderService(DispatcherPortlet.java:755)
at org.springframework.web.portlet.FrameworkPortlet.doDispatch(FrameworkPortlet.java:470)
at javax.portlet.GenericPortlet.render(GenericPortlet.java:233)
at com.bea.portlet.container.PortletStub.doRender(PortletStub.java:955)
at com.bea.portlet.container.PortletStub.render(PortletStub.java:414)
at com.bea.portlet.container.AppContainer.invokeRender(AppContainer.java:1053)
at com.bea.wsrp.producer.adapter.javaportlet.JavaPortletAdapter.doGetMarkup(JavaPortletAdapter.java:339)
at com.bea.wsrp.producer.handlers.markup.MarkupServiceHandler.doService(MarkupServiceHandler.java:259)
at com.bea.wsrp.producer.handlers.AbstractServiceHandler.service(AbstractServiceHandler.java:68)
at com.bea.wsrp.producer.container.ProducerEndPoint.processNow(ProducerEndPoint.java:337)
at com.bea.wsrp.producer.wsee.ProducerEntryPoint.handleResponse(ProducerEntryPoint.java:94)
at weblogic.wsee.ws.dispatch.server.ServerDispatcher.callHandleResponse(ServerDispatcher.java:341)
at weblogic.wsee.ws.dispatch.server.ServerDispatcher.dispatch(ServerDispatcher.java:189)
at weblogic.wsee.server.servlet.SoapProcessor.process(SoapProcessor.java:44)
at weblogic.wsee.server.servlet.BaseWSServlet$AuthorizedInvoke.run(BaseWSServlet.java:286)
at weblogic.wsee.server.servlet.BaseWSServlet.service(BaseWSServlet.java:169)
at javax.servlet.http.HttpServlet.service(HttpServlet.java:821)
at weblogic.servlet.internal.StubSecurityHelper$ServletServiceAction.run(StubSecurityHelper.java:227)
at weblogic.servlet.internal.ServletStubImpl.execute(ServletStubImpl.java:300)
at weblogic.servlet.internal.TailFilter.doFilter(TailFilter.java:27)
at weblogic.servlet.internal.FilterChainImpl.doFilter(FilterChainImpl.java:57)
at com.bea.portal.tools.servlet.http.HttpContextFilter.doFilter(HttpContextFilter.java:60)
at weblogic.servlet.internal.FilterChainImpl.doFilter(FilterChainImpl.java:57)

blah blah blah

[nate]

I am crawling out of my hole to give an update...

 

In business and especially project management I believe it is always a bad idea to make assumptions.  If you are making an assumption you are at a high risk of being unprepared.  Unfortunately with CMS' lack of communication and collaboration we are forced into making several assumptions.

 

The communication or lack there of with the Exchange is so absurd and irritating.  Much of what they do is barely tested, stuff that in a normal enterprise environment would take months of testing is tested by them for at most a week before implemented and it is all done internally, issuers have little or no testing ability with the Exchange.  On top of that there is little or no documentation outside of small legal "bulletins" that are released about once a month.  In fact we are up to bulletin 11 and there was no bulletin 5 or 9.

 

The lack of testing is really hurting my company because as we found out, three days into open enrollment, they consider changing from a PPO to a Managed Care PPO changing issuers.  What this means is they consider it the same as if you went from Blue Cross to Kaiser, even though you are staying within the same company, just changing products.

 

Many tasks are involved in changing issuers, including requiring a new binder payment, and assigning all new ID numbers for these members.  Our IT systems require special setup to accommodate these requirements and they were not in place so we are currently holding all enrollment for a subset of our membership while we urgently setup to meet these requirements.  We are working around the clock to get done in less than a week what would normally take a month.  Some of this is self inflicted in that they are IT limitations that might not exist in other issuers systems, but the fact stands that if we were able to do any testing at all or if we were given any documentation we could have been more prepared for this.  It is also an incredibly poor customer service action to give members who are staying with the same issuer all new ID numbers, it means they have to re-setup their auto payment and online logins, etc.

 

On top of this all the customer service team on the exchange side is garbage.  They do not have access to the enrollment database at the exchange and many times the requests we get are against their own rules and guidance.  The commonly misspell names and do not have access to ID numbers or other information that is necessary to look up these members.  To this day our enrollment and billing teams still do not have a way of sending in "tickets" to the exchange which take a minimum of two weeks to get a response and at times they take 6+ weeks and the response we get is out dated or useless.  They have nobody to call or email to get direction on a member urgently.

 

I know my we will ultimately be successful this year because I have an amazing team of people working for me.  I personally worked about 32 of 40 hours earlier this week and many of my direct reports did the same to solution for the garbage we have encountered.

 

So think about that when you guys read all the horror stories of Open Enrollment 2015.  Renewal will be a whole different monster, much of the renewal decisions have not even been finalized by CMS yet, and renewal tasks have to be completed between 12/16 and 12/31.  This year for Christmas I will be flying home from the east coast on Christmas eve and flying back the morning of 12/26.

 

tl;dr FML

[Blarg]

i just talked to a guy that does work on our house and they had just rolled over their Kaiser Insurance from work to Kaiser on Covered California, paid for the silver plan and now three months later they are being told that money was accidentally credited to the old Insurance and they are behind in payments for CC. They were told they had to wait for a refund from their cancelled insurance account, that even though they are still at Kaiser it is a completely different account and they can't just roll it over.

 

But they can't tell them when they will get the refund and got a bill from CC that was higher than what they originally signed up for. The excuse was the policy changed without notice so they have to pay an additional $600 or about 30% more than they signed up on the exchange for. Affordable? Not any more.