Please read this to hear about one woman’s struggles with getting health insurance post-Obamacare, in a state (New York) that has the Medicaid expansion. An excerpt:
In fact, I started this process in October. And only today did I receive an email that my eligibility had been determined and I should log on to the site and choose a plan.
A detailed timeline of the actions I’ve taken proactively and reactively over the past 5 months would be mind-numbingly boring to recount, much less to read…
I have now spoken to three representatives today.
No one can actually explain the relationship between Medicaid and these various plans. (One is “primary” and one is “secondary,” although the representatives have differed on which is which, and do not seem to know what those characterizations mean in practical terms anyway.) The site does not have any explanatory content on the subject. The plans (when the page does load, perhaps once every half hour) are indistingishable to me.
One representative listed the insurance provider names (Health Plus, Emblem, bla, bla) and said “just pick one and I’ll put it in for you.” But how am I supposed to distinguish between them, I asked?
She told me I should write them down and Google them.
One representative has told me I must choose a plan by Monday or it will not take effect until the next eligibility round in November.
The next representative tells me vehemently that this is not true…
You have to read the whole thing to get the full flavor, but that will do for an introduction.
These stories do not seem to be limited to the usual slowness and frustrations of dealing with most government bureaucracies. They seem to involve huge chasms in the law itself, combined with lack of communication, combined with true confusion on the part of officials and their representatives in understanding the law. If they don’t understand it (does anyone?) how could they ever communicate clearly on the subject to the consumer?
My own experience trying to get information about Obamacare for a relative in California has been similar, and Medicaid isn’t even involved. Every time I call, it’s a crapshoot in terms of the answers I will get to the very same question I keep asking over and over: are the networks the same if you buy the same policy from the same company on-exchange vs. off? I’ll spare you the details, but suffice to say I’ve been working on that (and some other questions) since December of 2013 and have probably put in close to 100 hours on the subject, and still don’t really know the truth. My current working theory, based on pooling all the answers I’ve gotten from Covered California plus the insurance companies themselves, is that the companies’ networks for the “same” policies on and off exchanges are the same de jure but not de facto.



