“They Are Close to Losing Me”

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TPM Reader TZ, an ACA supporter with a very vested interest in the program succeeding, tells us he’s at the end of his tether …

So, I have a huge vested interest in ACA working out. I am self-employed (as a consultant, laid off from pharma two years ago) and when our COBRA at company rates ran out 18 months ago I went onto the open market and sought insurance for me and my family (wife and two kids). Aetna refused to cover me because I am overweight (zoftig!). So, I had to stay on my company insurance but paying full freight, while my wife and kids went onto a crappy Aetna plan. So, one family, two plans. We also purchased dental on our own, it’s not very good, but its not great either. It’s a pain to have the family on two different plans.

For example, my son hurt his arm and had to go to the ER, but my wife had the insurance cards and wasn’t home. However, my COBRA at full freight expires at the end of this month, so I am planning on a catastrophic policy to cover just me for Dec, then in January the whole family goes into our shiny new ACA provided policy (probably gold, maybe silver). This will mean I continue to pay out of pocket the same amount, but the level of coverage we will be getting will increase by an order or magnitude.

So, it is with great anticipation that I have been looking forward to ACA. I live in PA, so we are in the federal exchange. I signed up for my account prior to launch, made myself informed on the law and its benefits. I am a huge supporter, and have been since it was passed. At the launch, I logged in dutifully and was hit full force by the failure of the web site. I kept at it dilgently for weeks. Finally, I was able to register and get an account. Step by step I have been able to get in farther and farther. I finally was able to do a complete application, but when it came time to the final verification stage. It said the system was down. That has been for weeks. And when you try to get in and finish the application, you don’t know the verification is down until the last step (you have to review every part of the application to get to the last step). I have tried calling in for the last step but no joy. I can of course go on and on.

So, I read TS’s comments this morning: “No way things will go well for quite a while. Getting website sorta working is crucial as you say. So is getting Congress out of town and the country past January 1. After January 1, hundreds of thousands of additional Americans will be insured and otherwise protected by this law, with numbers growing as Medicaid expands and people sign up on exchanges.”

I may not have TS’s gravitas, but we are quickly approaching a true crisis point. I don’t think people truly appreciate it. There is one month left to sign up for 2014 coverage. I think TS misses the whole crux of ACA working is that website working, in a month. If the website isn’t working, they have to be able to at least verify people’s eligibility on the phone or whatever to allow people to sign up. I think I am kind of the demographic they want: healthy middle class family that won’t be getting subsidies. But they are close to losing me. If I can’t get signed up by the end of the month, I have to make serious long term decisions about how to cover my family. She sort of glosses over the whole website working part to say that 100,000s will be insured by 01Jan. Maybe, but not in the federal exchanges at this rate. This is not a trivial problem, and even with 24/7 work on it, it isn’t getting better fast enough.

I would add one additional point here. I dont think TS (who is Theda Skocpol) is saying that 100k people are going to be enrolled on Jan.1. 100k people were enrolled in October, during the nadir of the federal exchange website’s problems. That leaves November and December, when the website is working better and will continue to work better and when the filing deadlines will certainly push people to actually pull the trigger on retaining coverage. What that number will be, whether it will be ‘enough’, I can’t say. But it will be way more than 100k people. All that says, TZ’s statement from on the ground, from someone who does support the ACA, is an important reminder of the stakes and the urgency of the situation.

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