Health Exchange Early Withdrawal Or The Grinch who stole Christmas

Posted by on December 16, 2013 10:35 pm
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Categories: The Nation

Picture of Shannon Bruner and her husbandLee’s Summit, December 16, 2013 – The problems with the Health Care Benefit Exchanges are far more serious than just the Federal Government’s site not accepting enough applications.  The Washington Healthplanfinder – the official ACA-Compliant Health Benefit Exchange for the State of Washing – has experienced some issues with Early Withdrawals.

These are health insurance policies so the amounts are not insignificant.  In fact, for most families that need the exchanges the most, the costs are a very large part of their budget.  One family (see the video) requested a December 24th payment date.  This would allow the family to buy gifts for Christmas and still meet their need to have Health Insurance.

The problem, as the reporter, Elisa Hahn tells the story, is that the Health Exchange reached into the families bank account – as authorized – but it did it the first week in December on the 9th, and not the last week as requested.  The family had their bills paid and then the large amount was taken from their bank account: Leaving them deep in the hole.

If you’ve ever done it, you know that the overdraft charges are huge, they are costly, and they help dig a very deep hole from which you find it very difficult to get yourself out.  This family is suffering through this as they approach Christmas.

People who are not experts in the Health Field should not be involved in it.  Thus the government should have stayed out.

People who are not experts in automatic bank draft collections should not be involved in such transactions because mistakes cost people money.  The Exchanges are not known for the proper processing of automatic payments.

When you put together politicians to guide the development of a site, that involves health care – something the politicians know little about – and then payment methods – again something that politician’s know little about – the you have a recipe for a Christmas Disaster.

So, is President Obama, past Speaker Nancy Pelosi, and Majority Leader Harry Reid directly responsible for this?  No.  They are not directly responsible since Washington set up their own exchange.  But, is the Affordable Care Act the reason these people lost their Christmas?  Yes, because the improperly specified and defined exchanges, that were poorly tested, and that are reaching into people’s wallets had no appropriate, knowledgeable, and ultimately accountable (with their jobs) people in charge.

In the end, this is truly a Christmas Sorry!

Respectfully Submitted
The Lee’s Summit Conservative

p.s., Send me a good Affordable Care Act story – from a recognizable source – and I’ll post it.

One response to Health Exchange Early Withdrawal Or The Grinch who stole Christmas

  1. Mike December 17th, 2013 at 11:06 pm

    Ok, so you don’t know me, so I doubt you consider this a “recognizable source.” Yet, I hope you have the consideration to post this.

    My family and I have been self insured for many years at this point – too many to count. Between small employers unwilling to provide health coverage, and yet other small employers hoping to take advantage of my family’s generally good health ratings to lower their personal deductibles for the “group,” we sought and obtained health coverage from a private supplier. We were the lucky ones – I and my children were able to join a large group, meaning that even if we had a major health incident, we wouldn’t get rated up after we were underwritten. Unfortunately for many, private insurance is available through individual policies.

    As a practical matter, this means that private (i.e. individual) policies work much like automobile insurance. The more health problems you have, the higher your rates become. For me, that translated to two small children being hospitalized for completely normal issues – croup, and me being hospitalized for kidney stones. All in the same year. Fortunately again, we found an extremely rare “group” policy and weren’t rated up.

    Now for the bad news. Because of my wife’s BMI and history of being prescribed antidepressants, our health insurer refused to underwrite my wife (i.e. pre-existing condition). We were forced to apply under the Missouri Risk Pool. This translated to premium payments equal to myself and my three children. In other words, our monthly premium doubled, because the insurer refused to provide coverage.

    Understand that we are out of pocket over $1000.00 per month in PREMIUMS. Also understand that the insurer’s refusal to provide coverage has a secondary consequence. My deductible for myself and my three children was $5,000.00 per year. My wife’s, the same. Essentially, we were paying over $12,000.00 a year to cap our base liability for the family at $10,000.00 per year. Translate that to the following: In order to obtain benefit from our health care coverage, we would have to incurr between $17,000 and $22,000 of health care costs per year.

    We were lucky. We could afford that.

    Now compare the ACA coverage.

    On December 5, we received a letter from the Missouri Risk Pool stating that the Missouri legislature had decided to end any coverage for state residents, a special gift from the Missouri legislature in a rash, uninformed reaction to the passage of the ACA (a discussion, I realize, for another day). We literally had 25 days to find new coverage. Fortunately for us, we had been through the private health care process before.

    Out of sheer curiousity, we applied under the ACA. To my utter surprise and delight, once the application was filled, we were given at least 8 different options of coverage, ranging from 1/3 the current premiums we pay, to slightly more than we currently pay. For all of us, INCLUDING my wife.

    We opted to pay a bit more per month for several reasons. However, the single BIGGEST reason was the following: Our deductible went from $10,000.00 per year to – get this -$3,000.00. A 70% decline. Moreover, our family’s max out of pocket is still $3,000.00 a year LESS than our deductible was with prior coverage.

    This translates to a savings of over $8,000.00 per year if something ever happens. And we all know that one trip to the hospital eats that right up. And with a family of five, I guarantee we will have many years like that.

    Again, you don’t know me, or my situation, so I really doubt you post this. However, if you want real, credible sources about the benefits of the ACA, I suggest you look to real people, instead of news sources. Ask them about their story. I think you will find that, at least with people like me, there is great benefit, and great relief that we don’t face potential bankrupcty every time we get sick.

    Yours Truly,

    Mike, from Lee’s Summit, MO