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Potholes On Path To Health Insurance

I have been calling Covered California for the past month, trying to get information on my health insurance application because my current coverage terminates on Dec. 31.

In keeping with the federal government's guidelines, I filed an application through a certified agent, who cau­tioned me to submit a paper rather than electronic appli­cation in order to protect this ultra-sensitive personal information. Basically, my agent told me he did not have enough confidence in the process to advise me to apply online.

That seems to have been good advice.

From what I have experienced, Covered California seems to be in utter disarray — a marketplace rife with disorganization. Covered California representatives have told me a different story every time I've called, and with excessive on-hold times to speak to someone.

For example, on Dec. 2, I was greeted with an “all cir­cuits busy” recording for nearly eight hours: It took the whole day just to get through to the recorded mes­sage that told me wait times are going to be longer than usual.

On Nov. 20, when I initially called to check on the status of my application, I was told there would be a short, 10-day, turnaround to input the data. These arbi­trary deadlines come and go without action however.

On Nov. 30, another representative completely dis­counted this 10-day time frame, volunteering to me that there is a “huge backlog” of unprocessed paper applica­tions. Moreover, she said, “mandatory overtime” was only authorized by Covered California managers to begin Dec. 2. This young lady was cordial and sincerely apologetic, but she sounded woefully unprepared for the job she had taken on — unable to answer even the most basic questions about what the public should expect from this process.

Even though this ship appears to be navigating rough seas without a captain, I have no choice but to keep holding on the line: in fewer than 30 days, I could sud­denly become one of the millions of “uninsured” who will be slapped with a 1% non-compliance income tax penalty for failing to procure health insurance coverage.

My story prompts several questions the public at large should be asking:

Are there true safeguards in place to protect the sensi­tive personal information being transmitted online?

Why can't certified agents get information any more easily than the applicants they represent — isn't their role to streamline an already ultra-complicated process?

Why didn't Covered California adequately staff its call center to deal with the throng of applicants?

When people submit applications in paper form by mail and fax, what happens to them?

Are they cataloged and date-stamped?

Does anyone know they have been received or are they just randomly piled in some office?

As an independent journalist, I attempted to contact Covered California's media relations office multiple times. However, Covered California's spokeswoman Kelsey Caldwell would not respond to requests for information, saying only that “our team (is) no longer assisting with op-eds.”

So, I have no choice but to hold the line.

But, I am examining my limited alternatives, should the ACA implosion that so many have predicted come to fruition. My only option is to forsake coverage until the process becomes more consumer-friendly, relying much more heavily on California's Hospital Fair Pricing Act.

The act, signed into law in 2006, mirrors aspects of the Affordable Care Act. It offers uninsured patients whose incomes do not exceed 350% of the federal pov­erty level discounts of between 65% and 85% of the “chargemaster” rate (the full price on the hospital's schedule of services).

Additionally, the act precludes hospitals from charg­ing qualified patients more for care than they would charge Medicare. Compare the qualifying parameters of the Hospital Fair Pricing Act with the qualifying parameters for a subsidy under Obama's Affordable Care Act and you will note that most applicants who qualify for help under the federal law also would qualify for a help under state law.

Thus, even if Covered California can't correct its way­ward course, the state already has a law on the books to protect uninsured individuals with modest incomes. Nonetheless, this is not what was promised. Finding health coverage was supposed to be easier, not tougher.

Now we not only have to worry about how to find medical care without insurance, we also have to worry about the penalty assessment. I think every American believes they deserve better.

This story was originally published in the December 13, 2013 edition of the San Francisco Chronicle. John Aiello is an independent journalist based in Northern California and his work has appeared in many regional and national publications. He is also the founder of the electronic fine-arts journal, The Electric Review. ( ©John Aiello; 2013. All rights reserved.

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