My Obamacare Nightmare: Yes, the Government Can Terminate Your Healthcare

By Brenton Smith

For most politicians, the Affordable Care Act (“ACA”) is simply wedge politics. Democrats see the program as a lasting legacy to their party and are unwilling to admit there is a problem with ACA. Republicans, on the other hand, tend to see its shortcomings as a political gift from heaven and are unwilling to fix even the most appalling problems with the program’s operations.

For the people stuck in-between these fixtures of politics—the self-insured—the Affordable Care Act is an ongoing nightmare and a caustic warning for anyone dreaming about Medicare for All. I know because I’m one of them.

I didn’t expect the Affordable Care Act to make healthcare more affordable, and it hasn’t. In fact, I tend to spend the same amount on healthcare despite deductibles that are 500 percent higher than my pre-ACA care. The range of providers is considerably less robust, and unlike in the good old days, “affordable” insurance no longer provides any coverage on the out-of-network spending.

These results aren’t terribly surprising, and they generally fulfill my expectations about the cost-effectiveness of government-provided services. Sticker shock, however, isn’t the nightmare. The nightmare is the never-ending cycle of paperwork that comes with affordable care.

Actually, your healthcare can be terminated. Two years ago, the government questioned whether my kids were US citizens and eventually threatened to cut off my affordable care if I couldn’t show proof that they were. Initially, the confusion appeared simple enough: The government would hold my healthcare hostage until I provided my kids’ Social Security numbers. I gave them the numbers, and the warnings were supposed to stop.

Unfortunately, the letters escalated in tone to a point where the government was going to cut off my credits, which was the only way I could afford healthcare at this point.

When I called the Marketplace, I was assured that my application was fine. When I received mail, I was warned that my healthcare would be cut off.

For the sake of brevity in this piece, I am going to have to skip over the 30 hours of phone calls and three visits to my congressman’s office. Long story short: The government determined it had the right to terminate my health care because I didn’t file the right paperwork. In fact, the government was going to cut off my health care because their system had two applications for me on file, one of which was almost entirely incomplete.

When I called, the people on the phone saw the completed application, which was fine. When I received warnings in the mail, the warnings dealt with the inactive application that was unconnected to actual credits.

I have had to condense the experience from two years ago because last year’s was even worse. In December, I received a notice that my form-blah-blah-blah was not included in my filing. I filed a 1040X, including the missing form, and received a check from the Treasury in April.

All done? No way. In May, I received notice that my health care credits were going to be terminated, and in fact, they were terminated in June. I contacted the appeals arm of the Marketplace and was told that the IRS did not receive my reconciliation of tax credits for the previous year. They indicated that the issue could be quickly resolved. Unfortunately, they requested the wrong information—twice. Thus I used up my two informal appeals by providing the information requested by the government.

After another 30 hours of my life went down the drain of bureaucracy, I faced my final appeal and the government was unable to tell me what documentation would be necessary to prove when the IRS received my reconciled taxes. They had a copy of my IRS check and a copy of the actual form time-stamped by the IRS. That was insufficient.

There are so many people filing appeals, it took nearly five months to get my formal appeal hearing. That meeting took about 15 minutes, most of which was spent on introductions and an explanation of the hearing. The decision took about 30 seconds because the hearing officer had my tax filing in its entirety. She determined that my filing was timely. My efforts were entirely wasted.

In other words, your health care can be cut off because the government can’t find the paperwork you have already provided and the Internal Revenue Service has already paid on.

I had to wait for the decision to appear in writing. That took about 10 days. When I received it, I had to call the Marketplace Appeals Center to “effectuate” the decision. In that process, the person had a list of questions I had to answer. The person was well-trained to take the required yes and no answers. She was unfortunately completely unable to explain the consequence of my answers. She indicated that I should talk to a tax lawyer if I needed help in answering them.

The questions were answered, and I thought the money was going to be sent to my former insurance carrier. You are likely thinking the story ends here. No way. The insurance company doesn’t receive the money, and it isn’t entirely clear why the government would send the money to them, anyway. So I returned to the Marketplace Appeals Center, which explained to me “yes,” the last conversation was not entirely clear. They were going to sit on the money until my appeal ran out.

All done? Then I would have to wait a period of time to reach out to my former insurance company to have them send me a refund check.

All done? No way. The delay in getting my credits corrected will mean that my 1095-A is wrong again this year. That means my reconciliation will be late again.

All done? No way. I am getting questions about my children’s citizenship status again.

The ACA is a predictable debacle. Much of the media is dedicated to talking about how wonderful the legislation is. Much is given to opinion pieces that the legislation should be replaced. None of it deals with how to fix the program in the present sense.

In the words of P.J. O’Rouke, if you think health care is expensive now, just wait until it is free.


Brenton Smith is the founder of Fix Social Security Now and writes on the issue of Social Security reform, appearing in national media like Forbes, Marketwatch, FoxBusiness, and FEE.org.

This article was sourced from FEE.org

Image Credit: President Barack Obama delivers remarks at an Affordable Care Act event at Temple Emanu-El in Dallas, Texas, Nov. 6, 2013. (Official White House Photo by Pete Souza)




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