Sunday, December 28, 2014

A Very Merry "Screw You" from Obamacare

For those of us who need to deal with Obamacare directly through the exchange, finding health insurance becomes more bizarre and frustrating each day.

After completing our 2015 application for coverage and managing to find a "reasonable" plan that will cost us only about $10,000 per year (before Obamacare, an identical plan in South Dakota would have cost us $3,000 per year), we just received a notice that we cannot receive coverage in South Dakota because we don't own or rent a home in the state and pay utility bills. Apparently, you need to provide proof of both mortgage or lease payments and the payment of utility bills to be eligible for healthcare coverage through the Obamacare exchange in South Dakota. Considering we had South Dakota coverage in 2014, I can only assume this is a new development.

So under Obamacare, you can't be denied coverage for a pre-existing condition, or even if you are not a U.S. citizen, but you can be denied coverage if you do not own property or pay rent to a slumlord and pay utility bills.

Even after explaining to the Dakotacare representatives that we live in an RV and provide for our own utilities by living off-grid, they either could not or would not understand our situation and address this ridiculous policy. The fact that we are legal residents of South Dakota, with valid drivers' licenses, pay annual property taxes to South Dakota on our truck and RV, are registered to vote in the state, receive all of our mail in South Dakota, and have South Dakota residency in the eyes of the most powerful federal agency in Washington...the IRS, was not a convincing enough argument. The help desk at didn't have any answers for us to solve this. Like most of my dealings with this group, they were clueless and helpless, trying to refer us to the South Dakota insurance commission to seek some help.

At least we have a partial solution. We will skip buying health insurance for 2015 and save that $10,000. If they try to penalize us with a fee for not buying insurance, we have ample documentation that we applied through the federal exchange, were approved, and were prepared to buy insurance when we were denied by the Obamacare-approved insurer on the exchange. I don't believe we can be penalized for not buying something that we tried to buy but were then denied by the provider. But who knows, things get weirder and weirder in this country every day.

Next year we will switch our residency to Idaho, where we do at least own raw-land property and pay traditional property taxes. I doubt the Idaho healthcare exchange will require proof of utility bill payment since it seems that about 30% of the state already lives off grid!  

I've been trying to give this legislation the benefit of the doubt for the last year and a half, but the steaming pile of excrement that is Obamacare just seems to get worse and worse every day. From revelations that a major designer of the program devised a way to sneak elements of it by the "stupid" American public (Jonathan Gruber), to "we have to pass it first before we can know what's in it" (Nancy Pelosi), to let's keep delaying the employer mandate and the impacts on Medicare until after our next elections because the impacts on the voters are just going to suck, and on and on and on, this is a piece of legislation that is destined to die a long, slow, painful, multi-trillion dollar death.  There's really only one thing to say:




  1. Those sorts of frustrating bureaucratic things are sooooo aggravating. That said, isn't it more South Dakota's "fault" rather than ACA? I only say that because in other states there is not the same problem vis-a-vis RV-ers getting signed up. It seems to be happening most in SD. I was lucky in that just as I was choosing a domicile state (a year or two ago), I read on some informative blog posts that South Dakota was going to be a tough state for domicile/health insurance. SD was previously my first choice state, as I am from a neighboring state and so it just seemed "right." However when I read about what was coming up, I chose another state and in that state it wasn't difficult for an RV-er to sign up for ACA health insurance (at least for me).

    It does seem wrong that SD (or whomever is doing it) is making it so difficult. I bet the folks who work with RV-ers (mailing services, etc.) are dismayed as well, as I would think it would result in some of their customers moving to another state.

    1. I wish the problems could be solved by just fleeing to different states, but that won't work either. It's not an SD issue as much as an insurance company finding a way around Obamacare requirements so that they can lower their risk exposure. We've seen similar problems with CA and ID. Those are blue and red states that both set up exchanges. It won't be long before insureres in other states realize they can exclude people who don't actually ahve physical addresses in their state of residence. Most RV-ers don't even need to use Obamacare. They have other coverage options. In fact, I've never met anyone who has to use an Obamacare health exchange actually say they like it better than what they had before. When I talk to an Obamacare propenent, they inevitably end being someone on Medicare or with coverage through a former employer such as a union. If you make less than $7,500 per year and are eligible to be added to the Medicare roles through Obamacare, you probably also like the program.

      The worst part is that the program seems to reveal a new ugly detail every other week. For example, I doubt very many people know that the penalty for not having coverage rises to 2% of their income or a minimum of $375 in 2015 and is set to rise every year after that. I can't think of a more regressive tax (other than maybe payroll taxes) that hits the working poor up through the middle class more directly than that.

      I've spent hundreds and hundreds of hours studying Obamacare and the healthcare industry over the past five years and could go on all day about these issues. But I'm not in the book writing business. :-)

  2. John you seem a bit aggravated (understatement) and I don't blame you. I do know that the Repub SD Governor refused the medicaid plan and the state chose not to set up an exchange. Don't know if that has any impact on what is happening to you or not. If this is an issue with the ACA then we should be hearing from other fulltimers. So far you are the first.

    In the end the ACA was a bastardized attempt to do something useful, namely provide universal healthcare. But since that is a SOCIALIST policy it was beaten to within an inch of its life and the result is the clusterfk we have today.

    I hope that it will be a starting point for something that this country really needs genuine universal coverage. It would be great if our politicians all saw that as a beneficial goal and tried to figure out a way to make it financially feasible rather than screaming socialism, communism, etc.

    I worked for and retired from insurance. In fact, I worked for both government and two of the largest companies in the country and based on that experience I don't believe either one has the market on incompetence.

    The latest example for me is that I have had to begin taking an expensive Jus that would run about $400 a month without insurance. Dealing with the carrier to get the first rx filled took two weeks, multiple phone calls to the doctor and the insurer with over 16 calls in the last two days including three automated calls from them one of which said it was on the way no worries only minutes after I was told it wasn't on the way. Even after they said everything was taken care of and sent me an email with a tracking number on 12/23 I was to learn on 12/26 it was the wrong tracking number and had not been mailed. Not because they called me but because I called them.

    I am currently trying to get an erroneous charge removed from a medical bill from the Mayo Clinic that occurred in July 2013. I notified them of their mistake in the same month. It was finally removed this November only to be added again the first of December. A year and a half later still fucking with it. It isn't complicated the charge was for a service they didn't perform. Called the insurer who had paid their portion at the same time and they didn't care and still don't have their money back. So, Mayo is attempting to collect it again including the insurance adjustment.

    I spent my life trying to stay healthy but that doesn't always work. Keep your fingers crossed you won't actually need to use healthcare anytime soon.


    1. that should have been new drug not new Jus


    2. You don't hear more from fulltimers for two reasons. First, almost all fulltimers are either old enough for Medicare or they have some heathcare coverage provided by a former employer such as a private or public sector union, and so they don't use Obamacare. Second, the majority of fulltimers we've met either still own some kind of property in the state they claim as their residence or claim a family/friend residence as their physical address and wouldn't have the issue even arise. Which one of those categories do you fall into? In three years, we've only met two other couples who are fulltimers and need to use the Obamacare exchanges. They both chose to skip the coverage and pay the fine.

      This actually has nothing to do with states that are red or blue or have exchanges or not. Our experience directly is with California, South Dakota, and Idaho. Three very different states. The results are all the same. Our premiums have gone up 300% over what they were when we bought insurance through the old site beforte Obamacare existed. We will be shifting to Idaho solely because we own some raw land there. It won't save us any money on premiums or give us better coverage. Idaho is a red state with a its own exchange.

      When you think about it, insurance companies are acting entirely rationally. As you know, when you blow up an insurance company's actuarial tables by completely changing what coverage they must provide and who they must cover, the company will protect itself from risk by raising premiums and doing everything they can within the law to limit who they have to provide coverage for. Dakotacare found a loophole so they don't have to cover SD residents who don't own physical property or rent in the state. This was a complete surprise to the Federal help line I called to complain about this, and they had no idea what to do about it.

      I'm not being political when I say this law is falling apart. Neither party is addressing the root cause of the problem that I've written about in past blog postings. I also don't think single payer universal coverage will ever work in this country to control costs. The healthcare industry lobby is the largest industry contributor to both parties. They will never allow legislation that will remove their monopolistic and secretive pricing protections to be removed. They will also never allow a competitive, cash-based pricing system utilizing HSAs to ever gain a significant foothold.

    3. "They will never allow legislation that will remove their monopolistic and secretive pricing protections to be passed."