Obamacare Lite

Is it Obamacare 2.0 or is it Obamacare Lite? Or, is it something better?  I’m still digging through the text and corresponding statutes and regulations, but at this point all I can tell you for sure is that it still has subsidies and tax provisions. Will the new bill still be tied to the IRS? At this point, yes. I expect a revision within a few days. On the positive side of it, the mandate is thankfully gone! Once it goes through revisions, committees, the House, the Senate, and the Presidents desk, it should be a bill acceptable to most of us.

At present, we are all stuck with what we have. What we have is no competition amongst insurance companies, high deductibles, and a firewall between patients and services. As I stated in the previous post, I have spent my entire life dealing with providers and insurance companies. The Affordable Care Act has only made things worse for me and millions of other Americans.

2015 was the first year of my enrollment into Obamacare. There was some mix up between the website and my insurance company, so I ended up with two accounts. The health insurance company sent cards and a full packet, and I sent them their due monetary requirement. Because of the mix up, they refused to pay their part of my prescriptions. It took almost three months of being bounced between them and the healthcare.gov enrollment representatives. It was eventually sorted out, and I was happy.

In 2016, however, things did not go as hoped. I made sure when enrolling that there were no mishaps on my end. I verified everything. In January, I went to pick up my prescriptions as I do every month. And again, the new insurance provider refused to pay a penny. They stated that one of the prescriptions was not approved in their plan even though it was generic. Even though it was a generic and my doctors office provided them with all relevant lab data and reports to prove I have to be on and have been for over a decade, they denied it. I appealed their decision, stating that going off of the medication suddenly could cause a myocardial infarction. It can! In addition, I and the doctors office provided data that proved dropping off of the medication would cause a shortened lifespan. They gave examples of this happening along with my own charted data over the past decade.

Still, they were heartless. I have to take this medication to survive. It wasn’t and isn’t a matter of an improved life, it’s a matter of survival. Even the general was $440 a month at my cost. I grew up in a business, so I understand the desire to cut cost. But, I wasn’t going to let them do at the cost of my life. I was more than willing to pay my part of the medication, but they were going to pay their part.

After a month of battling with them and spending 13 hours on the phone with their representatives, I demanded that the appeal be expedited. It was incredibly stressful. They were in effect telling me that I couldn’t have something that I have to take to survive. I don’t have millions of dollars or a board room of lawyers, but I continued to debate them daily. They finally told me that my “case” would have to go before a committee.

This somewhat innocent remark about a committee drove me to the tipping point. The term, “Death Panel” instantly came to mind. I remembered the warnings of the right about death panels and the left laughing at the notion. I was on the front line of this battle. I was having to deal with the quasi Socialist bureaucracy.

I told the woman doing her job on the other end of this particular call that my own distant cousins were put before a similar type of panel over seventy years ago and were subsequently put to death for nothing more than a patch on their chests and a number. She hung up on me after that. I went over the top, of course, but I had spent a month and a half at this point dealing with theses folks. Nothing was resolved.
My doctors assistant spent more time on the phone with them, trying her best to resolve the issue. I spent more time on the phone and eventually had to get a lawyer involved. After almost two months, the situation was resolved. They gave up, but if I wouldn’t have fought them at every turn, they would have persisted.

In 2017, I had to enroll with a new provider because the previous one went out of business. The new one tried to deny the same medicine, but once they could see the records from the previous insurance provider, they gave up and paid their agreed part.

This story is not about me getting something over on insurance companies. I paid my part, I only asked them to pay their part. This clearly shows, I think, just how bad it can be when government gets into the business of healthcare. This is about the massive bureaucratic nonsense that is the AFA. We must make sure that the new bill does not intrude into the daily lives of American citizens. Obamacare is tied to most aspects of our lives. When citizens become numbers and not people, we are all doomed.

I’ll have more to say about the new bill once I have time to finish digging through it.

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