There may not be four syllables more galvanizing to Americans than Obamacare. The Affordable Care Act has become something of a partisan rorschach test, revealing our attitudes on everything from the role of government in our lives, to our opinions on the healthcare industry, to simple red team/ blue team divides.
I’m just a guy looking to finally get health care. Now in my 30’s, I’ve lived most of my adult life without health insurance, and that’s been fine with me. I’ve been blessed with good health (which I attribute to genetics mostly, although I do exercise regularly) and the one time I needed treatment for a somewhat serious knee injury, I was lucky enough to be covered by insurance, which kept me from incurring thousands in medical bills.
But after a minor infection turned into a $120 visit to the Emergency Clinic earlier this year, I realized the value in being covered. There are just too many what ifs to consider and the chasm between those with insurance and those without it is as deep as it is wide. I’ve seen friends who have been financially devastated when they were hospitalized and had no insurance. Despite my moral objections surrounding the principals of health insurance companies, the reality is that you either pay a little each month or you end up paying a lot.
Besides, the commercials that have been running almost non-stop in Denver over the past month assured me that signing up and shopping for health insurance would be easy. With an optimistic attitude, I fired up Connect for Health Colorado (on a Windows-based PC, using Chrome as my browser) with the mission of getting insurance as cheaply and quickly as possible.
10:30 a.m. - The first thing that draws my eye is a box asking “Do You Qualify for Financial Assistance?” All you have to do to find out is enter your zip code and the day you’d like to start coverage on. And then the number of people in your household, then your first name, month and year of birth, sex, citizenship status, and state residency. Then another page asking yes or no questions about my “disability/ blindness status” (nope), “American Indian/ Alaskan Natives Status” (nope), “Incarceration Status” (um, weird question, but nope) and finally, “Within the past 6 months, has this person used tobacco products regularly?”
Do I have to answer?
I’m a smoker and like 90% of smokers, I’m not always glad I’m a smoker. On the one hand, I love my morning coffee and cigarette. On the other hand, pretty much everything else. I told myself when I started feeling guilty about smoking, I’d quit. That was three years ago. Now Obama is all up in my computer, asking me about my smoking habits over the past half-year. Who are you to judge, Obama?! I’ve seen this picture!
I click “yes” and move on.
I’m then asked to estimate my household income for the upcoming year. Man, this is getting personal. For a number of obvious reasons, I’m not willing to disclose that amount here. Let’s just call it...liveable. It turns out that I’m eligible for “Premium Assistance Individual And Family Plans” as well as “Cost Sharing Reduction (for applicable plans).” Well alright then! Now I’m able to move forward and find a plan!
10:35 a.m. - In just five minutes, I’m looking at a series of health plans that range in price from $97.79 to $401.18 (incidentally, I went back and checked on what my costs would be had I not admitted to being a smoker. $71.26 is the cheapest, meaning being a smoker will cost me $26.53 more per month in insurance costs. Don’t start smoking, kids). I can compare their coverage options as well.
Unfortunately, my ignorance about jargon like “co-insurance” and “EHB benefits” sends me down a Google rabbit hole that wastes almost 30 minutes of my time without providing any real answers about what package would be best for me.
11:00 a.m. - Back to square one. Now that I’ve figured out what my costs might be, I’m required to create an account on Connect for Health Colorado. Throughout this process, I’ve noticed a medium-level of security on the site (I get the “lock” symbol, but not in green, as it is when I log onto my bank account). Then there’s this warning:
“NOTICE: This system contains U.S. Government information. By accessing and using this system you are consenting to system monitoring for law enforcement and other purposes. Unauthorized use of or access to this computer system may subject you to State and Federal criminal prosecution as well as civil penalties.”
The initial application page has an even more ambiguous warning, reprinted in full:
“Important: Connect for Health Colorado and the Department of Health Care Policy and Financing are authorized to collect information on the application, including Social Security numbers and will confirm information that may affect initial or ongoing eligibility for all persons listed on your application. You are allowing Connect for Health Colorado and the Department to use Social Security numbers and other information from your application to request and receive information or records to confirm the information in your application. You release Connect for Health Colorado and the Department of Health Care Policy and Financing from all liability for sharing this information with other agencies for this purpose. For example, Connect for Health Colorado and the Department may get and share your information with any of the following agencies: Social Security Administration; Internal Revenue Service; United States Customs and Immigration Services; Department of Homeland Security; Centers for Medicare and Medicaid Services; Colorado Department of Labor and Employment; Financial institutions (banks, savings and loans, credit unions, insurance companies, etc.); child support enforcement agencies; employers; courts; and other federal or state agencies. We need this information to check your eligibility for health insurance or help paying for health insurance, if you choose to apply, and give you the best service possible.”
I’m not really sure why my health care information might need to be shared with the Department of Homeland Security, but since I'm fairly certain I have no choice, sure, go right ahead.
Now I’ve made it through to a page asking if I want to apply for financial assistance. Little do I know, this will send me to another page that forces me to sign up for something called PEAK, which requires me to fill out yet another form with all of my personal and financial information and create a username and password. Sure fine, whatever.
Turns out I’m not eligible for Medicaid, which I wasn’t even aware I was applying for. On the plus side, I now have a new account with the Jefferson County PEAK agency and another username and password to remember.
11:37 a.m. - When I’m rejected for Medicaid -- which again, I never realized I was trying to get -- I’m directed back to the Connect for Health Colorado site, which pleasantly informs me “is experiencing technical problems.” Undaunted, I enter in my confirmation (rejection) number from the previous screen, and I’m moved through to a few more pages that require me to re-enter my personal information, including my Social Security number, which I think I’ve shared at about three different junctures. Yet after entering it again and clicking next, I receive an unsettling warning:
“The external system to verify your social security number is currently unavailable. You can continue with your enrollment through a manual verification process.”
Great, let’s do that. After filling out more forms, I’m sent to a truly curious page, which confirms my identity through a series of multiple choice questions. “Which one of these is a street you used to live on?” “Which one of these is the name of a previous employer?” etc. It’s sort of like a creepy version of "This is Your Life."
After sifting through another page of ominously worded user agreements (are there any other kind?), I’m finally confirmed for the “Premium Assistance Individual And Family Plans.” And, now that’s it’s 12:03 p.m., I’m hungry.
12:56 p.m. - Having eaten my lunch (a healthy Chipotle burrito), answered some emails, and enjoyed by post-meal cigarette (of course), I’m ready to finish this bad boy up. When I log back in (the site logged me out, automatically) I’m thrilled to discover that all I need to do now is pick my plan.
As I said before, I’m confused by the terminology, so like all overwhelmed consumers, I do what comes naturally: Pick the cheapest one, which is the Kaiser Permanente Bronze plan. With my $105 credit, my monthly premium will be just under $100 per month, slightly more than I wanted to pay, but not by much. It appears they’ve thrown in Dental for free, which is awesome.
It’s worth noting that at every step, the website lists are all sorts of ways to get in touch with people who could have helped guide me through this process. For the purposes of this story, as well as my own obstinate nature, I declined.
By 1:22 p.m., it was all over. Now all that’s left for me to do is mail the check (no credit cards or cash accepted) for my first monthly premium, and I’ll be covered by May 1.
All in all, I’d have to say the experience was a mixed bag. On the one hand, the detours, diversions, repetition, and constant user agreements were, at best, annoying, and could even be seen as troubling to those who are philosophically opposed to sharing personal information with government agencies. On the other hand, compared to the hall of mirrors known as the Department of Unemployment, or the dispiriting bureaucracy of the DMV, the Connect for Health Colorado website was a model of sleek efficiency. Signing up for anything that requires inputting large amounts of personal information is never going to be fast or fun, so beyond a few tweaks, it’s hard to see how they could do better.
Ultimately, while I’m not looking forward to the new expense, I’ll sleep better knowing that I can go in for physicals, get medicine when I’m sick, and receive treatment for injuries should I need them. That peace of mind is why I signed up for Obamacare, and it’s a personal reason. That’s the thing about Obamacare -- it is whatever you want it to be.