Unlike some of our elected official who still believe there was nothing wrong with the US healthcare system that require change, I firmly believe it was badly broken. I firmly believe that there was a serious need to make changes to US healthcare system. Whether this change needed to come in the shape of Affordable Care Act aka ObamaCare, is another debate. But the existing system was expensive, cumbersome, un-sustainable and unfair.
However, poor debut of the Affordable Care Act or ObamaCare website including CoveredCA might be why the reason why young applicants have delayed their enrollment. Even our own experience with CoveredCA.org was more than 10 weeks of uncertainty and confusion before we got a denial of coverage letters. That might explain why young people are not enrolling with Obamacare and why they missed the massively optimistic projections of 5.5 Million by the end of February 2014.
I am certain everyone has their version of horror story of denied coverage for a loved one. But ours came in the shape of a complete surprise in 2007 when my daughter was 8 years old. She got her 1st ear infection which was treated with antibiotics and a follow up visit was to confirm her recovery. It turned out that as a Small Business owner, I was switching insurance companies few months after Sophie's ear infection. And that's when we got the surprise of the century from Blue Shield of California.
The letter from Blue Shield of California stated that they are postponing their decision to offer our 8 year old coverage for at least 6 months! I could not understand what this meant since it was clearly written by an attorney and not a healthcare provider. But I knew it was not good news. So, I called the Blue Shield of California and asked for an explanation. The agent simply repeated the information that was already on that letter and she restated that the company is not prepared to offer our now healthy 8 year old healthcare coverage. I pressed on and asked her to escalate my call to her supervisor.
She did get someone else on the phone and I neatly explained that I can understand they won't be offering my 8 year old daughter coverage for 6 months, but what were we supposed to do at the mean time? I was merely asking to see if there was any information that they had requested from our previous providers that would have made their coverage decision simpler. Were we supposed to buy insurance from Home Depot for the next 6 months while they got comfortable with their decision?
And it was then that this supervisor volunteered some un-necessary information. She told me that our 8 year old daughter who had only ONE ear infection in her life had TOO many ear infections! I confirmed that one ear infection was considered too risky for them and without responding directly she endorse the decision to postpone their underwriting decision and recommended that we re-apply for coverage in 6 months.
I was furious and beyond angry cause I now had proof that Blue Shield of California is only interested in covering healthy people and the one ear infection was sufficient grounds for their underwriters to avoid offering coverage to an healthy 8 year old who was not under treatment for ANY other sickness and was not taking any medication.
I was mad and I wanted to get some real answers. So, I contacted California Insurance Commissioners after referrals from Senator Barbara Boxer and Senator Diane Feinstine's office. They advised us that insurance is a State matter in California and they could not help us.
We wanted the California Insurance Commission to investigate this decision which appeared to us appeared extremely reckless, unfair and cruel since they gave us no option to appeal and were refusing to reconsider. So, we filed a complaint against Blue Shield of California. After 2 weeks, we got a very different letter from Blue Shield of California welcoming our 8 year old to their PPO plan!
In short, the previous Healthcare System was seriously broken and needed to be fixed. So, unless these website are able to offer quick responses for consumers who are looking for health coverage; the enrollment numbers will remain dismal and the plan will cost more than the original projections.
But then again, who can name a government program that was online and on budget?