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Fifty States of Obamacare Confusion, Stress, and Aggravation

From the last Morning Jolt of the week:

Fifty States of Obamacare Confusion, Stress, and Aggravation

No matter where you live in the United States, Obamacare is causing headaches, stress, and aggravation for someone near you.

In New Hampshire, vending-machine manufacturers are gasping at the new law’s requirements that calorie information be displayed on roughly 5 million vending machines – not just on the packaging of the food inside, but on the vending machine itself:

Carol Brennan, who owns Brennan Food Vending Services in Londonderry, said she doesn’t yet know how she will handle the regulations, but she doesn’t like them. She has five employees servicing hundreds of machines and says she’ll be forced to limit the items offered so her employees don’t spend too much time updating the calorie counts.

“It is outrageous for us to have to do this on all our equipment,” she said.

Brennan also doubts that consumers will benefit from the calorie information.

“How many people have not read a label on a candy bar?” she said. “If you’re concerned about it, you’ve already read it for years.”

To the Obama administration and their fans, America’s businesses are giant, bottomless barrels of money, time, and energy whose purpose in life is to be directed and redirected at the whims of those wise folks in Washington, in order to achieve the visionary “social justice” goal of telling people that, say, a candy bar isn’t nutritious or healthy for them.

In most states, the current worst stress and headache stems from people who think they’ve signed up for insurance through the state or federal exchanges but who haven’t yet gotten their confirmation or insurance cards from the insurance companies.

In Connecticut:

More than 34,000 state residents were slated to begin new private insurance plans Wednesday as part of the federal health law. But as the new year began, many people who bought policies through the state’s health insurance exchange still hadn’t received their first premium bills, which must be paid by Jan. 10 to get coverage this month.

In Vermont:

The state’s largest hospital had almost two dozen patients seek treatment with health insurance policies provided through Vermont’s health overhaul system since the start of the year, yet more than half of those did not have insurance cards, an official at Burlington’s Fletcher Allen Health Care said Thursday.

In Massachusetts:

Jessica Stanford of Sharon, Mass., is 40 and newly pregnant. She’d really like to see a doctor soon because she’s had several miscarriages and developed gestational diabetes during her last pregnancy. But she doesn’t have health insurance and is worried about racking up medical bills.

Stanford applied for subsidized coverage in early December. She keeps calling the Connector to find out about her enrollment status. One customer rep told Stanford she could take her application number to a doctor’s office for proof that the state will cover her, at least temporarily, but Stanford wants something more certain.

The Connector says it has extended coverage, through March, to 254,000 residents who applied for free or subsidized insurance and all residents who have had government backed coverage.

The agency is sending out letters explaining a temporary coverage plan that begins today (Jan. 1) for 22,371 residents who, like Stanford, are applying for the first time.

But Stanford doesn’t have her letter. The Connector is trying to expedite Stanford’s case…

But it’s pretty obvious the application process is still a mess. Only 497 of the almost 50,000 applicants who filed online have a new ConnectorCare plan. The agency can’t say how long it will take to finish processing the other 45,000 applications or bring 89,000 residents who have subsidized coverage, but haven’t even started to re-enroll, into the new, post Obamacare plans.

I can hear you now – well, those are all New England states. The only guy who knows how to run anything up there is Bill Belichick.

But it’s not much better in the upper Midwest.

In Wisconsin, a new survey of employers by Wisconsin Manufacturers and Commerce finds that “54 percent say that ACA has had a negative impact on their employees and 30 percent say it is too early to tell. Just 1 percent said the impact has been positive.”’

In Minnesota:

It’s a new year, but MNsure continues to wrestle with old problems involving its website and call center.

The application and account services portion of the state health exchange website was down Thursday afternoon for technical reasons.

“We are actively working on a resolution and ask that you visit us at a later time,” says a notice on the MNsure website. “We apologize for the inconvenience.”

Meanwhile, the average wait time for people calling MNsure for help on Thursday was 76 minutes. More than 2,200 calls had been received by MNsure as of 2 p.m.

For weeks, consumers have been frustrated by the combination of website glitches and lengthy waits at the MNsure call center.

Same bureaucratic nightmare in Grand Rapids, Michigan:

Shannon Wendt was no fan of the Affordable Care Act, but when she found out her family’s high-deductible health insurance plan would be canceled, she tried to enroll in a new plan through the federal marketplace.

 And then she hit glitches – and not just the usual problems with a stalled website.

Despite roughly 25 hours on the phone with dozens of health insurance navigators and supervisors, she still has been unable to sign up for insurance. The reason: her five children are deemed ineligible.

. . . Working with navigators by phone, she filed and deleted an application 12 times. She had her husband set up a separate application, but that ran into problems.

At one point, a navigator said she may have to submit proof of citizenship for the children. All five children were born in the U.S., and all have social security numbers, she said.

“Nobody’s said anything about it since then,” she said. “That’s kind of my working assumption – that somehow our kids are not considered citizens and that’s why they were rejected.”

Chicago, Illinois:

Dr. John Venetos, a Chicago gastroenterologist, said there is “tremendous uncertainty and anxiety” among patients who have been calling his office, some of whom believe they have signed up for coverage but have not yet received insurance cards.

“They’re not sure if they have coverage. It puts the heavy work on the physician,” Venetos said. “At some point, every practice is going to make a decision about how long can they continue to see these patients for free if they are not getting paid.”

And no, it’s not much better in the mid-Atlantic, either.


Pennsylvanians who applied for health insurance through the federally run website and were found to be eligible or potentially eligible for Medicaid were cautioned Thursday by Gov. Tom Corbett’s office that they may not have coverage yet.

An administration spokesman said the federal government continues to have trouble transferring the electronic files of more than 25,000 applications to the state’s Department of Public Welfare.

Keep this in mind as Obamacare fans keep telling you that the website is fixed.

A similar story in Montgomery County, Maryland:

“Somebody just got hit by a car today, who’s on the way to the hospital right now, who thinks they have coverage,” says veteran Montgomery County insurance broker Jack Cohen.

That person might be mistaken if they think they are covered.

“If you say, ‘I’m covered, I signed up for coverage Jan. 1, I just don’t have the card yet,’ the doctor is going to see you, but they’re going to make you pay out of pocket,” said Cohen, who’s heard from irate customers who are worried their payments haven’t been processed.

In West Virginia:

A glitch on the federal health insurance marketplace has caused problems for about 18,000 West Virginians attempting to sign up for health coverage under the Affordable Care Act…

The federal website would have transferred accounts of those people on to the state, [Jeremiah Samples, assistant secretary for the state Department of Health and Human Resources] said. Instead, the federal website is sending only “flat files,” which have basic information about the person but not enough to sign them up for Medicaid, he said.

The DHHR is sending letters to those 10,000 people informing them they will need to sign up again via the state’s Medicaid website.

In Virginia, the mandate’s in effect . . . but the uninsured are telling the doctors the problem is the same as it was before: They just can’t afford it.

Even with the Affordable Care Act and possible Medicaid expansion in Virginia, the Free Clinic of Danville says they’ll still have constant traffic.

Staff members say they’ve had numerous patients inform them that even with subsidies, they’re still unable to afford health insurance premiums.

Turning South, in Texas the description is “a sort of chaos,” which is probably not that much better than just plain chaos:

The entire tracking system was “in a sort of chaos” Thursday as consumers tried to use or confirm their new insurance, said Kelly Fristoe, an insurance agent in Wichita Falls, Texas.

“I’ve got pharmacies that are calling in to verify benefits on these new plans that are getting incorrect information,” he said. “I have people that are calling to make their initial premium payment, and they’ve been on hold for maybe three or four hours at a time and then they get hung up on.”

North Carolina:

Months after problems plagued enrollment in the State Health plan, thousands of current and retired state workers continue to face obstacles.

The new coverage year began Jan. 1 but state officials acknowledged Thursday that 105,000 state employees, mostly those who work at government agencies, do not have insurance cards used to obtain medical care.

State Treasurer Janet Cowell’s office, which oversees the insurance plan that covers 660,000 state workers and retirees, says the cards are being processed and will be mailed soon.


The kind of quiet relief is what a Santa Rosa Beach couple, artist David Hart and his wife Karen, a marketing consultant, are yearning for. As the Washington Post reported on Sunday, the Harts signed up for a plan through the federal Marketplace and paid by phone on Dec. 19. But they got worried when the check to Florida Blue hadn’t been cashed by Dec. 27, and began making calls.

On Wednesday, Karen Hart told Health News Florida that their problem has not yet been resolved. Their application shows up as complete and paid on, she said, and they even have a payment confirmation number, but they haven’t been able to get Florida Blue to fix the problem.

“We’re now stuck in the middle,” Karen Hart says. “It’s been an absolute nightmare.”

In Tennessee, one of their senators is underlining the economic impact of the new law:

U.S. Senator Lamar Alexander, a former U.S. Secretary of Education, Thursday said that as school starts back up in 2014, Obamacare is forcing cuts in hours for employees, such as substitute teachers, in at least 11 Tennessee school districts ‘and likely many more,’ harming students’ education in the process

School districts reporting fiscal challenges because of Obamacare include: Carter County, Clarksville, Franklin Special School District, Johnson City, Maury County, Oneida Special School District, Rutherford County, Scott County, Stewart County, Washington County and Wilson County.

Nor are things much better out West. California’s just now realizing that the exchange isn’t sustainable, at least not the way it currently operates:

Covered California projects it will lose $78 million in the 2015-16 budget, and it is not clear how the health exchange plans to close that gap and become financially self-sustaining once federal grants run dry.

While the exchange says that it will increase revenue and trim expenses to bring its operating budget into balance, its budget documents make no definitive statements about how, exactly, it will reach financial equilibrium . . . 

Since its creation in 2010, the exchange has paid its bills with nearly $1 billion in federal grants. But, starting on Jan. 1, 2015, the Affordable Care Act forbids federal grants for health exchange operations. And state law prohibits dipping into California’s general fund to pay for exchange operations.

How long until we see state governors pushing to delay the deadline for financial sustainability? Federal bailouts forever! Elsewhere in the state:

In California, employees of the state health exchange were still going through some 19,000 paper applications sent in the early days after Covered California launched on Oct. 1, spokesman Dana Howard said. He could not say how many were outstanding.


A major health care overhaul begins on Jan. 1, but it’s proven to be a big pain for many Oregonians.

Some people say they won’t have insurance in the New Year, despite their attempts to enroll in Cover Oregon.

 “I have spent a total of four hours on hold to no avail. I had a contracted insurance broker submit the application for me on December 4th but have never received a packet,” one viewer wrote to KATU in an email. “So frustrating as I really need coverage ASAP.” 

“I was in their system on every other call today. Now I am not,” another man wrote in an email to KATU. “I am disabled and need my insurance!”

In Washington, the good news is that the state can only take money from your heirs after you die to recover long-term care costs, not routine costs. Now you can rest in peace!

Washington’s Health Care Authority, as promised, has filed an emergency rule to amend Medicaid’s estate recovery policy.

Current policy allows Medicaid to recover all medical costs from a client’s estate after death, which caused some consternation among those signing up for health insurance through the state’s expanded Medicaid program. The change means that Medicaid can only recover costs related to long-term care services.

The emergency rule-making order, which becomes effective Jan. 1, 2014, said the change was made to “eliminate a barrier to applying for health care coverage under the Affordable Care Act.”

Hope you like paying higher premiums, Hawaii:

The Honolulu Star-Advertiser reported Tuesday the state Insurance Division approved increases of 9.2 percent for 11,000 individual plans and 5 percent for 26,300 small business plans administered by Kaiser. HMSA will be allowed to increase rates on 14,300 individual plans by 7.5 percent. HMSA increased small business rates by 6.8 percent for 118,000 members earlier this year.

Insurers say the increases are necessary to cover higher medical expenses, taxes and fees anticipated under the Affordable Care Act.


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