LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Sunday, October 20, 2013

Not your typical trip to the market

So last weekend I went to my State’s exchange where bright, colorful graphics in yellow, red, and turquoise and bold type fonts assured me that not only will I “Be Well,” but that I’ve arrived at the place that is “Finally, a simple way to get affordable health insurance.”

Well thank goodness for that. It’s about time.

Then the popup pounces.

It understatedly says that due to the heavy volume on the federal website, “those shopping for individual and family insurance plans may experience difficulty signing up.” Of course, they are sorry for the inconvenience.

You see, my bluish state has a red governor at the moment. She pussy-footed around long enough that we weren’t able to build an exchange of our own and have to the use the fed’s site. Except, as everyone knows, the fed site isn’t working. (To her credit, Madam Governor did later put the citizens of our state above partisan politics and expanded Medicaid.)

Anyway, I followed the link to the fed’s site and started to sign up. For me, at least, the first phase of the processes wasn’t as bad as many others have reported. It was tedious, but not difficult. The site never crashed on me. It was as slow as a dial-up modem in the old days, but I was able to plug along. It took me about two hours, most of it waiting for each page to load, and answering and confirming the same questions over and over again. It made me wonder why we the people of the United States didn’t just hire Steve Zuckerberg to build the exchanges? Facebook seems to handle heavy volume pretty well.

But little did I realize at the time that by filling out the forms honestly, I was setting myself up for no end of woe. Now, I want all of you to know that I’m not whining about my money problems, but I need you to have some background to understand what happened to me next. Like many Americans, I made less money this year than last, and next year—barring any miracles—I will make still less again. I don’t think I’m alone in this boat. It’s a struggle, but I’m not feeling sorry for myself. Well, not too sorry, anyway. But the federal Exchange site, as you will soon see, is not set up for the possibility of citizens having sinking standards of living, which strikes me as insane, because I perceive this as the norm.

How much am I down? Does it make a difference? At my clinic, we are all working under a 5% pay cut this year. The cost of writing off healthcare for all the recently uninsured folks is swamping the boat. Plus the insurance companies “covering” those who remain covered are always finding new and creative ways to deny paying us for care we’ve given. The only way to keep the lights on was to pay everyone in the trenches less. I doubt making 5% less would have much impact on the premium cost for a health plan, but that’s not all I’m dealing with in the bank account department. As you all know, I lost my University job this year. Happening late in the year, that has more of an impact on next year than it did on this year. But of course, the cost of health insurance through the exchange is supposed to be based on what we will earn in 2014. On top of all of that, one of my writing gigs is on tough times and my pay there is down about 50% since March. But wait, there’s more! A magazine I used to write for a lot got a new editor who doesn’t like my work, and the magazine that the editor who did like my work went to doesn’t have a freelance budget. Other places I write for simply assign less as they tighten their belts. And of course, in a bad economy book sales are down and royalties right with them. The bottom line is ugly, but I did my level best to estimate how much less I’d be earning and entered all that data. By conservative estimate, I’ve taken about a 30% hit on my gross income.

And that’s enough to make a pretty big difference on what Marketplace insurance should cost me on the Exchange.

Finally, when I was done, pressed the last button, waited and waited and waited for the final page to load. Then I got the magic message: my Marketplace “Eligibility Notice” was waiting. It was a PDF, but wouldn’t open or download for love or money. I even downloaded a fresh copy of Adobe Reader, but still no luck. I tried my iMac, my wife’s iPad, and my iPod. Finally I dragged an old crash-prone PC out of the back of a closet and booted it up. Three crashes later, I was able to view my 13-page eligibility notice.

And it, in essence, said I was not eligible to view my options for health insurance until I could prove that I will make less money in 2014 than I did in 2012. I was instructed that I had to snail mail to the Marketplace proof I would make less. They suggested signed letters from my employers certifying that they would be paying me less.

You’ve got to be fucking kidding me.

Obviously, for someone like me with multiple streams of income, this isn’t doable.

I decided to just change the application to say I expected to make the same as I made in 2012. I’d pay more, but at least I could see what I’d pay for real, instead of just relying on estimates from the Kaiser foundation calculator.

I went back into the federal website and found my application was carved in stone. No changing it, apparently.


So I spooled up the live chat to ask for help. I won’t torture you with the details of that conversation. I was treated with great suspicion and all but called a cheat and a liar for wanting to change my income data. In the end, I was told an I.T. specialist would have to unlock my application so I can make changes. Said specialist would call me in 48 hours. If I didn’t hear anything in 48 hours I should contact the Marketplace again.

After 72 hours, I contacted the Marketplace and repeated my story. This time they wanted to know when I could and couldn’t be reached. I told them I could be reached any day but Tuesday, Wednesday, or Thursday.

Naturally, they called back on Thursday and left a message saying they had tried to call me and if I was still having problems I should call them back.

Picture steam coming out my ears.

Next time: Apparently my wife is married to another woman and I’m not a citizen


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