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Donna Smith

Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation

November 18th, 2013 2:53 PM

Saving Money, But Losing Doctors on ACA Exchange

Affordable Care Act, Obamacare, Single-Payer, Medicare for all for life, medical bankruptcy

Finally, I was able to get the Medicaid denial I was waiting for and proceed to shop for new health insurance coverage on the Connect for Health Colorado Affordable Care Act/Obamacare exchange. As unpleasant as the unnecessary and intrusive Medicaid application process was, including the 37 day wait to have the application denied, I girded myself for an equally difficult process in shopping for coverage on the exchange. The process is all so flawed when viewed in the light of how simple and clean an improved and expanded Medicare for all for life system would be to implement.

I have to say I was pleasantly surprised with the service I received from the exchange navigator, even thought there were still some glitches to be resolved. I waited 22 minutes on hold before my call was answered, and for some reason my call was dropped twice after the navigator and I had begun the process. But both times, she called me back promptly to help me complete the process. I explored the plans available to me in the bronze and silver categories since I cannot afford any of them in the gold or platinum levels. The irony is that I work for a small non-profit where we advocate for health care for all without financial barrier, and my own financial barriers are great to having the coverage and access to care that I need.

Currently, I pay $875/mo for my individual coverage through COBRA/Aetna from my previous job as a single-payer organizer for National Nurses United/California Nurses Association. The deductibles are pretty high and Aetna has been tough to deal with, so I am not upset about changing this coverage. In fact, we cannot afford to keep up these premiums, so I was anxious to see what relief I might get from an exchange-based plan.

After about half an hour with the navigator and a call to Kaiser, I settled on a Kaiser silver plan that will cost approx. $450/mo for my coverage. That's a huge savings to me even though $450 is still an awful lot for us to afford.  My deductible will drop by about half, but my co-pays will double for office and specialist visits.  And I will have to change all my medical providers, and as a cancer patient in the middle of diagnostics/treatments, this is very worrisome. I just don't have many options. I tried calling my current doctor to see if we could have an appointment to make sure I at least have prescription refills I will need as I transition from the care I have now to whatever I will have in January. They said his schedue is now full through the end of 2013. And I cannot seek care through a Kaiser facility until my coverage begins January 1.

So, the saga goes on. How many people in the US are facing this sort of stress? Many, I suspect, as I always know that my health care situation is not unique. In such a dysfunctional, fragmented system, it is awful to have to leave my providers and just be another patient, another number while I try to develop new relationships. Will my health suffer? Probably.

We need a sane, humane and economically sensible system. We need improved and expanded Medicare for all for life. I'd like to have my health decisions be about health and be made with my doctors and other providers and not because of the financial realities of the greedy system we are expanding through this latest system change and the ACA. But, I did find the exchange process at least less difficult than what I imagined. For that I am grateful.  I just so wish my decisions did not have to be motivated by money rather than my health.  

November 18, 2013 -- Today's count of the health care dead and broke for profit in the U.S.:

The 2013, to date, U.S. medical-financial-
industrial -complex system dead: 39,993
The 2013, to date, U.S. health care system bankrupt: 632,028

** These figures are calculated based on the Harvard University studies on excess deaths in the U.S. due to lack of insurance coverage or the ability to pay for needed health care, and the Harvard University study that calculated the high percentage of personal bankruptcies attributable to medical crisis and debt in the U.S. 123 people die daily due to lack of coverage or cash to pay for care; 1,978 go bankrupt every day due to medical crisis and debt though the majority had insurance at the time their illness or injury occurred. This statistic is also based on the 1.2 million bankruptcies in the U.S. in 2012, according to the U.S. Bankruptcy Court, and calculating those medically-related bankruptcies from that number.

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