If President Obama would like to dig inside the numbers of his plunging job approval ratings, I am happy to offer my own experience with the Affordable Care Act (ACA) as a data point.
Call me Patient Zero, if you like, although I’m hardly the first person to be furious with what’s happened since the roll-out. Instead, I am more of a typical casualty.
The problem began last week when I received a letter from Health Pass New York cancelling the Oxford insurance my wife and I have had for the last year. As a freelance writer under the old dispensation, I had qualified as a Sole Proprietor and was able to insure both of us. The cancellation letter informed me that I was no longer a business. My wife and I would have to enroll as Individuals.
Our policy from Oxford has been far from ideal.
We chose to pay less in monthly premiums in order to go outside its limited system of doctors. What we most wanted in a policy was a bulwark against financial devastation from a catastrophic illness. Nonetheless, I still had to cough up $1,300 a month with a $5,000 deductible for the two of us.
The cancellation was anxiety-producing enough. Like an eviction notice from a landlord’s lawyer, the letter was signed by a powerful bureaucrat I had never met. A lot of people around the country received similar messages, creating instant panic by ordering them to rethink their long-term health care. Instead of easing insecurity about one of the basic issues in their lives, the ACA had the opposite effect. Being kicked off my former plan—without warning—has promoted suspicion and hostility toward the law and the people in government that dictated the sudden change in my status.
Is this the time to mention that Obama promised what happened to us wouldn’t happen? You know the quote: If I liked my current plan, I could keep it? “Period.” Let’s be charitable and say he wasn’t well served by his staff of advisors. That’s better than thinking he didn’t understand his own signature piece of legislation.
The news of my cancellation didn’t bother me at first. Perhaps it could work in our favor, I thought. After all, insurance rates are supposed to drop as more people jump in the pool. The ACA wasn’t socialized medicine, we were told, but the capitalist magic of competitive pricing. So, I went on the New York State of Health.gov and registered.
It was then--after I reached the page with all of the competing plans, having answered all of their nosy personal questions about my race--that I grew truly unhappy. For it was then I learned that our old insurer was not one of those now available. My wife and I had only in the last couple of months found an internist whom we liked and who took Oxford. Now, we had to start everything anew. The site offered plans by companies I had never heard of, such as Oscar, and ones we had already had a bad history with, such as Emblem. These choices were the equivalent of no choice.
I have visited the site several times by now and pushed the sliding bars around and plugged in names of hospitals, trying to determine if one of these plans might be suitable. One of them might indeed be as good, or better, than our old plan. But the design is so confusing that I can’t be sure.
Therein, it seems to me, lies the fundamental screw-up with the roll-out. Obamacare is failing not because the website crashed in the early weeks, but because websites are not designed to answer questions or allay doubts of this magnitude. Buying health insurance is much more like buying a car or a house than like shopping on Amazon, which Obama's health-care advisors seem to hold up as the model for what they're trying to do.
To protect ourselves from being crushed by bills for cancer or long-term recovery from a stroke, my wife and I need to know the fine print and the NYSH website doesn't tell me anything close to what I need to know.
I’m not about to click on the name of an unfamiliar insurer and lock myself into a policy I may find out later doesn't cover us. Websites are built to force you to make a decision, one that then forces you down a particular path toward the next decision. The NYSH website doesn’t give me enough information to make a confident choice in any way. Customer service, please.
If I feel this paralyzed by what to do, how can people who aren't at ease with computers be expected to register and buy policies? The ACA is supposed to bring the uninsured poor into the system and they would seem to be the least likely group to be able to participate in an Internet-based network.
The whip-smart kids who engineered Obama’s reelection with their mastery of social media and best-ad-buy-for-the-buck algorithms don't seem to have a clear view of the audience they are trying to help with this policy. Government can’t drive down costs through massive enrollment if the masses are not equipped or inclined to enroll.
To be clear: I am theoretically in favor of the ACA.
The health-care system is broken and in need of an overhaul, not a tune-up. I voted for Obama—twice—so it’s not as if I want his plan to fail out of ideological spite.
But I doubt it can succeed as it’s currently being presented and sold. My suggestion is that the president have a national teach-in, on television and streaming live, wherein he would stand in front of a projected computer screen and go step-by-step from registration to purchase. Teenagers could show their reluctant or fearful parents what to do. Provided the website didn’t crash, the ACA might finally enroll enough customers to justify its shaky existence.
Meanwhile, my wife and I plan to hire our former insurance broker to sort through the various policies. Her job, threatened by the ACA, seems to me more necessary than ever. When we have a question or complaint, she is paid to be responsive in a way that a website can never be.
We have a few months to consider options. Our policy won’t be cancelled until May 1. Before then I may need to visit a doctor because the main effect of Obamacare so far has been to make people angry and afraid and confused. That’s not healthy.