Note to a friend who asked yesterday if I’m depressed

With a sense of great hopefulness, I wrote this note to an old friend yesterday:

Since I’ve now spent the entire day behind the keyboard tapping away, literally nine or ten hours, I have a better answer for you than I did last night.   

I’m not depressed as much as in a constant state of having to keep a watchful eye on my constantly provoked rage at the injustices around us (all rage, of course, believes it is righteous and directed at injustice).  This internal battle is exhausting sometimes, and far from ideal, but better than screaming and fighting all the time.  

I’ve noticed that when I set out the reasons for my feelings clearly on a page, it makes me feel a bit better about the issue that torments me.   I feel distinctly not depressed at such times, after I’ve put the issue down with clarity — I feel energized and hopeful sometimes.  

I took a few hours, from the time I woke up, to sit and write this about the maddening health care situation I told you about yesterday, submitting two identical complaints, receiving two completely different outcomes:  CLICKEZ ICI 

I later decided to start tackling the issue more directly, in a way that could be more useful to my fellow citizens, and wrote the attached letter to the NYS attorney general’s office.  (see attached, appended hereto and made part hereof at FN 1)

These actions, putting feelings into simple words, identifying and clarifying an issue, refining my description over the course of the day to make it as clear and readable as I can, this exercise of “fighting back”, improved my mood greatly today.  The impeachment situation being already decided “fuck your ‘fair trial’, you insane partisan faggots, 51-49 suck it!!!!” there was no reason to listen to any of it today.   “If he takes a shit, you must acquit!”, said Dershowitz, in an argument no more demented than any of his others — and no truer words were ever spoken by the stable genius himself.

Anyway, whether it’s delusional or not (since I don’t sell any of my work and virtually nobody ever reads it) it is this daily practice of sitting quietly and writing about the things that vex me most, or things that intrigue me, sometimes, — what you flatteringly referred to as part of me being a knight– (and I’ll take Don Quixote over Donkey Trump-hay any day) and I thank you humbly, and with a chivalric bow, for that– that I believe is keeping me from a complete emotional meltdown (and also enabling me to look squarely at some truly horrible things and historically alarming events without vomiting my guts out).

I’d love to have a JH [her excellent therapist– ed.] to talk to regularly, but lacking someone like that, I accept that I have to be my own best therapist much of the time.  I find I’m always listening carefully, understanding of my motivations and gentle with my flaws and mistakes. That seems to be a pretty good start, anyway.

FN1:

Madam Attorney General:

I am enclosing a copy of the letter I am sending to the two Assistant Attorneys General who oversee your overwhelmed Bureau of Health Care.

The gist of my letter:

The complaint submitted on my behalf by your office, seeking to overturn my termination without notice from an ACA health plan was without force or effect.  The identical complaint, submitted through the new New York State Department of Financial Services on-line consumer complaint process, forced the private health company to immediately reverse the termination and apologize to me for its “mistake”.

It is hard for me to understand how a consumer complaint submitted by the state’s top law enforcement office did not yield the same legal result as one submitted through the Department of Financial Services.   I bring this puzzle to your attention.

Yours sincerely  

 

Bureau Chief, Assistant Attorney General Lisa Landau
Helpline Manager, Assistant Attorney General Adrienne Lawston
Office of the Attorney General

Bureau of Health Care
The Capitol
Albany, NY 12224-0341

Dear Ms. Landau and Ms. Lawston:

I am writing to find out why your helpline workers are unaware of what is apparently the only way in New York State to resolve a complaint about termination without notice of an ACA policy by a health insurance company. The Department of Financial Services’ likely brand new, virtually secret, on-line consumer complaint process expeditiously solved a problem your office was helpless to solve. The complaints I submitted through your office and NYSDFS were virtually identical — one had no effect, the other made a corporation reverse its “legal” and “unappealable” determination.

On January 22, when I called to pay my premiums through June, I was informed by Healthfirst that my insurance had already been canceled due to my failure to pay my January premium by January 10. I was told this was done “within the guidelines” and that my termination for failure to make this payment within the ten-day “grace period” was not appealable except by an internal appeal to their own “financial” department that would make the final determination. They also insisted that notice was not required before termination of health insurance for “late payment”. The outcome of the corporation’s internal appeal process was predictable.

Your office complained to Healthfirst on my behalf, emailed me an official looking verbatim copy of what I’d told the extremely empathetic worker who helped me over the phone. Soon afterwards I got a call back from the Health Care Bureau with the bad news — Healthfirst had not reconsidered its decision to terminate my health insurance. I was advised by your office to contact The New York State of Health Marketplace to reapply for coverage beginning March 1, 2020 [1].

I subsequently found and submitted the on-line DFS complaint, its text virtually identical to the complaint submitted via your bureau. Two business days later I had a call from Healthfirst apologizing for its “mistake”, telling me my insurance was in full force and effect, would cover the expensive January 8th procedure I’d had and allowing me to pay premiums for the next six months over the phone during that call, as I’d tried to do a hellishly stressful week earlier. The rep admitted they’d received my DFS complaint and that’s why she’d been instructed to call me. I have to assume Healthfirst had been in violation of the law.  I also have to assume there is no penalty for the violation and that anyone similarly mistreated, who didn’t find the new DFS consumer complaint form, remains without insurance.

Why is this quick and effective new on-line DFS complaint/enforcement process something your staff is unaware of and therefore unable to inform consumers about?  How can it be that the AG’s complaint form lacks the same force of law?

I assume your office gets many calls on this issue every January, as termination for “late payment” is a common reason health insurance companies have long used to terminate particularly the unprofitable low-cost policies of low income customers. I would guess this old insurance industry chestnut is as common a reason for terminating benefits as the old “pre-existing condition” loophole they used to use.

The ACA has protections during the year against such terminations; I know for a fact that notice is required before terminating a patient’s health insurance for late payment. I assume because Healthfirst quickly changed its iron-clad, guidelines-bound determination that their original irrevocable, “non-appealable” termination had violated the law. The law in question being a complicated, voluminous, health industry co-written law that virtually nobody can scan for a quick (or even painfully slow) answer to this kind of question.

The answer to a relevant and common yes or no question of law (does the ACA allow them to cut off my insurance on January 11th without any notice or appeal?) should be on a fact sheet available to those who answer your help line. Especially since the AG’s small, under-staffed, overworked Health Care Bureau is the sole government mini-agency in the state dedicated to helping NYS state consumers in vexing, sometimes life and death disputes with private health insurance companies.

I hope you will let me know that you’ve informed your staff of what I bring to your attention today. Please feel free to contact me about anything related to this letter. My current mission is to somehow publicize this secret avenue of redress for my fellow citizens screwed, as I was, by the virtually unregulated corporate “persons” who provide health insurance under the Patient Protection and Affordable Care Act. I fortunately had the skill set and tenacity needed to persevere until I discovered and used the new DFS complaint process. How many thousands of vulnerable NYS citizens thrown off insurance without notice have that chance? When they call your office they should be given a fighting chance to reverse illegal decisions that suddenly and without warning “irrevocably” deprive them of access to affordable health care.

 

 

[1] Dealing with NYSOH conjures only dread for me, based on my experiences with them, including two traumatic three and four month quasi-appeals I had to win before they would correct their own easily verifiable mistakes. Not for nothing, NYSOH is an agency that in my long experience with many state and federal agencies is among the most cumbersome, unresponsive and inept. I understand that the political appointee who runs it, Donna Frescatore, has been promoted for her stellar work at NYSOH and is now also overseeing Medicaid in the state. It’s good to know the right people, I suppose.

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