Transparency — Life and Death Edition

I tend to brood about our need for basic truth — and how often we are deliberately denied it.   We truly can’t make intelligent decisions about anything without having the basic facts to weigh.  Basic facts themselves are under attack in our “alternative fact” world.   In a time of global plague, when thousands are contracting a novel disease that, as Obama said of torture, kills some folks, transparency actually translates directly into lives saved.    

This we know:  try to stay at least six feet from people if you go out in public, wash your hands often, if you cough or sneeze do it into a tissue or into your elbow.  We also know that because of a shortage of tests for this new virus, we really don’t have much meaningful data on infection or death rates relative to infection in the US yet.  Without data it’s impossible to predict the rate of spread or the death rate if you catch this serious and infectious bug.

Trevor Noah made a great point the other day.  If you have the facts beforehand you are better prepared not to freak out when the scary thing is happening.   He describes a pilot addressing a plane about to go into turbulence.   The pilot explains that the plane is about to fly through a pressure system that should last up to thirty minutes, seat belt lights will go on, he will climb to a higher altitude to try to find a smoother path and so forth.   When the plane begins to buck, everyone is ready and somewhat reassured to know what’s going on and how long its likely to last.   He contrasts this with the insane pilot who says nothing beforehand, then, as people are thrown around and the vomiting starts,  gets on the speakers and tells the passengers that everything is fine and that the ride couldn’t be smoother.

Clearly, a belligerent and defensive leader who can’t help snarling and lying is not the ideal leader in a time of pandemic.   Many excellent pieces are being written daily about a president who snaps with open hostility at reasonable questions from the “fake media” instead of answering questions the nervous public needs to have answered.  I won’t waste a word on that compulsively lying fuck, beyond linking you to a very well-done opinion piece on the subject that might make you feel a little bit better.  

I am thinking of the frequent difficulty in getting ANY information in a corporate culture.  It is as if the citizen has no right to know even the laws that protect her.   The provisions of the New York State law that protects patients from illegal termination of their health insurance, for example, are carefully guarded secrets.   How can this be?   It simply is.   Need to know, motherfucker.

I have been trying to find out, for two months now today, what law Healthfirst clearly violated in terminating my insurance, which was then restored two business days later amid apologies for its “mistake”.   The corporation would not have changed its “unappealable” decision without being confronted with the exact provision of the law that it had violated.  The citizen’s right to know this law?   That is left up to a bitter troll assigned to the “case” at the New York State Department of Financial Services.    Here we go, the month I’ve been dealing with this particular asshole (the only person in NYS with access to this law, according to NYS government)  in our emails:

2-20-20   All inquiries are assigned promptly and responses are issued in a timely manner to the very best of our ability given the nature of the inquiry, the research involved and the volume of correspondence received.

then:

I surmise that you are eligible under the Affordable Care Act for Medicaid coverage; had purchased an individual health insurance poli9cy through New York State of Health;  that the insurer had cancelled the policy for non-payment of premiums, after you had missed the contractual grace period; and that the policy was reinstated through the intervention of the New York State Department of Financial Services.  Correct?   You inquire about appli8cable statutes and regulations.

me:  
Pretty much correct.   I had the one-in-a-lifetime luck of having my NYSOH-purchased insurance (“Essential Plan”) restored within a couple of business days after the DFS complaint.   It’s still hard to believe health insurance can be cancelled without notice of the once-a-year  ten-day “contractual grace period.”   That the “contract” requires no notification of the harsh consequences of not paying by a certain date.  I’d like to see the applicable statutes and regulations.

reply:
 What is not correct?.  If it is in the contract, how can you assert no notice?Please furnish DFS CAU file #. 

me:

file number. OGC-2020-252309 
Only correction, Essential, rather than straight Medicaid, plan.

 

To my mind, the provision being likely contained in a contract (nobody has asserted this to me) I received a year or two ago is not the same as actual, effective notice to a consumer of the dire consequence for missing a short “grace period”. Thousands of consumers are subjected to this termination for failing to meet a “contractual  obligation”  an obligation that can easily be noted on an invoice.  It does not seem unduly  burdensome to require companies to print a warning on their first annual invoice. I’m looking for the black letter law on this.

reply:

In preparation for researching your question, I have to understand the past.  Review of the CAU file seems the most efficient method.

me (after two weeks):

Any progress locating the provision of NYS law pertaining to ACA health plans that allowed Healthfirst to terminate my insurance, then reconsider, pursuant to a DFS complaint, and call to tell me my insurance had never been terminated?

reply:

Raft being reviewed

me (after four weeks, still thinking “raft?”):

Any progress?   I am still trying to find the section of the law that Healthfirst reconsidered when reversing its unappealable decision to terminate my health insurance.   I’m also trying to confirm that the DFS complaint triggered Healthfirst’s reversal of its cancellation.  

reply:

Patience.  You are reinstated.  State offices are closed.

me:
Pardon my impatience.   It comes from the extreme difficulty of accessing (even by State government experts) the provision of the patient protection law that protected me from the apparently illegal “mistake” that resulted in the loss of my health insurance.    The illegal practice no doubt affects many other low-income New Yorkers every year, perhaps thousands, and I’d like to do what I can to publicize the unknown patient protection law that health insurance companies freely violate.

True, I had the luck to find the DFS on-line complaint, which immediately fixed the problem, in my case. Countless other low income New Yorkers did not have the luck I did.  The obstacle to that luck is great when the law itself is secret: nobody at any city, state or federal agency is  able to point those affected to the provision of the law that caused Healthfirst to reconsider its “unappealable” decision to terminate my health insurance.   A law that nobody can find is not really a law, even if, in the rare case, it can cause a corporation to immediately reverse itself.

I want to alert every state and city office I contacted to the exact legal provision that caused Healthfirst to reverse their determination.   If the law requires notice before terminating a health plan, as appears to be the case, that should be known by every department and nonprofit in the state that deals with ACA healthcare.

I know it has only been eight weeks or so (and barely a month in the case of DFS) that I am seeking this black and white legal provision, and it may seem churlish of me to ask for an update during a pandemic, but I’d like to update the various enforcement offices and advocacy groups I spoke to and complete my letter to the editor with a correct citation to the law so that others can hopefully be spared the ordeal I went through.  

Nobody should be subjected to that kind of sudden, unnecessary stress; everybody should be informed of their rights under the law.   You’d feel the same way if it happened to you, or someone close to you.   I’m attempting to do a public service and I’d greatly appreciate your eventual assistance.

reply:

First, State offices are closed.

Second, Insurer admitted a mistake.  Why do think  that insurer is “screwing” others?

me: 

It cited an ironclad right to terminate my insurance, claiming it was done lawfully, according to the “guidelines” that entitled it to terminate without warning for failure to pay during a once a year 10-day January grace period.    It told me there was no appeal, beyond an internal one that I lost.  It immediately changed its “mistaken” determination only after receiving my DFS complaint.   I am certain many others were similarly, illegally, denied health insurance.  I’m looking for the elusive law they violated.   

We can lose the quotation marks around screwing, though it’s the politest way to describe it for those who don’t get lucky and find the DFS form/remedy. Insurance companies have every incentive, and no disincentive, to cull low-cost customers during this one time a year period.   Violate the unknowable law, get caught, admit mistake, no harm, no foul.  America?   Democracy?   Not what they used to teach in Civics.

Silence was the last reply from this particular troll, gatekeeper of secret NYS laws pertaining to health insurance companies.  I suppose I’ll contact the little dickhead again in a couple of weeks, but, seriously, folks, what the fuck?  Does anybody really need to know the law that will cause a corporation to reverse an illegal decision?   You got yours, man, what are you whining about?  

Stay healthy, stay safe.

 

 

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