American Exceptionalism (pandemic version)

When it comes to glittering generalities pulled out of a wordsmith’s talented ass, grand-sounding but largely meaningless, American Exceptionalism is no exception. What it actually means … well, it’s similar to The Free Market, Manifest Destiny or Making the World Safe for Democracy.   I offer a humble example here, of how profit-driven private industry is the most exceptional possible answer to American health care needs [1].  

I went to a lab for a blood test today, in preparation for next week’s telephone appointment with a nephrologist to find out if my rare kidney disease is still in remission, as it was seven or eight months ago, when we last checked.   I was supposed to have checked in with the doctor last month, but as I found out on the eve of the visit, I had no health insurance, though I’d paid my premiums through June.  Nobody had bothered to inform me that my health coverage had been summarily cancelled a few weeks earlier.  Oh, well.  Apparently no law requires it.

No worries, problem fixed, a few short weeks later I have my affordable health insurance back.  I call the lab yesterday to make sure they have the digital paperwork, but because of COVID-19 nobody at the lab can pick up the phone to confirm this.   No appointment needed, come on in, short waiting times, says the recording.   So I take a ride over today.   Pleasant place, everyone very nice, short wait, plenty of hand sanitizer available, they call me in and ask for my paperwork.  

I explain that it was digitally transmitted, on April 10, according to a note on my phone.  The lab has no paperwork on the computer for me.   Perhaps there was a paper file faxed over?  I am asked.    They open the file cabinet, check the hanging folders of paper files.  Nada.   Can I have them fax over the paperwork?   I call the hospital where the nephrologist’s office is, navigate the phone tree, get connected to the person I need to speak with.

Carmen at the nephrologist’s assures me they uploaded the document on April 10, it’s in the lab’s database, she’s looking right at it on her computer.   I give her the fax number and she tells me she’ll fax it right away.    No fax arrives.  I call Carmen again and she informs me the lab’s fax machine is not receiving faxes.  She reads me a requisition number 0062216, this should allow them to pull it right up on the network.  Only it doesn’t, as I find out a few moments later.  

Crystal, a lovely phlebotomist with whom I am starting to become friendly by now, asks me to spell my name.  I do.  She is surprised.   Somehow they had my name as a long, hard to pronounce one, starting with a P, not a W, something like Pidelszkfflmm.  Crystal asks if I could have typed it in wrong when I signed in on the iPad.

I look at the keyboard on my phone and notice that P is all the way on the other side of the keyboard from W, the first letter of my last name.   Not likely I typed in my own name as Pidelszkfflmm, I’ve typed my name many times, never anything like that.  Never mind.   There must be some work-around.   Yes, Crystal says brightly, I can ask them to email it to me, go home, print it out, bring back the paper copy. When I explain the many extra steps involved for me, and how I want to leave time for the results to come back, and remind her I’m still fasting and ready to have my blood drawn, Crystal gives me her email address.  I call Carmen a third time, we repeat the email address to each other a few times, she tells me she’s emailing it, she waits with me on the line until the email arrives.

“You got any jokes?” I ask Carmen after a while.  She finds this funny, but can’t think of one.  

“I watch the news conferences every evening,” she says, and we do a kind of sickly pseudo-laugh together.  

Crystal gets the email from Carmen,  she does the blood test, all very pleasant, all within an hour or so of walking in to the place.   I am ready to leave, take off my N95 mask, find some food, break my fast.

“I hope you didn’t just use the bathroom,” Crystal says to me after my blood is drawn.  I’m thinking of COVID, but it’s not that, she also needs some urine to send to the lab.  I shake my head, three minutes ago I could have filled up two of those little cups, but…

While I’m waiting for a tall cup of cold water to do its thing, thinking about Crystal’s warning to me that the PSA test (prostate-specific antigen — a screen for prostate cancer)  included in the kidney doctor’s blood test might not be covered and I may be billed separately (I assure her I throw such bills in the recycling bin) I ask her if she knew that in Iraq, under the brutal dictator Saddam Hussein, Iraqis had universal health care.    She is non-committal.  I continue: after the US liberated Iraq from the dictator and brought democracy, after destroying hospitals and so on, they instituted American-style health care, with the result that today many Iraqis no longer have health care at all.  

Crystal nods. “Of course, of course we did that, ” she says, her eyes smiling savagely over her mask, “American Exceptionalism.”  I give a little chuckle, have to hand it to her.  Great girl, and the way she slipped the needle in, with barely a prick, also most exceptional.   We talk about how it is exceptionally American that teeth, vision and care in our old age are not considered part of basic health care, not covered by most American health insurance.  I nip off to the bathroom for a moment with the little plastic cup.   She calls me Mr. Eliot again as I hand her the little cup of warm urine.   As I’m leaving, her last customer of the day, she fondly calls me Mr. Eliot again.   Very likable young woman, Crystal.

If you have a “Free Market” where the fittest bring the best product to market for the cheapest price for the invisible hand of the marketplace to place in front of wise consumers, why wouldn’t you commoditize every aspect of human life?   Health, you understand, is just a commodity like everything else.  Life itself, you can actually put a price to it, make a pretty exact valuation based on net-worth and earning potential, easily calculated by actuaries.   There’s actually no guesswork involved, it’s practically science, fixed and elemental as the stones themselves; that’s the exceptional thing about American Exceptionalism!

 

 

[1]  I think of the Grey Lady, America’s second finest news source (The Onion is America’s finest news source), whose distinctive, objective style of reporting harkens back to an earlier time, when the status quo was not questioned in any fundamental way by decent people.   She fittingly got her nickname in a more proper era when we still had firm notions about what was ladylike and what was gentlemanly, when an unruly girl was admonished to act like a lady.   The Grey Lady, now a stately, dignified, respected old matriarch, was, in her earlier days, a hard-working, discreet and strictly upper-class sex worker.    You can look it up.

 

 

 

Notice to sustain legal termination of benefits for those who rely on a government program for health care

It gets better, the closer you look.  By better I mean, of course, much worse.

Here is the top of the March 11 notice I had absolutely no notice of (until, in desperation, suddenly, irrevocably without health insurance or access to affordable health care, I stumbled on it on April 14):

Screen shot 2020-04-28 at 12.01.26 PM.png

That highly effective, legally impeccable March 11 notice, transmitted immediately to my insurer (my only copy was belatedly found, a month too late, nestled in the inbox of the website we are forced to visit once a year to re-enroll,) referred to the “separate notice” I also had, exclusively in my inbox on their website, the one placed in my inbox the day after I re-enrolled last December.  

Emails from your agency, your corporation, reminding us about voluntary customer surveys untaken, updating us about your handy new phone app?  Sure, absolutely, we can send as many of those as you like.  A single email informing you your health insurance is in immediate jeopardy of sudden cancellation without notice?   Show us the law that requires that, loser!

An unambiguous warning, you must admit, that March 11 notice.  If I’d seen it, I would have known what I needed to do immediately (as I quickly and easily did on April 14, as soon as I found the March 11 notice on-line).  Unfortunately, the law doesn’t protect LOSERS from their own negligent mistakes, loser!  What’s hard to understand about read the fine print CAREFULLY?

There was, admittedly, a strong hint in December’s “separate notice” informing me that, although I had apparently successfully re-enrolled for 2020, and would be covered for a long period, that I was not yet actually fully qualified for the insurance that had been approved (and that covered me from Jan.1 through March 31, and from May 1 til the end of the year, presumably).  

That much was  made plain in the very first lines of the 12/7/19 letter, the “separate notice” noticed in the notice of March 11.  In hindsight, the clues “for a limited time” and “required document(s)” are dead giveaways. How could I have been so dang STOOOO-pit?!

The 12/7 notice begins:

We have redetermined your household’s eligibility on December 6, 2019 for enrollment through NY State of Health based on updated information we recently received.  Below are the results of our determination: EW Marketplace ID: HX000075019789123123345677889

Eligibility Result: Eligible to enroll in the Essential Plan with a $(redacted) premium per month for a limited time. This means that you must return required document(s) to NY State of Health to continue your eligibility. The Essential Plan will cover all essential health benefits with low co-pays for certain services and no annual deductible. You may choose to also enroll in dental and vision benefits for an additional monthly premium. This eligibility is effective as of January 1, 2020.

What you need to do next: Provide additional information in order to confirm your eligibility – More information about what documents you need to provide NY State of Health can be found in the “Request for Additional Information to Confirm Your Eligibility” section of this letter.

Using your health coverage – You will receive services through your health plan. Information about your benefits can be found in the “Additional Plan Enrollment Information for Essential Plan” section of this letter.

In fairness, the “Request for Additional Information to Confirm Your Eligibility” section plainly described the  document I needed to submit.  It was right there, in impossible to miss black and white, on a long list on page 12 of the twelve page letter.   It is likely the drop-dead cancellation date of March 5 (triggering the March 11 notice to insurer to cancel effective March 31) was also explicitly mentioned somewhere in the bulk of the letter, perhaps after the several pages that repeated certain legal rights in a host of languages spoken by the citizens of New York State (which is where the tax document I uploaded was listed).

The point, of course, is not whether any of it is fair or not.  The point is not whether somebody with the means would hire a lawyer and take legal action to have something done about this kind of outrageous institutional abuse.  A person of means would not find themselves in this position anyway, there are certain minimal protections for the average prosperous citizen, even as they may not be robust protections (except for the extremely wealthy).    The point is:  if you depend on the kindness of your government and the corporations it does business with TO HELP YOU, what are you going to fucking do about it, you fucking loser?  LOOO-zuh!

Go write a sarcastic tweet, as is your absolute privilege under the United States Constitution, Amendment One.

No Intent Can Be Implied– though, to be honest, the intent is pretty clear

We are sometimes reminded, often by lawyers for people doing bad things, that we cannot infer legal intent from a mere course of conduct, no matter how consistent or seemingly suggestive.   This lawyerly principle applies even when that intent is expressed in a clear, polite, unambiguous “fuck you, asshole.”  

I’ve had my health insurance cancelled without warning twice since January 2020; luckily for me I found out about it the second time (cancelled without notice March 31) just in time to have my low-cost insurance back, as of May 1.  Nobody is to blame for any of this except, presumably, me, though intent on my part remains unclear.  

In January, when I called to pay my insurance premium for the ACA health coverage I’ve had for several years, the insurer told me I’d missed a ten-day “grace period” they’d had no obligation to inform me of and that my insurance had been irrevocably cancelled, pursuant to the “guidelines” (whatever those might be).   Two days later Healthirst, the insurer, confirmed that I’d lost an internal appeal and that my insurance had been properly terminated.

Meanwhile, I found an on-line consumer complaint form at the New York State Department of Financial Services, the agency responsible, among other diverse duties, for regulating health insurance companies that do business in the state.   Within two business days of submitting this complaint I had a call from Healthfirst, apologizing for its mistake and restoring my health insurance.

I was naturally curious about what law or regulation had caused them to reconsider their irrevocable, unappealable, legal decision.  They could not tell me. I want to know this law.  I’d like to publicize it to the many agencies I’d spoken to, government agencies who had no idea what the patient protection law in New York State requires of insurers before they can terminate ACA insurance without notice. Hearing nothing back from the Department of Financial Services, after my complaint quickly resolved my sudden lack of insurance,  I wrote them this:

I had a call from Healthfirst on January 28 informing me that their termination of my insurance had been a “mistake” and that they were sorry.  They admitted they had received my 1/24 NYSDFS complaint and were ready to accept the payment for January-June 2020 I’d attempted to make on January 22 when they informed me that I had no health insurance and that there was no further appeal at Healthfirst, or anywhere else.

I am wondering why:

1) there is no notice requirement before a health insurance company can terminate health insurance.  (I had absolutely no notice of the “ten day grace period” they suddenly waived after my DFS complaint);

2) NYSOH Marketplace, sole provider of ACA health plans in NYS, does not inform consumers of the practice of insurance companies abruptly (and “mistakenly”) terminating insurance for failure to pay during a “grace period” nobody is informed of;

3) there is no findable provision in the Patient Protection and Affordable Care Act, or NYS law, that sets out notice required before terminating policies.  

Is there no provision requiring private health insurance companies to direct suddenly insurance-free patients to the new NYSDFS on-line complaint process that can force immediate compliance with the unknowable law?

Is there someone I can talk to at DFS for more information about these questions?

Two weeks later, on Valentine’s Day, in fact, I had a response from DFS [1], a form letter, addressed to me, instructing me that DFS has no jurisdiction over my low-income healthcare and that all future correspondence should be addressed to the overwhelmed NYS Department of Health, the agency that oversees all Medicaid and Medicaid-like health plans for low-income New Yorkers.   The NYS Department of Health, perhaps because its programs serve primarily poor people with no other options, has no analogous on-line process for quickly resolving violations of undiscoverable laws.

My individual story had a quick reversal of fortune, a lucky, happy ending.   I did not lose my insurance for more than a few days, and it had been retroactively restored with alarming speed.   That was the position of the attorney at DFS who was assigned to provide me a copy of the law that had caused Healthfirst to reconsider its unappealable termination of my insurance.   He e-mailed me that since the insurer had admitted its error and restored my insurance that I should no longer need to see the provision of the law that had forced them to do so.

I periodically wrote to this lawyer for status updates, since he’d been assigned to provide me the relevant legal provisions I’d requested.   He asked me again, only six weeks in, to be patient, and questioned my stubborn-seeming need to know the law, since my insurance had been restored.  He also disputed my assumption that I’d not been alone in having my low-cost insurance abruptly terminated.  

He didn’t necessarily agree that a private company, with every incentive to cull non-profitable low-income insured from its rolls, and no disincentive, outside of being forced to admit error, if one of the poor devils stumbled on a legal remedy at the agency that regulates them; none of that meant that private insurance corporations would necessarily take advantage of unsophisticated or language-challenged low-income customers it was forced to insure by the opaque 906 page Patient Protection and Affordable Care Act.

It became a kind of hobby of mine, trying to remain polite to this government attorney, who seemed to be a kind of troll, judging by his terse non-responsive responses.   I was probably being unfair to the man.  He was probably right; I should have simply been grateful instead of a persistent burden to this hardworking government lawyer.

All was well, until, suddenly, in the midst of the worldwide pandemic, where I found myself at its epicenter, a doctor’s office I had an upcoming kidney disease-related appointment with (by phone) informed me that my insurance came up “inactive”.  I told them that was a mistake, my premiums were paid through June.  They told me I’d have to straighten this out with my insurer.   

It could not be straightened out with my insurer, who informed me that unfortunately there was nothing they could do — they were following orders from a New York State agency that they were forbidden, by law, to contact on my behalf.   I was told on that April 10 call that the insurer had been informed, electronically on March 11, to cancel my insurance effective March 31.   I’d had no such notice. Nobody, apparently, had any legal duty to inform me that I was about to lose my insurance or even that I was now uninsured.  During a pandemic.

I did not react well to this news.   In spite of the personalized February 14 warning that I was not entitled to use the DFS on-line complaint form (a warning not made anywhere on-line when you go to complain) I immediately submitted this:

I was informed Friday afternoon, when I called my insurer after being told by a doctor that my insurance came up “inactive,” that my Healthfirst health insurance, prepaid through June, had been cancelled, effective March 31 by the New York State of Health Marketplace.  

According to Healthfirst, no reason for this termination was given by NYSOH, NYSOH, I was told, had sent Healthfirst notice of their intent to terminate my ACA insurance on March 11.  Neither Healthfirst nor NYSOH provided me any notice of this termination, not prior to the effective date nor since.

I am instructed to call NYSOH, an overwhelmed and unresponsive agency on a good day, where one hears this recording:

New York State of Health is experiencing high call volume.  Because of the public health emergency we are extending the due date for people who are expected to renew before April 15.   You will receive another notice of the new due date before any changes will be made to your coverage.   You do not need to take any action at this time.  

Also, because of a new federal law, no person who currently has Medicaid coverage will lose their coverage during this emergency.  If you are enrolled in Medicaid and get a notice from New York State of Health telling you that your coverage will end after March 18, 2020, you can disregard this notice.  You will have no gap in coverage.  If you have Medicaid you do not need to report any changes to your account except a permanent address change.

I have to assume that termination of prepaid health insurance without notice violates some NYS law, administrative rule or something, in addition to the due process protection of the US Constitution and the PPACA.  One searches for New York’s legal answer to this question in Titles 10 (Health) and 11 (Insurance) of the NYCRR  in vain, there is no chapter on point.  

Can you help me get my improperly terminated insurance back during this worldwide plague? I’d be eternally grateful.

 

Thankfully, before they had time to act on this complaint, a friend helped me discover a copy of the March 11 “notice” from the NYSOH, on their website, in my inbox.  I’d received no email informing me of its existence on the website low-income New Yorkers are required to visit annually to re-enroll, not that day (when I could have acted to save my insurance for April), not any day.   I also did not receive a copy of this notice by mail, not in March, not on any day.   When my friend asked if I’d checked the website, and my “inbox”, I went on-line, saw the “notice” for the first time, fixed the omission in my application, re-enrolled and was quickly good to go effective only a few weeks later, on May 1.

I attempted twice to retract my DFS complaint, on April 14 and April 15.  I wrote:

I withdraw complaint CSB-2020-01351366.  Healthfirst had nothing to do with this termination of my ACA health insurance. They might have informed me of the impending loss of my insurance, which they knew of for three weeks before it was terminated, although they likely had no legal duty to do so and every business reason not to.  My complaint should not go to Healthfirst.

My insurance was terminated by the NYSOH, for my own oversight,which remained uncorrected for lack of notice of the mistake by NYSOH.  I have since been able to correct this oversight and my insurance will be restored effective 5/1/20.  

Please terminate this complaint. 

I was too late, though, the wheels of justice were already grinding on my behalf. The very next day I had a call from the same Resolution Specialist at Healthfirst who’d resolved nothing previously, informing me in grim tones that they had received the DFS complaint, that she was calling pursuant to it and so forth.   My description of that unexpectedly pleasant chat is here.

Here’s the thing, though.   Within a couple of days, on April 17, I had an email from DFS with two attachments.  The first attachment was the same form letter I’d received previously, directing me, as a low-income New Yorker, to the Department of Health, informing me, again, that, although they’d once again quickly investigated my complaint, DFS was not the proper agency to contact, since I was too poor to qualify for their on-line consumer services.  

The second attached PDF was an official summary of legal findings  — something we must note was not prepared or sent to me in the previous case, when the insurer had, and later admitted, erroneously terminated my health insurance in January.  

Again, no inference of intent is drawn, why should it be?   Can an agency or a corporation even have intent?   The report of their legal findings was dated April 16, 2020, the day after my second attempt to retract my complaint.

Curiously, on the cover sheet of this three page report, next to the box “Has the member been made whole?” the answer DFS inputted was NO.

I have transcribed it from the PDF faithfully (outside of a few added comments):

This communication serves as the Plan’s Response to the Member EW (sic), grievance against the Plan regarding his termination of coverage on 03/31/2020.  We have researched the member’s grievances and provided below is a summary of our findings and resolution.  

Upon receipt of the complaint the Enrollment and Billing Departments advised:  

* The Member EW enrolled into Healthfirst Essential Plan with an effective date of coverage for 01/01/20.   The Member’s coverage was active and paid through March 31, 2020 (paid through June 30, actually, but why quibble?).  

* On 04/15/20 the Enrollment and Billing Department advised (who?) that the Member’s coverage was terminated as per the New York State of Health transaction file no. ET00158341700 received on March 11th, 2020.   (Note, 4/15 was days after I complained of this conversation, which took place April 10)

* An inquiry was sent to the New York State of Health regarding the Member’s coverage termination.

The Plan advised (was advised?) that on:  

*On 12/07/2019, the New York State of Health sent a letter requesting proof of income that needed to be submitted by 03/05/20, in order to maintain continued coverage.  (why March 5, a deadline both arbitrary and capricious?)

* On 03/11/2020, the New York State of Health sent another letter indicating that proof of income was not received as requested, and that Member’s coverage will be terminated effective 03/31/2020.     (really)

* On 4/14/2020, the Member uploaded the required documents and was re-enrolled for an effective date of coverage 05/01/2020.  

* On 04/16/2020, the Member Services Department outreached the  Member regarding his complaint.   The Member informed the Plan that he realized that the termination was not Healthfirst’s decision, but on the part of the New York State of Health.   The Member advised that he tried to rescind the complaint but realized it was too late (he did when he got the call from insurer– for sure — ed.).  The Member verified that as per New York State of Health that his coverage would begin 05/01/20. A credit is currently on file and will be applied to the Member (sic) future coverage (applied to July’s premium, actually).  

We trust that this response provides sufficient explanation for your inquiry.

The official report was signed by a female employee of DFS, to whom I can only say, (with Joe Biden-like insouciance), it could all not have been clearer, sweetheart.

 

 

[1]

Screen shot 2020-04-28 at 2.46.39 PM.png

 

retracting DFS complaint number CSB-2020-01351366

As I emailed the New York State Department of Financial Services earlier today:
I have been unable (last night and so far today) to log into the DFS portal where I submitted this complaint yesterday.   I was told to email your agency here.
I withdraw complaint CSB-2020-01351366.  Healthfirst had nothing to do with this termination of my ACA health insurance.   They might have informed me of the impending loss of my insurance, which they knew of for three weeks before it was terminated, although they likely had no legal duty to do so and every business reason not to.   My complaint should not go to Healthfirst.
 
My insurance was terminated by the NYSOH, for my own oversight, which remained uncorrected for lack of effective notice of the mistake by NYSOH.  I have since been able to correct this oversight and my insurance will be restored effective 5/1/20.  
Please terminate this complaint.  

Low-Income Funnies, Pandemic Edition

Because I get my low-cost health insurance through Obamacare, the Patient Protection and Affordable Care Act of 2010 (ACA), I am required to re-enroll every year.  I do this, along with every other low-income New Yorker without employer-based insurance, during the relaxing weeks just before Thanksgiving to just before Christmas.   The ACA is administered in New York State by an overwhelmed agency called the New York State of Health Marketplace.  ACA health coverage is, as we learn, an easy-come easy-go form of health insurance.

The “entitlements” our government generously extends to people of low income are precious, sometimes matters of life or death.   Oddly, such benefits can be instantly clawed back with little or no notice to those who benefit from the programs, if the poor sucker makes a simple but inexcusable mistake.  I used to see this all the time when I represented some of the poorest and most desperate New York City tenants, most of whom I was able to save from homelessness.  

A wheelchair-bound double amputee got a late notice of a “face to face” meeting she was required to attend to keep her housing voucher intact.  She was unable to schedule Access-A-Ride on one day’s notice.  I spent over a year, thirteen times in Brooklyn Housing Court, trying (and in the end succeeding) to restore her housing benefits and prevent her eviction.  The government’s attitude was that this lazy bitch should have found a way to be at that meeting if she wanted continued assistance paying her rent.

So it was for me, years later, that the New York State of Health decided that the fatal December 6 mistake in my 2020 application had gone unaddressed for long enough.  On Good Friday (I’ve had better Fridays) I was informed that my health insurance had been cancelled on March 31, 2020.  I had no notice of the cancellation until I tried to use my insurance again in April.  

From a legal point of view, it is debatable whether I had notice from NYSOH before they terminated my health insurance.   I had the scantest fig leaf of legal notice of my original oversight and what action I needed to take to correct it; two letters in the inbox of New York State of Health’s website, a place otherwise uninsured New Yorkers visit once a year when we are forced to log in to reapply.  

True I had no emails from NYSOH telling me to check the inbox on their website on pain of losing my health insurance during a pandemic (I had several emailed ads for the handy new NYSOH phone app during this time), or any notice by regular mail (as their web-posted letters claimed I’d had) but NYSOH inserted both long, detailed legal warning letters right there in my on-line inbox, on December 7 and March 11, to be used as conclusive proof of notice in the event of a lawsuit by the disgruntled former recipient of government-subsidized health insurance.

I finally learned of my easily fixable mistake, after 74 hours of life-shortening stress and anger, while talking about my legal options with an old friend from law school (an online Article 78 to challenge the arbitrary and capricious cancellation of my insurance without reason given, or notice). Once I discovered it (tip of the hat to you, Jon) it was a matter of about 20 minutes on-line to fix my December 6 omission, re-apply and have my health insurance restored effective May 1, 2020.  [1]

My December 6 omission, by the way, was failing to include proof of income I didn’t receive until several weeks later.  My insurance was, I was informed in the first of these on-line letters I didn’t see, conditional, its continuance beyond March 31 depended on me fixing this mistake before that date, and I simply, willfully, refused to comply with the part of the law I’d forgotten about this time.

If I’d had actual notice of the problem, on the date of their second notice, I could have easily updated my application, fixed the fatal problem in March and avoided any interruption in my health insurance coverage.  

You have to admit, it’s funny as plague-infected shit, in a certain sick and deadly way.  May you and your loved ones never know from such hilarity.   God bless the child that’s got his own and God bless these United Shayyyysssssh.   

 

[1] Fortunately I discovered what I needed to do and re-applied before April 15.  If I’d re-enrolled after the 15th, my insurance would not start until June 1.

Education and Clarity of Language might not help you

Yesterday’s attempt at an Op Ed for the Grey Lady ended with this now deleted paragraph about the seeming impossibility of getting my improperly terminated health insurance back during a raging plague.  Observe the plangent notes of heroic  self-pity:

So I am left to accept my punishment and practice mindfulness.  I sit here lowering my blood pressure, and my heart rate, by thinking of the miracle of communication — how I can sit and convey these deeply fearful things to a stranger, merely by arranging the words properly on a page.  I hope someone will remember I did this when they are lowering my body into a mass grave.   My murdered ancestors would want no less for me.

Admittedly, useless — DELETE! — though I do still greatly appreciate the miracle of written communication, as far as it goes sometimes.  Nothing like writing the situation out clearly when you are in great trouble or danger.

Today I wrote this concise complaint to the NYS Department of Financial Services, the NYS agency that regulates all insurance, financial houses, hedge funds, banks, etc. in New York State,  My latest attempt to take a flying fuck at a rolling donut (though their on-line consumer complaint form immediately fixed a similar insurance termination without notice problem back in January):

I was informed Friday afternoon, when I called my insurer after being told by a doctor that my insurance came up “inactive,” that my Healthfirst health insurance, prepaid through June, had been cancelled, effective March 31 by the New York State of Health Marketplace. According to Healthfirst, no reason for this termination was given by NYSOH.

NYSOH, I was told, had sent Healthfirst notice of their intent to terminate my ACA insurance on March 11.  Neither Healthfirst nor NYSOH provided me any notice of this termination, not prior to the effective date nor since.

I am instructed to call NYSOH, an overwhelmed and unresponsive agency on a good day, where one hears this recording:

New York State of Health is experiencing high call volume.  Because of the public health emergency we are extending the due date for people who are expected to renew before April 15.   You will receive another notice of the new due date before any changes will be made to your coverage.   You do not need to take any action at this time.  

Also, because of a new federal law, no person who currently has Medicaid coverage will lose their coverage during this emergency.  If you are enrolled in Medicaid and get a notice from New York State of Health telling you that your coverage will end after March 18, 2020, you can disregard this notice.  You will have no gap in coverage.  If you have Medicaid you do not need to report any changes to your account except a permanent address change.

I have to assume that termination of prepaid health insurance without notice violates some NYS law, administrative rule or something, in addition to the due process protection of the US Constitution and the PPACA.  One searches for New York’s legal answer to this question in Titles 10 (Health) and 11 (Insurance) of the New York Codes, Rules and Regulations  in vain, there is no chapter on point. 

(I was wisely advised to follow my hunch and delete this line:  I am still waiting (since early February) to hear back from your office for a citation to the text of the controlling law.)

Can you help me get my improperly terminated insurance back during this worldwide plague? I’d be eternally grateful.

Alternatively, can you direct me to the nearest rolling donut?

You Have the Right Not To Be Angry

If you are not wealthy in this country, you have a very limited right to express anger publicly.   Anger, like health care, is a privilege in America, not a right.

A wealthy person who feels aggrieved may hire a team of lawyers to legally bludgeon the person who inflicted the injury.   An angry wealthy person may take out a full-page ad in the newspaper of record, calling for vengeance against someone he hates.   Our current president did this, as a private citizen, when he purchased a full-page of the New York Times to call for the death of five boys locked up for, and eventually exonerated of, a heinous crime.    Anger is all the rage among the rich and powerful.  It is a luxury not permitted to the weak.

I was told in no uncertain terms in January, mistakenly it turns out, that my Affordable Care Act health insurance had been properly terminated without notice, for my failure to do something I had no notice of.   I’d been told by the insurance company that everything I needed to do to have 2020 health coverage had been done.  Then they informed me I had no health insurance because I’d failed to pay a “binder” during a once-a-year ten day grace period that nobody told me about.  The invoice made no mention of a do-or-die grace period.

I had no warning, no chance to fix what they told me was fatally broken in our contract.   This lack of a heads-up struck me as fundamentally unfair, as it probably is, except in a world where superhuman corporate “persons” rule over regular puny earthling persons who proceed at our own peril.

I was angry about this, even after the multiple complaints I submitted resulted in the reversal of this irreversible decision.   Within a very short time I had my insurance restored;  in fact, I had a call from the insurance company apologizing and telling me that my insurance had never actually been terminated.   I rescheduled a canceled cardiologist appointment and had an expensive treatment paid for by the insurance company, at about 30% of the uninsured sticker price, with only my co-pay required from me.

Still, I was irked about the lack of accountability for a health insurance company that had made me suffer agonizing anxiety as I exerted myself mightily to find the hidden legal remedy (hint: NYS Department of Financial Services).  I am pretty sure that the “mistaken” termination had been unlawful, this seems clear by how quickly the final determination against me was changed.  

To my dismay, nobody I spoke to in the city, state or federal bureaucracy could tell me what that violated law was, not its name, its existence, what exact patient protections it contained.  I wanted to see the text of the law, to read the precise patient protections my health insurance provider had ignored, to such unfair and frightening effect.  It is apparently not the right of a powerless citizen to have this kind of information.

I began lashing out in letters and emails, and on the phone.  A Resolution Specialist from Healthfirst called and promised me a written apology and a record of the many calls I’d had with the insurance company, which would allow me to trace exactly what had been done to me and how it had been corrected.   I wanted a roadmap of how the unknowable law had been violated.  I feel a strong need to inform others in my situation of their rights and legal remedies.   None of what I was promised by Healthfirst was delivered.  

I became increasingly unsettled, as my case was repeatedly “escalated” and never resolved.  I included some inflammatory remarks in letters and phone calls and asked pointed questions about some very obvious things.  

For example: due process is guaranteed in our constitution.  It is fundamental to a free society that people have the right to some kind of hearing, some process, before they can be deprived of something they legally own.  In my case, I’d re-enrolled for coverage in time and subsequently paid for my health insurance through June.  How was it legal to void our contract without notice to the consumer?

As if in answer to this question, I was informed on Good Friday, during this pandemic (not a very good Friday for me) that my insurance had been terminated again, without so much as an email to inform me of this sobering fact, and without any reason given, effective March 31, 2020.

I learned this when I had a call from a doctor I was scheduled to see (over the phone) on Wednesday telling me my insurance came back “inactive.”  When I called Healthfirst to snarlingly enquire, the rep confirmed that they had been instructed to terminate my insurance by the New York State of Health Marketplace, the state’s sole purveyor of Patient Protection and Affordable Care Act health insurance policies.

In the absence of law, those with the power to do so can freely oppress those who are powerless.   If you have no power, you must not be angry about this.  Anger is so bad for your health, your immune system, all of your relationships!

I was told the New York State of Health contacted Healthfirst on March 11, instructing the private corporation to terminate its contract with the patient.  No reason was given.   Any day between March 11 and March 25 would have been an ideal time for either or these entities to inform the patient of the jeopardy he was about to face (no health insurance during a worldwide plague) and the need for immediate action on his part to prevent the loss of the insurance he’d already paid for.  

There was no email, phone call or letter — none from Healthfirst, none from the so-called New York State of Health.   Healthfirst sent me a notice that my ongoing cardiac treatment had been approved through July, an invoice showing that my premiums were paid through June, and numerous instant email reminders that I’d not taken the voluntary customer satisfaction survey after each call.   Not a peep about the insurance cancelled ten days before I found out about it when a doctor’s office alerted me to it.

Had the doctor’s office not called, I’d still be blissfully unaware that my health insurance has been quietly null and void for thirteen days and counting.  Seems there should have been some legal process due before a patient is deprived of healthcare during a pandemic, no?

The well-paid CEO of Healthfirst would be perfectly within her rights to be furious at me, after being subjected to provocative lines like these, no matter how otherwise accurate they might be:

A corporate “person” is an appetitive psychopath, without conscience or remorse, driven to devour and only constrained by the rare regulation in place to restrain the gnawing impulse to maximize profits, a corporation’s only legal imperative.

The removal of health insurance during a plague is arguably an excessive punishment for an impolitic expression of something that is well-known: private health insurance corporations have every incentive to cull from their rolls older, low-income patients who cost them far more in medical care than they pay in premiums.   That’s just good business sense, however else one might feel about it.  

Why the New York State of Health intervened a month ago, as I was told by Healthfirst the other day, with no reason given, to terminate the ACA insurance of a customer who had re-enrolled and completed his end of the contract with a private insurance company is a question I will not be able to get an answer to any time soon.   During this terrible plague, everyone is overwhelmed, many mistakes are made, lines for help are very long and it is best to stay calm, even when provoked to great fear and anger.  Particularly if you are powerless in a state ruled by the bottom line.

That said, it would be a wonderful thing for citizens to actually be allowed to know the laws that protect them from arbitrary and capricious decisions with terrifying consequences.  It’s kind of maddening that we are not, if I might be so bold.

 

An unknown consumer law is no law

Under the New York law that administers the troubled, frequently attacked, never amended, industry-drafted Patient Protection and Affordable Care Act, the January termination of my health insurance, by Healthfirst, was overturned by Healthfirst.  

On January 22, 2020 I was informed that my insurance for 2020 had been terminated, without notice, for failure to do something I was also given no notice of.   On January 28, pursuant to my on-line consumer complaint at the New York State Department of Financial Services (where else?)  I had an apologetic call from Healthfirst.  

My insurance had never been terminated, I was told, the supervisor who claimed it had been, and filed the internal appeal I’d lost, had been mistaken when she told me my health insurance had been cancelled.   It had never actually been terminated at all.

Apologies were offered, I beat the poor rep into the ground forcing more and more explicit apologies and admissions out of her.   I paid my premiums through June and lived happily ever after, though I never was able to learn what law had revealed Healthfirst’s “mistake” to it, what law had caused it to overturn an apparently unlawful determination against me.

I have been seeking since to find this law, to cite it by name,  quote its language and set out the requirements for a legal termination of a New York State citizen’s health insurance.  I’d like to help inform my fellow low-income citizens that there are laws in place to protect us from unfair, in fact, illegal, termination of our ACA health insurance and a way to enforce that law and keep our health insurance.   Nobody I have reached in the state government can find the applicable provisions of law for me.  

A law that calls itself the Patient Protection Act (or it used to, before Trump changed the name), while leaving information about key protections unknowable, is useless.  Worse than useless, really, since the legal protection actually exists, only it’s secret — unless some concealed right is accidentally triggered by a lucky individual who files the right hidden complaint.  I will keep searching, apparently it can take a long time to answer certain seemingly straightforward  questions of law and fact.

Just as it will be a while before I can learn what “mistake” resulted in my insurance being irrevocably cancelled again, as I learned yesterday, this time by the government agency that administers the Patient Protection and Affordable Care Act in New York State.  The agency that proudly claims that it is helping all New Yorkers during this public health crisis.

Law, it’s so last century.

 

Death By Corporate Bureaucracy

A cautionary tale about conservative, industry-drafted half-measures to protect all citizens from death due to lack of health care, a human right, particularly in a country as wealthy as ours. [1]  

I had a call from my nephrologist’s office yesterday.   Due to the pandemic, the doctor is doing telephone visits only.   Would I like to keep my appointment for next week?   If so, I’d need to take a blood test two or three days before.   We made the arrangements, since it is a good idea to keep an eye on a potentially fatal kidney disease that seems to be in remission. 

An hour later I got a call from the Insurance Verification Unit of the hospital the doctor works for.   The woman informed me that I came up as uninsured.   As we spoke she ran my Healthfirst ID number again — insurance inactive.   That’s not possible, I told her, I had a hassle with the insurance company in January, but that’s all been straightened out, no gap in coverage, premiums paid through June.   She told me to check with them and call her back with the update, or else I’d have to pay the full uninsured price for blood tests and the telephone visit with the doctor (non-negotiable retail prices nobody can tell you in advance, of course).

I called Healthfirst.   After a rocky first start where I antagonized an agent named Cat by brusquely instructing her to call my doctor’s office and tell them my insurance was in effect, resulting in being placed on hold for fifteen minutes, I called back.   The second rep, a pleasant woman named Annie, responded immediately, in her heavily accented English, to my gentler query.   “No,” she told me within a few seconds, “your insurance was cancelled on March 31.   We didn’t do it.   It was the New York State of Health, you have to re-enroll with them.”

Annie informed me that a month earlier, on March 11, 2020, days before the pandemic epicenter where I live went into lock-down due to the public health emergency, The New York State of Health, sole purveyors of Patient Protection and Affordable Care Act insurance in New York State, sent Healthfirst a notice that my insurance would be cancelled effective March 31, 2020.   No reason was given.  I was paid in full and she could see I’d re-enrolled for 2020 prior to the original December 15 deadline, having done so on December 6.   Annie told me I needed to call New York State of Health and immediately try to re-enroll.

“Why didn’t Healthfirst notify me three weeks before my insurance was cancelled that I’d better get busy if I wanted to remain insured in April, during a pandemic?”

“It was not Healthfirst, it was the New York State of Health, you have to call them, we cannot call them for you,” said Annie, helpfully.   She explained that it was a law, she didn’t know which one, or maybe a policy, that prevented Healthfirst from being able to help me keep the insurance I’d paid them to provide me.  She just knew that, unfortunately, Healthfirst couldn’t do anything to assist me, it was up to me to work it out with The New York State of Health.

I called the New York State of Health Marketplace, the most opaque, overwhelmed and incompetent bureaucracy I have ever encountered (and I spent years dealing with Adult Protective Services and NYCHA two infamous paragons of overwhelmed inefficiency) .   This is what I heard:

Thank you for calling the New York State of Health, for English press “1”

New York State of Health is experiencing high call volume.  Because of the public health emergency we are extending the due date for people who are expected to renew before April 15.   You will receive another notice of the new due date before any changes will be made to your coverage.   You do not need to take any action at this time.  

Also, because of a new federal law, no person who currently has Medicaid coverage will lose their coverage during this emergency.  If you are enrolled in Medicaid and get a notice from New York State of Health telling you that your coverage will end after March 18, 2020, you can disregard this notice.  You will have no gap in coverage.  If you have Medicaid you do not need to report any changes to your account except a permanent address change.

If you need assistance applying for coverage or have a question about your individual marketplace account, press “1”

If you are an in person assister, which includes navigators, brokers, certified application counselors and health plan facilitated enrollers, press “2”.

All other callers, or callers that have pressed one, please continue to go fuck yourself.  After only a few hours on the phone today you will have the opportunity to have a quasi-judicial arbitration of the decision against you that will be decided (probably in your favor) within three or four months [2], possibly more because of the unprecedented public health crisis that is quickly killing thousands .  Please continue to hold.

The next few hours were spent making a lengthy telephone log for Healthfirst, including my recorded, at times learned, lectures on the routine mistreatment of low-income healthcare customers, the incentives for corporations to cull the rolls of people like me, 63, low-income, “takers” who force the insurance company to spend way more than they take in from my premiums.  I described the abolition of the Department of Insurance and the Commissioner of Insurance position back in 2011, when NYS was an early adopter of Obamacare.  I compared the decision to merge oversight of health insurance with regulation of all financial services in New York State to the Supreme Court’s cynical conclusion that since we had a half-black president we were now “post-racial” and since racism is dead there is no need for federal enforcement of the Voting Rights Act Martin Luther King had fought for.   I brought in Justice Tawney’s “no rights that a white person is bound to respect” in the context of the rights of low-income patients protected under secret laws that nobody is entitled to see.  

I described the troll bureaucrat at the NYS Department of Financial Services, the man assigned to locate and send me the citation to the law that had overturned Healthfirst’s illegal termination of my insurance.   He wrote to tell me I had my insurance back so what is my problem?  Why do I even need to know the law Healthfirst had allegedly violated when allegedly illegally terminating my insurance?   He’d research the law I’d asked about when he got the time, but I needed to be patient, it had only been two months– AND WE’RE IN THE MIDDLE OF A PANDEMIC.  No response to my letters to Healthfirst CEO Pat Wang or the office of the NYS Attorney General.

Eventually a sympathetic Healthfirst supervisor named Monique, who I spoke to for perhaps an hour, put me through to “Legal”.   This department, presumably, would at least be able to tell me the law they had reconsidered in reversing the “mistaken” termination of my insurance in January.   By the time Monique patched my call through, of course, their office was closed.  I heard a message about making a request for your records, with an email address I very much wanted to have, but I was too slow to jot it down.   I was told to leave a message and they would call me back.  I have been told numerous lies by Healthfirst in recent weeks, so I am a bit skeptical about this promise being kept, but I left what I hope was a relatively calm-sounding message.  

“They will definitely call you back,” said the optimistic rep I called next, to ask for the direct line to the law department.  Of course, he didn’t have it, or the email contact for them, but he assured me that if you leave them a message they “have to call you back.”   I smiled a bitter smile he could probably hear over the phone, took a breath and told him my recent history with untrue promises from Healthfirst.  I didn’t bother to quote the Arbeit Macht Frei [3] lines from the end of the absurdist word salad I’d received last month from Healthfirst:

Healthfirst takes grievances seriously and wants to assure you that all issues are thoroughly investigated.  Healthfirst sincerely apologizes for the miscommunication and any inconveniences it may have caused you. Our mission is to provide Healthfirst members with high-quality health care. Your satisfaction and well-being is our number one priority.

My best guess as to why an agency all NYS consumers who buy Obamacare health insurance are forced to deal with only once a year at renewal time for everybody, in the hectic days between Thanksgiving and Christmas, would intervene in March to summarily cancel a valid insurance contract between a consumer and a private corporation (making a sham of our vaunted “free market” where business contracts are sacred) is the standard functioning of bureaucracy.

Perhaps when Healthfirst told me they’d cancelled my insurance back in January, before apologizing a few days later for their “mistake”, somebody at Healthfirst — during the two or three business days this mistaken cancellation was in effect — conveyed this erroneous cancellation, as mandated by law,  to The New York State of Health.   True to form, this crack outfit got right on it, irrevocably and without explanation (or notice to the insured) canceling my insurance two months later.

A paranoid thought enters my head in the absence of a rational, or even irrational, explanation:  I’m being retaliated against.   Who is retaliating?  

Perhaps the director of the overwhelmed New York State of Health, a politically adroit woman named Donna Frescatore, a political appointee who has been running the New York State of Health Marketplace since its inception, a public servant to whom I have been unkind, here and in numerous emails, when critiquing her opaque, cumbersome, asshole mechanisms for administering healthcare justice, or correcting the many mistakes made by her overworked, undertrained staff.  

When I asked for her name years ago I was told that it was NYSOH policy not to allow reps to divulge her name or contact information, they’d all been read the order.  Admittedly, they admitted, NYSOH is not a private corporation where such secrecy is routinely guarded, it’s a state agency, a public agency, but still, they had their orders.  At the time public servant Ms. Frescatore, now also in charge of Medicaid in NYS, was difficult to locate.  Not anymore.   Here she is, first google hit:

NY State of Health continues to meet the strong demand for comprehensive, affordable health insurance coverage,” said NY State of Health Executive Director, Donna Frescatore.   Feb 20, 2020

It probably didn’t help matters that I included a few snide, angry, intemperate couplets like this one, toward the close of  my second letter to the CEO of Healthfirst:

A corporate “person” is an appetitive psychopath, without conscience or remorse, driven to devour and only constrained by the rare regulation in place to restrain the gnawing impulse to maximize profits, a corporation’s only legal imperative.  

Of course, this kind of viciously overwrought snideness, defensible or not,  is understandably infuriating and never yields a good result.   Who am I to express such unrestrained anger to the head of a corporation that has already had someone call to apologize verbally for accidentally fucking me?  Who am I to demand to know the law under which my arbitrary denial of health insurance was overturned?   

Who knows who eventually read these words, addressed in an electronic supplement to the Department of Financial Services complaint that forced Healthfirst to overturn it’s final determination that I’d have no health care in 2020 (unless I paid full sticker price for it)?

I am wondering why:

1) there is no notice requirement before a health insurance company can terminate health insurance.  (I had absolutely no notice of the “ten day grace period” they suddenly waived after my DFS complaint)

2) NYSOH Marketplace, sole provider of ACA health plans in NYS, does not inform consumers of the practice of insurance companies abruptly (and “mistakenly”) terminating insurance for failure to pay during a “grace period” nobody is informed of

3) there is no provision in the Patient Protection and Affordable Care Act, or NYS law, that requiress notice of termination policies and fair access to the new NYSDFS complaint process that can force compliance with the law.

Is there someone I can talk to at DFS for more information about these questions?

I was eventually referred to the aforementioned troll.  A few days later I got a letter from the NYSDFS instructing me that since my insurance is a form of pay-as-you-go Medicaid (my income being 167% over the official poverty line) I may not use their handy on-line complaint form, the one that restored my insurance within two business days.  

Because of the low-cost insurance I have, a kind of pay-as-you-go Medicaid created by the ACA, I must wait on line with the rest of the poor people at another state agency, where the newly promoted Donna Frescatore is also deputy director of Medicaid in NY State.   This agency, the New York State Health Department, has no on-line form, or on-line help, or anything else (it’s designed for the poor, after all), but, stay positive and have a nice day, Dude!    

Remember, stress is very bad for your immune system, particularly during a plague!   Please continue to hold, just pretend your life doesn’t depend on it!  

LOL.

 

 

[1]  When the law protecting  low-income patients is designed by the conservative Heritage Foundation, whose mission is to protect the profits of private enterprise, you get more deaths during a health emergency than would generally be considered acceptable in a civilized nation.   The business of America, after all, is business.

[2]  One year I was denied health insurance for three months while I waited for a determination from a NY State of Health arbitrator that the NY State of Health had mistakenly denied me coverage.   Another year it was about six months before the premium subsidy I was entitled to was applied, retroactively, to my account, which I’d been paying full price for pending the decision in my favor.  

[3]   The German words meaning “Work Liberates” were worked in wrought iron on top of the gates to the infamous Nazi death camp where slave laborers for German industry (including Bayer) were worked to death.

 

The Corporate Brain

First thing to understand–  they’ve got the whole world, in their hands.   Corporations.   We live in a global corporatocracy [1], whatever else is also going on.

There are rules we must understand, living under the rule of “persons” accountable only to shareholder profits.  One is to know the kind of “person” a corporation is:  a psychopath — incapable of empathy, remorse, or moral reflection.  The corporate “person” has one legal interest: the bottom line, increasing stock value for its shareholders.   A corporate person will only do the right thing (like paying to remediate its own negligence, or even intentional defiance of existing laws) if targeted by law enforcement and, after exhausting every legal appeal, being ordered to comply by a court of law.   Since corporations spend a fortune on armies of lawyers and lobbyists to influence the drafting of every law that could have an impact on their profits, good luck there, Charlie.

Two is to understand the nature of the corporate brain — it is purposefully segmented into as many unrelated subdivisions as needed to shield the larger organism from harm.  This is a deliberate device to protect the corporation, in part by exhausting the consumer, who must often speak to many unrelated segments of the corporate brain to try to get a reasonable answer, or redress of any kind.  I provide two examples from my recent, ongoing experiences with two random corporations.

Brand new Dell computer does not perform an essential function, seeing my cellphone as a hotspot.   It sees other nearby hotspots and wireless networks, but it cannot find the only network I can use to connect to the internet.  The computer is under warranty so correcting this defect should not be a major problem.   

Except that Dell has compiled a legally unassailable list of specific exemptions from their limited warranty.  They have me run all the diagnostic tests on the brand new computer and, after an hour or so, tell me that there is no problem with the computer’s hardware, and that therefore the problem, which appears to be a software configuration error, is “out of warranty.”   Not to worry, they tell me, Dell has a paid service that can fix the problem for me.

As is typical in corporations, “Warranty” has no way of communicating with “Out of Warranty”, and therefore has no way of informing a customer that 3 years of “out of warranty” service costs $239, plus tax, a more limited version of this “premium” support goes for $169 and a one-time fix will set you back $129.  The customer can only learn these prices after another long wait on hold.   The customer must listen to a loop of ads for wonderful Dell products and services, while waiting to learn the price, and submit to being thanked over and over for how important their business is to Dell.

Enough reason never to deal with this particular corporate motherfucker ever again, but at the same time, Dell is merely on the vanguard of maximizing profits through express warranty limitations.  Corporations can make a lot more money by making customers pay to fix built in problems than by covering their repair for free.  They hire legal geniuses like now-Justice John Roberts, creator of the arbitration clause, to exclude the most expensive repairs, even of Dell’s own design flaws, from the limited warranty.   “What don’t you understand about the word ‘limited’, sir?   All of the limitations are explicitly set forth in the thousands of words of our warranty, which we will send you for free.”

The beauty is, there is nothing you can do.  It’s all legal and ironclad.  Put the computer back in the box, scrawl “FUCK DELL” on top and bring it back to the store.  (I would advise not scrawling “FUCK DELL” on top, it could void the return and force you to pay at least $129 to be able to use the brand new computer).  Caveat emptor, asshole.

Healthfirst, the corporation I pay for health insurance, told me, on January 22, and again on January 24 (after their internal “appeal”), that my insurance had been terminated for my failure to pay a “binder” payment during a once-a-year ten day “grace period.”   They also informed me that under the law they had no obligation to inform me of this “grace period” before terminating my policy.    Then, on January 28, another department in Healthfirst called to tell me that my insurance had never been terminated and apologized for their “mistake.”  

Since then I have been trying to find out what the law actually is.  No state or federal agency has any idea why I was cut off and why I was reinstated.  Nobody can point me to the section of the law that made Healthfirst reverse its unappealable termination.   None can confirm which of the various complaints I submitted resulted in the overturning of Healthfirst’s original determination.

Finding and publicizing the short answer would provide a valuable service for my fellow citizens, screwed by the thousands exactly as I was.   To put it simply: what protections against termination without notice do patients have under the Patient Protection and Affordable Care Act, Obamacare?   You know, the federal law the right wing has been rabidly trying to abolish since it went into effect? [2]

I finally got a letter of explanation from Healthfirst, in an envelope marked “Grievance and Appeals”.  It was entitled “Notice of Grievance Resolution”, as though on February 14 I had contested Healthfirst’s decision to restore my health insurance after terminating it weeks earlier.   The notice states that my insurance was properly terminated for my failure to pay the binder during the ten-day grace period.  It states that my insurance had never been terminated, as confirmed by the call I received on January 28 apologizing for Healthfirst’s “mistake”.

Why this corporate change of “heart”?   That, sir, is nobody’s goddamned business.  Please continue to hold, your business is very important to us.

 

 

[1]  Wikipedia:

Corporatocracy is a recent term used to refer to an economic and political system controlled by corporations or corporate interests. The concept has been used in explanations of bank bailouts, excessive pay for CEOs as well as complaints such as the exploitation of national treasuries, people and natural resources. Wikipedia

[2] The law itself is now finally under reconsideration by the Supreme Court, in light of a federal court striking down the “mandate” that was upheld by one vote when John Roberts found this requirement of Obamacare constitutional.  Keep your helmets on, my fellow hostages.