Stories are emerging about enrollment problems in the health insurance exchanges; enrollment completed, premiums paid, but no coverage notification made. In other words, administrative and system screw ups all of which are understandable given the millions of enrollments and diverse systems used in the states. These problems are easily resolved and coverage will be made retroactive assuming all was in order from the start.
On a lessor scale these things happen in employer plans and on the individual market routinely. Until the issue is resolved, it can be annoying and stressful … but is there any reason for confusion over a coverage effective date to prevent needed, perhaps life-saving, health care?
In November, a tumor was found on her brain, and doctors discussed surgery.
Mr. Rolain paid $136 toward the first month’s premium, which was offset by a tax credit of $420, according to a copy of his statement and a receipt. Mr. Rolain said he was dumbfounded when he took his wife to an oncologist in March and learned she wasn’t covered. They postponed surgery for two months, he said, until they got notice that she was insured.
“She wasn’t so far along when they found the spot. Now the doctor said it had spread up the whole left side of her head,” said Mr. Rolain, 73, whose wife had surgery May 14.
By then, Ms. Rolain’s survival prospects had diminished. She died June 30. [Excerpt Wall Street Journal 7-8-14]
What would you do?
It seems to me there is enough culpability to go around here; patient, the spouse and mostly the health care system. Given the facts as we know them, wouldn’t a reasonable approach have been to provide the care needed and then fight about the payment? Did the doctor/hospital knowingly risk the patient’s life because of concern over payment? Was the patient informed of the risks of postponing surgery? We don’t know, but we do know that somebody made bad a decision for no good reason.
What would you do?
In Nevada, about 150 people have joined a lawsuit seeking class-action status against that state’s exchange and Xerox Corp., which helped set up the marketplace. Thousands of residents remain uninsured despite paying premiums or completing all steps to enroll, according to the suit, filed in Clark County.
Are they “uninsured” or is it a matter of fixing the paperwork and setting the correct effective date?
QUINNSCOMMENTARY 
What happened to no one is denied health care? That is what I heard over and over when I supported insurance reform so everyone could afford insurance. No one wanted to hear the argument that no one is denied care at the emergency room whether they can pay or not, they are still billed and it doesn’t mean they get treatment for a serious illness once they are stabilized. A friend of our son was 19 years old when he discovered he had brain cancer. He was fortunate enough that his parents had insurance as well as survived. After graduating college the recession hit and he wasn’t able to find a job that had health insurance (before Obamacare). He had a seizure and was taken to the emergency room. They told him to see his neurosurgeon who would do an MRI and sent him home. He couldn’t afford that neurosurgeon and the MRI. He couldn’t afford the emergency room visit but they were willing to reduce the cost (who pays for that US) and give him installments. With Obamacare he would have been able to stay on his parents policy. He would have gotten the care he needed. I’m not a big fan of Obamacare. It’s what we got stuck with. Yes there are many things that have gone wrong, many things that need to be fixed but what we had before was not better. People died with that system as well when they shouldn’t have. All I can ask is what kind
of country do we live in. We subsidize homeowners with flood insurance because we don’t want them to lose their homes we think that would be devastating but we complain about subsidizing health insurance which saves peoples’ lives.
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