Tuesday, March 11, 2014

A Tale of Two Clients

On the one hand, the plural of "anecdote" is not "data;" on the other, I believe that these two clients' recent experiences with the ObamaTax Exchange may be illustrative of a broader set of problems:

Client Number 1 recently lost his employer-based health insurance (the employer made the perfectly sensible decision to cancel the increasingly expensive group plan altogether), leaving himself and his family to fend for themselves on the Exchange.

After fiddling with the Subsidy Calculator, they determined that they were eligible for about $200 a month in subsidies ("premium discount"). That's a lot of cash to leave on the table, so they headed to the Exchange.

Over the course of the past week or so, we've spoken most every day, as he finally decided which plan he wanted. I had quoted this plan both on and off the Exchange; the off Exchange plan allowed him to add a reasonably-priced dental option that included ACA-compliant Pediatric Dental; the on Exchange version required digging through dozens of dental plan options to find one that fit.

We determined that their best bet would be to buy the medical plan on Exchange, and the dental plan as a separate, stand-alone policy. And so, I thought, we're finally ready to go on this one.

Ah, not so fast there, buddy:

This morning, Client 1 called and asked "hey, if I end up the year and it turns out I wasn't really eligible for the subsidy after all (I ended up making too much), do I have to pay it back?"

Well, yeah.

There was a pause, and he replied, "in that case, let's go back and do the off Exchange version - I'd rather forego the subsidy than worry all year about having to pay it back."

Client Number 2 is in no such danger: he definitely qualifies for a subsidy. After shopping on the Exchange, he also picked a plan that fit his needs and budget (well, close enough for gummint work). So he logged on, started the enrollment process, and then promptly stopped and called me: "hey, Henry, do I  have to answer all these Medicaid-related questions?" I replied, "only if you want the subsidy."

Some background on Client 2: he chose not to go the early renewal route, and his current plan expires on April 1st, at which time his carrier will transition him onto (what they deem) an appropriate, comparable ACA plan. Or, he can shop the Exchange for one better suited, taking advantage of the anticipated $300 per month subsidy, as well.

Again a pause, and then, "y'know what? I'm going to just stick with the plan that [his insurance company] has me moving to; I'd rather pass on the subsidy than get cauight up in the Medicaid stuff."

So here are two families that selected a plan, only to leave it twisting in the wind in their Exchange "cart." One wonders how many others whom Ms Shecantbeserious counts as "enrolled" did likewise?

And what does it say about the ObamaTax itself that folks are willing to walk away from significant piles of cash to avoid it?

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