TONY WILSON: Glitches in healthcare.gov leave some without coverage

Tony Wilson

Tony Wilson

When I encounter a technical glitch with a piece of equipment at my office I follow my standard operating procedure (SOP) to resolve the issue.

(In the spirit of full disclosure, let me point out that the most advanced piece of equipment we have at my office is a color printer. It’s not like we are working on 747s around here.)

It’s a four-step SOP:

  1. Stare at the blinking red light and say, “I wonder why that red light is blinking?”

  2. Turn off the device and unplug it. Wait one to two minutes, plug it back in and turn it back on.

If step 2 doesn’t work, I move on to the next steps:

  1. Stare at the blinking red light and say, “I wonder why that red light is still blinking?”

  2. Walk away from the printer until I hear someone else in the office say, “I wonder why that red light is blinking?”

Everyone knows that whoever touched it last when there are witnesses — and that’s really the key — bears the responsibility of fixing said piece of equipment, even if it’s not your print job that is in queue.

If there ever was a piece of equipment that has a blinking red light and needs to be turned off and unplugged it’s healthcare.gov.

There is case study after case study hung in the queue. I’ll share one.

I have a client who is applying for coverage through healthcare.gov because her employer coverage will end March 1. According to the tables on the exchange website, she and her family are eligible for a subsidy.

The total monthly premium for her, her husband and their child is fairly high, and the subsidy would help them significantly with the cost, thus easing the monthly premium burden on the family budget.

She was denied the subsidy and no one at healthcare.gov can explain to her why.

We utilized the Live Chat feature on the website to find out and the response was: “Well, you have the option to remove your application and reapply. By re-applying you may find yourself eligible for the tax credit the second time. If your eligibilities still show that you do not qualify for the tax credit, you have the option to appeal your determination.”

First, do what?

Second, she’s removed her application and reapplied seven — seven — times. Still no subsidy.

We called healthcare.gov and received the same response from a representative: file an appeal. Their SOP is for her to file an appeal — by mail. It could take up to 90 days for her to get a response — by mail.

(Jay Leno was on target with his recent comment: “Only the federal government could come up with a website that’s slower than sending something by mail.”)

We inquired if she should complete her enrollment, and if her appeal is successful, will the subsidy be applied retroactively? The healthcare.gov rep could not answer that question.

We explained if she waits to apply she will be without coverage, potentially, for up to three months. I don’t want a client to proceed or not proceed and then suffer the consequences of a decision later when she doesn’t have all the facts necessary at the time for her to make an informed decision.

“I just want to know what the standard operating procedure is in situations like this,” I commented.

“We’re not sure,” the healthcare.gov rep replied.

The red light is blinking. Questions or comments? Feel free to email me at twilson@nfp.com.

Tony L. Wilson is a partner with NUVISION Financial Corporation based in Conyers. NUVISION is a subsidiary of National Financial Partners Corp. (NFP), which provides benefits solutions for companies.