With all of the new bad news coming out this week from ObamaCare, here’s another horror story about the Healthcare.gov exchange from Utah that exemplifies the incompetence of government bureaucracy. One basic and nearly ubuquitous feature of health care — and indeed of family life — is the birth of children. Health insurance plans have made it simple to add children to family plans for decades, allowing new moms and dads to have the costs of childbirth covered ex post facto, as long as the covered individual notified the insurer within a set period of time, usually 30 days. Now, however, the federal exchange requires an extra step that turns the process into a needless catch-22 — and leaves families exposed to devastating financial damage. Salt Lake City’s CBS affiliate KUTV explains the madness:
Maggie and John, Shawnsi and Robin each got paired with their own health insurance company thanks to the act and now, naturally, they want to add their children to their policies.
Federal law does not allow their insurance companies to add the kids directly. Each mother must go back to the healthcare marketplace to add their child.
All three families attempted to add their newborns within the 30-day window of the child being born, as is required, but each was denied.
“The marketplace said it was required we had to go through CHIP,” Maggie said.
CHIP stands for the Children’s Health Insurance Policy. It is a program offered by the state of Utah to help insure kids whose parents can’t afford it. But each of these families do fine for themselves financially so they don’t qualify for CHIP.
CHIP (actually, the P stands for Program) is the federal-state welfare program that insures the children of low-income Americans. Why do new parents have to apply to CHIP at all, if they know they can’t qualify — and if they already have family health insurance? Why bother with this extra bureaucracy if parents clearly make too much money to enter the program, and don’t want to apply anyway? Presumably, this is an attempt at saving money in the exchanges, although certainly not for families, who may have to pay up to 5% of their income for coverage. (The ObamaCare exchange coverage is capped at 9.5% of income for family plans.) HHS is filtering additions of newborns specifically to keep them from enrolling in exchange plans if possible:
If your children are eligible for CHIP, they would not be eligible for any cost breaks on Marketplace insurance. It would likely be more affordable to cover your children through CHIP. Remember, you and other family members may be eligible for savings on Marketplace coverage.
Actually, no it wouldn’t be “more affordable” for families already paying for family coverage, which would likely be most of those seeking to add a newborn to their policy. And if they don’t qualify, then it’s a moot point anyway. That eligibility could have been determined through the ObamaCare exchange, had it been properly designed to deal with additions of newborns.
Instead, thanks to the run-around Healthcare.gov requires, families end up running out of time to add their newborns to their policies — and health insurers can’t step in and assist them any more:
Sure enough, CHIP denied her baby. Now when she turns to the marketplace to try and add her daughter, they turn her away.
“They denied us, saying we went over our time limit and there was no evidence we tried adding her to our insurance,” Maggie said.
Maggie says she protested sending marketplace workers copies of their own emails promising to extend the window but it did no good.
One executive from a Utah insurer says anyone who gave birth in 2014 will have the same problem, and it’s mystifying to Shaun Greene. “Insurance companies have been doing that for years,” Greene told KUTV about adding newborns to policies. “It’s not difficult.” Not until government takes it over, that is.
After KUTV began making calls, the three families in this story mysteriously had the obstacles removed for their coverage. It’s not what you know in government-run bureaucracies, but who you know … and who you embarrass. That’s one great reason among many to get government out of the business of running marketplaces rather than just regulating them.