Getting Sucked into ObamaCare is a Lot Like Being on Probation

Yves here. Lambert, in his relentless Obamacare skullduggery, has unearthed yet another ugly feature of this Rube Goldberg contraption for enriching health insurers: unprecedented levels of required reporting to the Federal government. Your humble blogger had already flagged one, that Obamacare is designed with the bizarre assumption that everyone in America has a steady paycheck. You are supposed to be able to estimate your income. How can people who are part-time workers, with employers who ratchet up and down how much time they need, supposed to comply? Or even worse, how about self-employed people, who have variable and unpredictable income and expenses, as well as the occasional collection issue.

But Obamacare policyholders are ALSO required to report on a raft of “lifestyle changes” including when you become pregnant (which means you also need to report if you have a change in that “status” via miscarriage or abortion), or a change in “household size”. One assumes that means “household” from an IRS standpoint, but could it mean from a Census perspective? Do renters have to report if they take on a roommate?

And even better, as Lambert discusses in detail, HHS also makes it hard to prove that you’ve made the required updates. Charming.

By Lambert Strether. Originally published at Corrente

I got a cheery note in the mail from HHS about “life changes” that the grateful recipients of ObamaCare must “report”[1]. Be on the lookout for the real piece of skullduggery, because it’s not obvioius at first glance:

Life changes to report

You must report a change if you:

  • Get married or divorced

  • Have a child, adopt a child, or place a child for adoption

  • Have a change in income

  • Get health coverage through a job or a program like Medicare or Medicaid

  • Change your place of residence

  • Have a change in disability status

  • Gain or lose a dependent

  • Become pregnant

  • Experience other changes that may affect your income and household size

  • Other changes to report: change in tax filing status; change of citizenship or immigration status; incarceration or release from incarceration; change in status as an American Indian/Alaska Native or tribal status; correction to name, date of birth, or Social Security number.

When and how to report changes

You should report these changes to the Marketplace as soon as possible.

If these changes qualify you for a special enrollment period to change plans, in most cases you have 60 days from the life event to enroll in new coverage. If the changes qualify you for more or less savings, it’s important to make adjustments as soon as possible.

Important: Do not report these changes by mail.

You can report these changes 2 ways:

  • Online. Log in to your account. Select your application, then select “Report a life change” from the menu on the left.

  • By phone. Contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325)

Learn more from the IRS about how changes can affect the premium tax credit you may be eligible for.

Look. Wouldn’t it be simpler if they just make ObamaCare recipients wear ankle bracelets?

As for the skullduggery:

No, it’s not that they say you’ve got to tell HHS about the “life change” and mention in passing that you’ve got to go incriminate yourself at to the IRS web site to find out the financial impact of the “life change” (and remember, if you’re “on the bubble” with an income or eligibility issue, ObamaCare’s defenders, even Kaiser, say you should game the system, so don’t commit yourself with HHS before you check with the IRS; there are land mines everywhere!)

Yes, it’s this. This is the real gaslighting:

Important: Do not report these changes by mail.

You’ve got no record, and you’ve got no protection. If the website is down, or it doesn’t accept your data, or the backend is still screwed up (which it is) you could get a shock when you find out what happened to your subsidy, in the best case, or be guilty of perjury, in the worst. It’s madness to use a website for this information. And if you use the phone, be sure to record the call. There’s no equivalent, now, of notarizing your paperwork and sending it to them, signature required and return receipt requested.

This after months in which the website didn’t work, and the HHS has screwed up hundreds of thousands of accounts! If these people were worthy of my hatred, I’d hate them.

NOTE [1] Note this is totally a class thing. If your income is four times the Federal Poverty line, you don’t get into ObamaCare anyhow. That means that the vast majority of the economists, and big shot academics, and career “progressives,” and lobbyists, and insurance company executives, and talking heads, and consultants who foisted this thing on us are not subject to the same onerous reporting requirements they impose on us. Shocker, huh?

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99 comments

  1. George Hier

    You mentioned recording the call, for later use. That jogged my memory of a recent Slashdot discussion about recording a call to Comcast. There were two major things I took away from that:

    First, check if you’re in a Two-party consent or All-party consent state. You should be fine recording in either case, but you have to announce this fact in an all party state. “May be recorded for quality assurance purposes” indeed.

    Secondly, a couple of posters were recommending this JK Audio doohickey for recording teleconferences. You plug this thing into your phone, then you plug an MP3 recorder into the thing. Saves you the trouble of having to buy a fancier phone, or do a bunch of wire stripping.

    I’ve never used JK Audio products before, but it looked like an elegant enough solution that I bookmarked it for later reference. They’ve got some other products listed for cellphone use as well.

    1. Yves Smith Post author

      Some people take the point of view that if the call is recorded by the other side, that party has consented to being recorded. Dunno how you verify that.

      1. jgordon

        On the other hand, the statement “this call may be recorded for quality control purposes” is an explicit permission for the call to be recorded. Or was there another way to interpret that?

        1. fresno dan

          “this call may be recorded for quality control purposes” is an explicit permission for the call to be recorded. Or was there another way to interpret that?”

          Honestly people…..the powers that be can record you for the purpose of f*cking you whenever they want. You have no right to these recordings to defend yourself however. If you record anything that shows the power doing something wrong, you are guilty of something (see arrest of journalists at McDonalds for confirmation).
          It couldn’t be simpler……

          1. mellon

            There are a growing number of people who record literally every interaction with everyone. I think thats a very good idea.

            Google “sousveillance”

            Also, all of these snags are designed to make it so troublesome that many people lose their coverage when something serious happens to them, because they miss some little thing. Back when we could have single payer, that stuff would have made a good argument, eh?

            But, the American people said no to that with the Uruguay Round Agreements Act.

            1. OpenThePodBayDoorsHAL

              Rather than simpering and squirming all about how to attempt to comply with the grotesque Orwellian Hobbesian Leviathan Super Corporo-Fascist Police State that America has become, Americans need to seriously ponder putting the clicker down and arising from the couch. Bullies only know one language, and that is Force. Recall that the Force of hundreds of millions of citizens applied in unison is far more powerful than any of their SWAT teams. This will require reaching across political divides to people you may not agree with on most issues except the only one that matters: Opposition.

              1. Gerard Pierce

                When it comes to force, I think that Terry Pratchett had the final word in his novel “Interesting Times”:

                “I know about people who talk about suffering for the common good. It’s never bloody them! When you hear a man shouting “Forward, brave comrades!” you’ll see he’s the one behind the bloody big rock and the one wearing the only really arrow-proof helmet!”

                If you must recommend the use of force, you should at least specify that it should be a two-by-four in a dark alley in the early hours of the morning. /sarc-off

                1. OpenThePodBayDoorsHAL

                  Fair comment, especially for me personally since I chose flight over fight, moved to Australia and gave back my US passport. At least AUS is 50% less business-as-usual fascist. But even that is a direct action…compared to the limp chronicling in the blogosphere of lost rights and futures, followed by resigned surrender just to endure whatever comes. May as well open your wrists in the tub like Marat.

                  1. Gerard Pierce

                    You are being way too nice. (By the way, in the history that I read, Marat did not kill himself, he was assassinated in his bath. The history of the times was often incoherent, so one of us was misinformed.)

                    I’m not that much against violence, just against advocating that someone else should go out and get killed. My preferred tactic would be to convince one part of the elite that some other part of the elite has stolen their money. If you could also convince them that their opponents are Obama worshiping liberals it would be worth the effort just for entertainment value.

      2. MaroonBulldog

        Yves, you verify consent by conduct, which is implied consent, if you verify it at all.

        In a two party state, if the other side is recording a call, and has given a required form of notice that they are doing so, how does the other party verify that you have consented to the recording? The other party verifiesyour consent by your conduct in continuing the call once the notice is given. If you don’t consent to being recorded, your recourse is to hang up.

        In the two-party state of California, one permitted way to give required notice is to play a “warning tone,” a 1440 Hz beep tone that repeats every fifteen seconds. If notice is given this way, the recording party does not have to give a “this call may be recorded for injurious purposes” warning expressed in words.

        So, in California, a “consumer” might be able to satisfy the state law by playing the same beep tone that radio stations and public safety officers use. Someone should build an app for that

        1. Code Name D

          But the question I have is would recording this do you any good? So you have recordings of multiple conversations with your insurance broker regarding your insurance policy. One presumes that the judge would bother to take the time to listen to them. One presumes you can step in front of a judge at all.

          1. lin

            Code Name D, you would probably best transcribe the conversations if anything ever got to court. It’s tedious but you can either hire someone or just transcribe the relevant parts. But probably the bigger goal is to not have the matter progress to litigation. You’d likely be better off taking your case to the news media or social media, or just playing the tape for a company official to hear.

            1. Code Name D

              You’re missing my point. I find it highly unlikely that the common person would ever manage to get it to court. Usually these things will first land in litigation where the corporation holds all the cards and facts simply don’t mater. Court cases of this sort usually hinge on legal minutia in interpreting contract law. They are not like trial courts where one can present evidence or cross examine.

              So I am wondering just how useful recording phone conversations will be in addressing abuses? It’s not a foolish recommendation – but I doubt its practicality either.

              And how are poor people to be expected to manage this material? For a complex dispute, one could rack up a few hundred hours. This takes time and money, of which poor people do not have a lot of. Even storing media takes space that will be at a premium. And that is assuming they even have a computer to begin with.

        2. lin

          I worked in a bank that played the intermittent beep and it is very intrusive. You want your subject to forget they’re being recorded.

    2. Lambert Strether

      So, great. To protect yourself, you’ve got to break the law. Well done, all. The whole thing reminds me of a factoid I heard about the Prussian social welfare system: Eligibility was determined at the police station. Prussia is a dead parrot, of course.

  2. trish

    “If these people were worthy of my hatred, I’d hate them.”

    I’ve got to work on that. not worthy not worthy not worthy not worthy not worthy…

    (couldn’t the NSA , w/ the corporate data miners, phone companies, work on the keeping tabs on the “life changes” thing? Though the idea that this stuff must be reported like this does sort of work to keep the “customers” under their thumb and conscious of it. the serfs might forget the ankle bracelet is there. or may get uppity. )

  3. dearieme

    Dafter than the NHS; well done, America. For heaven’s sake, if the USA is incapable of designing a better system itself, why not copy someone else’s? France? Singapore? ……

    I suppose the gangsterism of US politics precludes that option. No doubt that won’t improve much under Hellary.

    1. OpenThePodBayDoorsHAL

      I throw up a little in my mouth whenever someone mentions the zombie sleepwalking march to business-as-usual fascism under Hilary.

  4. Kmurp

    I assume many of these questions are designed to figure out if you would qualify for a subsidy or for Medicaid itself? If so, a number of these things would be necessary to provide that information.

    1. Lambert Strether

      See under “Rube Goldberg” contraption. The problems with ObamaCare are the problems of ObamaCare itself. Single payer doesn’t have these requirements, so besides being simple, rugged, and proven, it’s far less instrusive.

  5. Jill

    This is exactly what is happening with USGinc’s massive database on terrists! It never seems to work for the stated intent but it works really well as a corporate/govt. data mining process.

    Similarly, the Obamacare site simply does not work very well for getting even the crappy health insurance or subsidy they offer. Yet it shows extreme efficiency in the collection of data.

    Come to think of it, this reminds me of how ineffective congress is, except when they’re not. And president Obama certainly is able to get his wars done but appears ineffective on all matters relating to things that matter in a nation–things like upholding the rule of law, infrastructure repair, and national, universal health care for starters.

  6. craazyman

    It sounds like dying is less painful than keeping all your Obamacare records up to date. I don’t know about other people, but for me complicated paperwork is almost unbearable. If you ignore it long enough, sometimes it goes away completely and it seems it doesn’t matter anyway in some cases == like mortgages. It doesn’t seem to matter there if you did your paperwork or not. Imagine that! Days of complicated paperwork and it just gets ignored when it counts.

    Maybe healthcare will come to this. Everybody just forgets all about your paper work. They just give you a blank stare and when you show up at the hospital you better have cash.

    Sounds like getting health insurance can kill you. Does this stuff come with a warning label? Can you submit a claim for medical treatment for stress and exhaustion brought on by applying for Obamacare? Can you get reimbursed for doctor visits needed to treat stress from other doctor visits? It’s like a big circle. You get on and it just goes around and around and around. The best thing is not to get on in the first place. But that’s not easy. You need to define reality so that there is no such thing as death. There’s just youth and then a phase state transition.

    1. trish

      “Sounds like getting health insurance can kill you.”
      but dying would harm profits. though I guess the slow die can work well through coverage refusal for any costly dying problems.
      Painful? Ah, well, just serfs…What’s it matter, a ratchet-up of pain from peanut wages, unemployment or fear of, etc. Keeps them too preoccupied, busy, anxious, sick to rise up.
      The neoliberal OccupythePeople. So they don’t Occupy.

      1. craazyman

        Walking Across the Street with Your Head in a Cloud

        I’ve noticed the cashiers and counter help at the lunch shops on Third Avenue seem more sullen and angry these days. It’s things like that that make you think and wonder. You turn your mind into a precision tool that measures the momentum of the sh*t approaching the fan. You can see it in the flashing harsh and frazzled glance of a face or the way a servers arm bitterly extends in haste across the counter with a half-filled cup of coffee. You’re paying for a full cup. Then it’s an overly polite smile when you ask for it full. These are the signs. It didn’t used to be like this. Before it was just a lazy and distracted vacancy or a sullen sense of erudite superiority clothed in nose rings and pink hair. Now it’s a silent tension, a pregnant silence before the birth of some demonic explosion. Even the South Asians are getting testy. That’s quite amazing, as they’d generally endure almost anything with a sullen stare. there’s one in particular, who sells me two cookies every day, and it’s a game for her to f*ck with my order. I’m at the point where I’ve blasted her head to toe with a genteel and good humored politeness conveying an equivalence of being like we’re two characters in a play that neither of us quite respects. It’s an affectation, I admit. Now she smiles at me. She must go home to some kind of a family in Queens. It may not be bad, actually. It’s easy to be sentimental about these things and see victims when it’s just a bored girl. That’s what happens when you have an overactive imagination. Sometimes a cigar is just a cigar and a person is just bored. You never know for sure until the riots start.

        1. Lambert Strether

          There’s probably some startup working out a way to measure “sullen-ness” from CCTV cameras using facial recognition software. …

          That said, I agree. Something in the air. Could be all the war talk, could be more. Some fresh hell of rental extraction sucked the last discretionary twenty bucks out your cookie-seller’s wallet, or made trouble for the family.

    1. Cocomaan

      You’re not supposed to work for yourself in the new millennium. You’re supposed to work for someone else.

  7. jgordon

    About the above, hopefully those who were desperate or foolish enough to enroll in Obamacare are getting a net benefit out of it. Being relatively young and healthy though, there’s no way in hell I’d want anything to do with it. The IRS fine (if it’s ever levied) is a much better deal.

    More importantly, this is really a forewarning that the collapse is right around the corner. Though still standing, the tree is near dead, and Obamacare is like a parasitic fungus eating away at the base of the tree, to help it fall the faster. Society is already rotten and ready to collapse. As good stewards we should be helping the process along, as no one benefits from having moldy and stinky (if technically still “alive”) trees around.

    1. Jim Haygood

      True story: day before yesterday on the Brooklyn Queens Expressway, I spotted a geezer in a dusty 1980s-vintage Chrysler K car, tooling along in the slow lane with his head barely visible above the seatback. A bumper sticker on his vehicle read, ‘I [heart] Obamacare.’

      Obamacare: by popular demand!

      1. bruno marr

        …if that driver is really a Geezer (over 65) he’s on Medicare and shouldn’t need Obamacare.

      2. trish

        How about this one- almost tossed my lunch: Obamacares

        (this on a lexus with with a I support my public radio one, too.)

  8. Lyle

    Even in the old days if you had a life event you had to report it to the insurance company, in particular a birth wedding or divorce as it affected coverage. As to the income estimates, the goal is to have the subsidies not result in a large bill due on april 15 because to many subsidies were paid. Those who do not have w-2 wages should already be filing estimated taxes, and should likely report income estimates for this purpose as well.

    1. David

      Exactly. There is nothing odd here. BCBS asked for the same things for 20 years before ACA, so what is new? Nothing!

    2. Lambert Strether

      It is true that as a downwardly mobile WASP, I may be encountering insane systems that my privilege has previously shielded me from. That doesn’t make them any less insane.

      Yes, I do understand that the accomplished rentier adjusts the intake of its sucking mandibles to take account of the actual volume the host makes available to them (we call this “eligiblility”) but still….

  9. Joe Buck

    Excuse me? First off, self-employed people and those with variable income already need to estimate their income. It’s called estimated taxes. Second, the significant events you describe are opportunities to change your insurance; ordinarily someone is stuck with their current policy for a whole year, but if they have a new child, get married, lose a job, etc. they get to switch. All of this reporting has been standard in the private insurance market, except that one part that used to be standard (disclose every possible pre-existing condition and if you forget one little thing they don’t have to pay) has been outlawed.

    Single payer would be better, agreed, but you’re coming off like a Bircher here.

    1. MaroonBulldog

      Intrusive state cradle-to-grave monitoring and supervision of a person’s “significant life events”, purportedly for the person’s own good, is justifiable paternalism, if the concern is authentic and the person being supervised is incompetent; otherwise, it’s totalitarianism, if competence is not in question, or authenticity is . Commanding an income that falls below four times the federal poverty limit does not equate to incompetence.. Nor does it appear that PPACA’s implementation is motivated by authentic concern for “consumers’ own good.” So, to me, Lyle comes off as a fascist. Or an Obot. As if there’s a practical difference.

    2. Lambert Strether

      You should get that knee looked at. This sounds like a Bircher?

      Note this is totally a class thing. If your income is four times the Federal Poverty line, you don’t get into ObamaCare anyhow. That means that the vast majority of the economists, and academics, and career “progressives,” and lobbyists, and insurance company executives, and talking heads, and consultants who foisted this thing on us are not subject to the same onerous reporting requirements they impose on us. Shocker, huh?

    3. Yves Smith Post author

      If you are incorporated, it doesn’t work that way. Try again. Lots of self employed people take all their payroll, one chunk, in 4Q, particularly those with seasonal businesses (dependent on Christmas sales).

      And for those not incorporated, you can get away with paying estimates based on prior year actual, and square it up in the 4th quarter, when you know what actually happened. By contrast, Obamacare expects you to get it right MONTHLY.

      I suggest you do more homework before making sweeping statements.

      1. Nathanael

        If you’re self-employed, you have to pay all the premiums up front and wait to get the subsidy on April 15th next year.

        If you do this, you don’t need to report *anything* to them (unless you get married or divorced). They don’t tell you this, but I did my research on it.

    4. Carol Sterritt

      Joe Buck, I would agree with you, except I am wondering about the penalties for failing to report one or several of those items. It is always the public that is penalized. Relative to their income, people whose dogs pee on the beach are fined more than BP is!

      I am on another blog, and recently someone who had out of pocket costs regarding her home repairs as a result of Storm Sandy’s damage, she is relating to how little she will ever get from her Big Insurer. So apparently the big Insurers are not at all regulated. I mean, do they have to report to anyone when they screw us over?

      How about my own case: Kaiser Permanente (Be well And THRIVE!) totally mis-diagnosed my husband. My husband then went on to have blood sugar levels of over 400 for three months. As a result he went blind. But we were powerless to sue Kaiser – they deleted all computer records related to his dates of service. So they couldn’t have mis-diagnosed him in Oct 2005, as he never had any Kaiser appointments! And even if they had not deleted records, there are few attorneys willing to take on Kaiser. And this all has to be done with 60 or 90 days etc. At one point, with my spouse having been so screwed over as once he was finally diagnosed with having diabetes, he was given the wrong medicine for the condition! that I was told he might not live!

      The above wiped us out financially – yet who did Kaiser have to report to on this situation!

      Meanwhile “Anthem,” once known as Blue Cross Blue Shield, has a gorgeous website up as part of “California Covered” and it is complete with photographs of some well liked and very decent doctors. Only problem – those doctors are not part of “Anthem” and right now, a friend is telling me, not a single doctor that people in Marin County are told exist inside the Anthem program are actually willing to take on “Anthem” patients! So people in Marin County have to travel to other counties to get help!

      If we the public have to report things, then let’s “INSURE” that the Big Insurers have to report things also. And let’s have fines to penalize them as well.

  10. Jake Mudrosti

    Since the beginning of the year, Anthem Blue Cross has been sending a separate monthly billing statement, in addition to the main billing statement: $5.87 per month for “Dental Pediatric.”
    This doesn’t even remotely apply. But a customer service rep insisted that the extra monthly bill is correct, and in fact necessary to comply “with the law.”

    The makings of an interesting psych experiment: keep adding extra charges/requirements to the basic health insurance, and see how far you can push it until the customer finally calls b*****it.

    1. David

      Dental insurance has always been billed separately from health insurance. The incremental surcharges have being going on for decades, hence the ACA, which at least slowed it down a tad.

    2. Carol Sterritt

      Jake, See my comment exactly above yours regarding Anthem.

      Oh and one other thing – Anthem is notorious for telling the insured that they must have the doctor’s or dentist’s office submit the paperwork for the billing, and then they tell the doctor’s office only the patient can submit the billing, and then they don’t have to pay anything ever, do they?

  11. Banger

    Thanks to Lambert and Yves and the many comments here at NC I am now considering voting straight Republican this election, except for local offices. Obamacare is a yet another sneaky attack on civil liberties and human dignity.

    1. MaroonBulldog

      Banger, I must take immediate exception to your characterization of Obama: I find nothing “sneaky” about it.

    2. Lambert Strether

      ObamaCare is a Republican plan, originating at Heritage and test driven by Mitt Romney (with the good people of Massachusetts strapped to the top of his car, no doubt). Why would ObamaCare make you vote Republican?

      1. Banger

        Well, I’m thinking about it–I may end up just not voting for anyone other than third party. The fact is that I feel guilty for being critical of the RP over their obstructionist tactics and I believe they deserve a hearing because they were right in opposing the law and I didn’t initially understand what had gotten some of them so worked up.

        1. Lambert Strether

          Well, it would be nice to have a legitimate opposition party, for sure. I’m just not sure that the Republicans are that party. For example, IMNSHO the truly principled conservative argument against ObamaCare is that you shouldn’t force people into a market (’cause otherwise, it’s not a free market, right?*). And ObamaCare — and the whole “nudge theory” variation of neo-liberalism pushed by of career “progressives” — mean that forcing people into markets is foundational. But they dropped that argument, presumably at the behest of insurance companies, and then went on the “repeal” tantrum. Just bizarre. Kayfabe. Another way of saying this is that I do believe there are some arguments put forward by Republicans that are worth listening to, but the party as a whole is not worth listening to. Of course, I think the same of Democrats.

          * Automobile insurance is the typical riposte, but the cases are different: You avoid the health insurance market by avoiding a car, but needing health care is an unavoidable part of the human condition.

          1. MaroonBulldog

            Needing health care is an unavoidable part of the human condition. Needing doubtfully so-called health “insurance” to finance health care is not–“health insurance” is a recent invention and sorry excuse for what is pathologically accepted as the best deal our political system can deliver under present circumstances.

          2. mellon

            Perhaps “Third Way” Obama is working with them to help them rebuild their brand? They helped him out a lot in the 2008 primaries.

          3. Code Name D

            Q: Do you vote Democrat?

            A: No

            Q: Then you must vote for Republicans then.

            A: Hell no.

            Q: Oh, so you are one of those unreasonable people who is waiting for a third party.

            A: Third party? Hell, I would settle for for a second party.

            1. PeonInChief

              Many years ago, Julius Nyerere, then-President of Tanzania, was asked why his country had only one party. He replied that the United States also had only one party but, with characteristic excess, had created two of them.

        2. Vatch

          “I may end up just not voting for anyone other than third party”

          Yes! That’s the path to choose.

      2. trish

        I really don’t understand the vote republican thing- heard this before. Like they’re gonna work for the public. One party right, one right-er. All corrupt. I refuse to vote either party at the state or federal level.

        1. jrs

          The best argument to vote republican (unless they are the LOTE – sometimes – maybe locally, maybe in the case of say an anti-interventiont like Ron Paul – but not usually the case) is that maybe then you’d have someone (old Dems) who would oppose the horrible policies we’re going to get either way. But since the opposition is pretty toothless even when it IS opposed to the policies it pretends to oppose (like wars), even that seems a pretty feeble non-starter of a reason when you get down to it.

          1. hunkerdown

            The best argument to vote GOP is that the GOP candidate is to the left of the Democratic candidate.

            Would that my erstwhile fellow Californians would have thought of that in the 2000 Senate elections. There might never have been a Senator from Palantir running interference for the intelligence community and pontificating about her superiority like some kind of Leona Helmsley clone.

            1. mellon

              I wonder when we’ll wise up to the candidates” game and start voting for issues directly instead of candidates.

              1. hunkerdown

                Probably as soon as we ditch the Establishment, which (unfortunately) some are very devoted to and will protect with their lives.

  12. Meredith

    this is bad, but its kind of typical for benefits that have government subsidy- this is how we treat poor people- like we are all either a) con artists, or b) there to collect data from against our will. Unemployment in some states requires not only long waiting periods and confusing processes for challenging employers denials, but also tracking all kind of info about jobs applied to, other income, etc. Not as bad as this, but in combination its horrendous. Someone who receives unemployment, food stamps (also really bad in terms of paperwork and waiting periods), and obamacare is just supposed to be filling out paperwork all day everyday- like a full time job. As if searching for a job is not in itself a full time jobs these days.

    1. mellon

      Perhaps one of main points of Obamacare was to get all of the lower income people into private (non-governmental) databases. No regulation!

  13. Pepsi

    The words you guys use “gatekeeping” and “crapification” are so accurate. It stresses me out so much to do things that should be simple, because I know that A. the first time they won’t go through B. the second time will take some extra period on the phone and C. some sort of billing ‘error’ is inevitable.

    1. MaroonBulldog

      “Gatekeeping” defined: something that is disagreeable but paternalistically done to us for our own good, to protect us from harming ourselves through overmedication. Cf: euthanaisa

  14. Karl

    These kinds of reporting requirements are fairly typical for collecting any sort of income based benefits like food stamps (SNAP) or Medicaid benefits. They are not new, except to the extent that people getting an ACA exchange subsidy weren’t collecting any other benefits previously.

    1. human

      Except that the enrollment process, in order for them to first determine if you are even eligible for a subsidy, gets ALL of that data up front.

      1. Lyle

        The goal of updating income is to avoid large bills come after April 15 2015. Once the 2014 tax forms are in the IRS will true up the actual income with the estimated income on the ACA app and send bills or checks as the case may be to make things even out.

        1. Nathanael

          If you decline to get the subsidies prior to April 15 (so that you get refunds on April 15th), you don’t have to report any of this crap.

          That’s the only real option for the self-employed.

  15. Chris Herbert

    In Massachusetts 99 percent of citizens are covered. Nobody bitches. Democrats would prefer Medicare for all, single payer. But the Republican Party will not allow it. That it is Rube Goldberg-ish is because we keep trying to obtain some version of a ‘market’ for medicine. Which is an impossible task. Doesn’t exist. Cannot exist. This last step (for now) of Obamacare got millions of the last 16% of Americans uninsured, insured. Had Republican states allowed Medicaid expansion, the nation would be near universally covered. Now we just wait until it dawns on most voters that we already have in place a universal-ready system working for about 40 percent of the population: Medicare, which would knock about 13 cents off every medical dollar spent in the United States.

    1. hunkerdown

      Who cares what Democrats want? It’s what the Democratic Party wants, and the Democratic Party wants Wall Street.

      1. hunkerdown

        Chris Herbert, I meant to add, is there any particular reason you’re ignoring the disjunction between the Democratic Party and those who think that voting for a Democratic Party operative makes them a member with standing?

    2. cripes

      Chris Herbert:

      You mean “universally covered” by crap insurance with huge deductibles, narrow networks, and price gouging co-pays and coinsurance after the extortionate premium.

      Methinks you don’t have to actually rely on this garbage.

      1. Joek

        It’s not coverage unless your health-care problems are a) actually covered and aruably b) resolved, or at least a good-faith attempt is made at resolving them.
        Obamacare is NOT about health care, it’s about partial health insurance, via profit-making insurers no less. If that’s fine with those defending it, good for you and your low expectations and/or acquiescence to being ripped off (and letting the government and large corporations protude even further into your private life to the extent you still have one while ripping you off).

        Mandating that all Americans ascent to giving money to for-profit corporations who can and will deny coverage, to be treated by for-profit physicians and hospitals who are insured against malpractice (meaning that even if you have a legitimate actionable case against a doctor you are likely to be railroaded into accepting an inadequate settlement, especially after your lawyer who joined them in dissuading you from going to trial takes his cut), is immoral in the extreme. Advanced nations appear to have recognized this. Some day we may too, but until then you’ll see ACA supporters producing a significant minority of the comments even on blogs such as this.

        I wish they were shills but sadly they are likely just unwitting victims of the propaganda machine.

        1. Carol Sterritt

          Oh please, protection monies are always considered coverage! Aren’t they? I mean you don’t want the family’s store burnt to the ground? It is all part of the Big Deal you make that you must never refuse to make, even if you don’t understand the terms.

          I will repeat what I wrote above about one insurer: Anthem:

          Meanwhile “Anthem,” once known as Blue Cross Blue Shield, has a gorgeous website up as part of “California Covered” and it is complete with photographs of some well liked and very decent doctors. Only problem – those doctors are not part of “Anthem” and right now, a friend is telling me, not a single doctor that people in Marin County are told exist inside the Anthem program are actually willing to take on “Anthem” patients! So people in Marin County have to travel to other counties to get help!

          If we the public have to report things, then let’s “INSURE” that the Big Insurers have to report things also. And let’s have fines to penalize them as well.

  16. cripes

    Two things:

    We (the ACA-insured or potential insures) are so bogged down in the minutiae of navigating the Go*damn perpetual enrollment process, there is almost no mental energy left over to consider access to health care, Oh wait, Access to Health Care. Is there any? As others have pointed out, HHS doesn’t bother to count this trivial “metric.”

    The other is my amazement (perhaps also because of the same enrollment-obsession) that no one seems to notice there is no provision to train and employ enough doctors and health care staff to accommodate 8-50 million more patients. Isn’t that a basic planning function in any medical system? Don’t we count heads and send enough doctors to the latest country where our war-fighters are bringing democracy? Seriously, where are the doctors going to come from?

    The World Bank says there are 2.5 physicians per 1,000 population in the US. (Italy 3.5, Russia 4.3). Anyway, that’s 20,000 new doctors to care for 8,000,000 patients, or 125,000 doctors for all 50 million who were getting by with emergency rooms, or nothing at all. Fortunately, Forbes has a pertinent quote:

    “America is suffering from a doctor shortage. An influx of millions of new patients into the healthcare system will only exacerbate that shortage — driving up the demand for care without doing anything about its supply. Right now, the United States is short some 20,000 doctors, according to the Association of American Medical Colleges…Obamacare is further thinning the doctor corps. A Physicians Foundation survey of 13,000 doctors found that 60 percent of doctors would retire today if they could, up from 45 percent before the law passed.

    Doctors are also becoming choosier about whom they’ll see.”

    http://www.forbes.com/sites/sallypipes/2013/06/10/thanks-to-obamacare-a-20000-doctor-shortage-is-set-to-quintuple/

    And then, there’s the narrow networks. The 60% of doctors over 50 nearing retirement. The surge of doctors refusing Medicaid/ACA patients.

    What a fustercluck.

    1. FederalistForever

      @cripes. Our immigration policy bears on this issue. We need to make sure that as our population expands, the number of physicians in our population also expands, to maintain (or even improve) the ratio.

  17. Code Name D

    So you MUST report these “life changes” to HHS, as if keeping them abreast of your changing circumstances will allow the ACA to better fill your needs. But it looks more like HHS’s tells YOU what your situation is, and its up to you to provide documentation to correct their system.

    Today’s news announced that 1800 Kansans are at risk of losing their insurance coverage because of inconsistencies regarding citizenship. It’s an unsettling coincidence that Brownback has fanatically harassed minorities at nearly every opportunity, and challenging citizenship in order to kick minorities off of the voter registrations is one of his latest scams. (It might suggest more undisclosed problems with voter registrations and other state services.)
    http://kmuw.org/post/kansans-could-lose-health-insurance-over-questions-about-citizenship

    My understanding of the HHS role in Obamacare is mostly policing. It’s their job to mine the big data in order to look for potential fraud. And where found, they will eject people from their policies as they are no longer qualified.

    My concern is that with big data being rolled into this mix, there is the assumption that big data equals reliable data, and thus is a tool to be used to ferret out fraud. I don’t think it will work out that way. I fear that if you dig down deep enough – you are bounds to find fraud some where, even if what you find are simple mistakes.

    When you “update” the HHS about your status (face book any one), it may expect to see that new status reflected in your universe of other related documents. You told HHS that you are now married – but it notices that your car insurance forms still registers you as being single. Or that another life insurance that you had forgotten about years ago still has you in collage.

    You may count yourself lucky if all you have to do is babysit your account in order to update your current status with HHS with “Minor headache, took IBP, told spouse not interested in sex tonight.” Most of your time will likely be spent trying to convince the infallible data-minors that there data-file is wrong, and that you did not marry your little brother when you were six, or because you were an only child.

    Oh and an FYI for Lambert. News is that Kansas is the only state that has a significant increase of the uninsured. (To which we may add another 1800, nice.)
    http://kmuw.org/post/kansas-only-state-nation-significant-increase-uninsured

  18. MaroonBulldog

    “Note this is totally a class thing”: No one belongs to any class unless someone else puts them there; and the purpose of classification is to put other people into classes that enjoy fewer rights and privileges than the persons doing the classifying. The way to accomplish the purpose is through legislation–fascist legislation: putting persons into classes and keeping them there, cradle to grave, is the essential aim and theory of fascism. For years, I’ve been saying that the American administrative state is fascist in its design. Now you are seeing what I’ve meant by that.

  19. Nathanael

    FWIW, if you refuse to take the “advance premium subsidy”, and only take the subsidy as a rebate on your tax return at April 15th the next year, you don’t have to do any of this.

    Of course, only the relatively well-to-do can afford this option.

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