An Update to My Open Letter to the Obama Administration and American Citizens

    December 23^rd 2013 is the day my life as I currently knew it changed.   I decided that the letter I had written about my experience with healthcare.gov and the new Affordable Care Act needed to be posted to what I thought was my little world of Facebook Friends.  I addressed it as An Open Letter to the Obama Administration and American Citizens.  My hopes were for my family and friends to read my letter and understand what we were going through.  I wanted them to know if they were going through it too - they were not alone.   I knew it would be shared and I asked it to be shared.   However I never could have dreamed it would travel in social media as far as it has to date.

    

    First, I want to make sure there is no confusion - I am Karri Kinder who lives in Alabama.  I did write that letter and I am also writing this letter.  Every word of my letter is true.  This is happening to countless Americans.  I am now more convinced of that than I was when I wrote my letter.   I have had so many people contact me with their own “Obama Care Horror Story” as some articles have named it.  There were a number of other Americans just like us with such similar stories; it began to be quite eerie.   I knew what I had done would spark conversation among the American people.   I was speaking out and helping others to do the same.   I was letting my children’s’ voices be heard, I was letting our story be told.  But, as I realized I was also opening my family up to the court of public opinion too.

    Once you put something on the internet it is always there, and while I never meant to do any harm, my words sparked anger in many of my fellow Americans.  I could not understand it.  All I was trying to do was to get the word out there about what was happening to us and what was happening to my children.  They are the only ones who have mattered through all this.  They were the reason I wrote my letter – I needed to be their advocate.  I, as their mother, had to tell their story. And I am very glad I live in a country where a single individual’s voice matters.

    Again, everything in my previous letter was completely the truth.  We were covered by Blue Cross Blue Shield (BCBS) of Alabama for $380.00 a month, including dental coverage.  I wouldn’t even begin to know how to make up that number.  That is what our plan cost and that is what I paid for the last 12 months.  Everyone’s premiums are different; they fluctuate from state to state as well.  However, I saw my fellow Americans coming to my defense when my numbers came in question on several sites – for that I am very grateful.  They also were telling their stories and sharing their premiums and confirming my numbers were not a lie.  Their numbers were similar to ours.  Many will say that our plan was so cheap because it was one of the sub par plans we have heard all the politicians talk about on the television.  But to us it wasn’t.  It met our needs and wants in a health insurance plan.   My child’s medical needs (he has ADHD) were being met.  All of his care this past year had been covered at 100 percent.  When we went to the doctor for his ADHD care, we never paid a co-pay.  When we saw his therapist for his behavioral therapy we never paid a co-pay or received a bill for that either.  His medicine that he takes (generic form) cost us $100 for the first prescription, for us to meet his deductible and then a $15 dollar co-pay the rest of the year each time we filled a prescription.  So, again for us our BCBS plan was meeting our needs. 

    I kept my letter politics free.  My letter wasn’t about the political side of the Affordable Care Act.  It was about what was happening to us and how it was hurting my family.  After all the stories people have sent me, it is clear there are many “glitches” in this system.  I for one am so happy that people, who were being denied coverage for pre-existing conditions, now are able to get insured.  I have always supported that aspect of the ACA.  It is not right that someone who wants health insurance and is willing to pay the premiums for their health insurance, were not allowed by the insurance companies to do so.   However that is where my support stopped.  I don’t feel it is right to force other people, into a system they don’t want or truly need to be a part of.  What happened to “if you like your current plan, you can keep it?”  We certainly liked our plan but we are no longer allowed to keep it, it doesn’t meet all the requirements of the ACA and that is why it was terminated. 

    So here we are on January 4, 2014 and I do have some good news.  Because I decided to write my letter and speak out - people stepped up and helped us.  We were contacted on January 1, 2014 by the U.S. Department of Health and Human Services.  I was told by the woman I spoke with that she had read my letter and wanted to get her team involved and see what they could do to help us.  I recounted to her what was happening and that I had been advised to go ahead and sign me and my husband up for a plan on healthcare.gov.  We went with a lower cost plan because it was going to just be the two of us.  We had no idea what it was going to cost for the children once we got some answers.  So we went with BCBS Blue Value Saver plan.  The cost of the plan is $459.19.  We qualified for $255.00 in subsidies so the final cost of the plan to us is $204.19 each month.  I told the lady that I would cancel that plan if I needed to.  What we wanted was to have all of us on one plan like we always have been.  She said, “If the kids qualify for ALL Kids then I am pretty sure they have to go that route or you will have to buy them a plan at the normal rate.”  So again we were told more than likely we will have to go through ALL Kids.  She took the rest of our information down and said she was getting her team to work on it and would either call us back or ALL Kids would contact us.

    January 2, 2014, a gentleman from ALL Kids contacted me as the Health and Services rep had stated.  He had more questions for me and he said wanted to make sure we needed to go the ALL Kids route, since the U.S. Dept of Health and Human Services rep told him that we didn’t want to put our kids on ALL Kids unless we had no other option.  He went over the program with me and said they would be working on my application.  He also told me it was a very good thing that I had went ahead and filled out an application with them personally because they had still not received our application through healthcare.gov.   I couldn’t believe that information had not been sent yet.  Remember I had received our first results on December 6, 2013.  I was even more confident at that point that my letter had made all the difference for my children.  I can’t imagine how long we would have waited to be contacted by the state, because our application was somewhere in limbo land through the healthcare.gov site.  I was also very grateful to the one person with healthcare.gov who actually told me I needed to go ahead and file a separate application with ALL Kids. 

    January 3, 2014 at 2:00 pm I returned a missed phone call from ALL Kids – I had been at work and unable to answer the original call.  They told me that our children have now been approved and they went over the cost with me.  The cost to us for both boys will be $208.00 annually.  So that means it will be a little over $17.00 a month for coverage through ALL Kids for both boys.  I was told we should be receiving our packet information and cards in the mail within the next 5-7 business days.  I thought when all this started that when we finally got our boys coverage through something I would have a huge sense of relief and weight off my shoulders.  Please, do believe, I am incredibly grateful that they have coverage now and I am indebted to those who made this possible.  However, I truly hate the fact that it is not how we wanted them to be covered.  We don’t want to have to be reliant on the government, which is what makes my heart so heavy today.  I think to myself, just a month ago, we were paying for our whole family to have private insurance and now today that is not the case.  There are so many people out there who needed these services due to falling on hard times and other circumstances.  I think it is a great program for those who need it, to get back on their feet.  However a month ago we were not the people the program was designed for and today we are - to afford coverage and still have some money to spend and support the U.S. Economy by affording to buy clothes, food , clothes, gas, and other necessities.  Again, I am forever indebted to those who got the ball rolling for them to have coverage – those who called me and made sure my children would get coverage quickly.  We just didn’t want to have to be reliant on the government when we didn’t have to before the ACA was passed and enacted.  Seems we should have a healthcare system that maintains affordability on all levels without needing the government’s funds to afford a modest lifestyle as middle class Americans. 

    Lastly, I want to thank my family and friends for all the support you have shown us.  To all, my fellow Americans, who did not know us and shared our story.  To our Alabama State Senator Tom Whatley (R -27^th District) who took the time to call us and offered his help and support.  All of you had a part in helping get us answers and a solution to our situation.  So many sent us their thoughts and prayers and we are so thankful to each and every one of you.  I encourage everyone who has shared their stories with us to please write your own letter so others can see that we are not the only family this is happening to.  There are so many stories in my email inbox of families, just like us, getting lost in the ACA system and that were paying for their own healthcare plans that were affordable for their families until now.  If we all speak up then our government will have to listen and work on fixing the problems as a whole.  I will support all of you who decide to speak out.  It is not an easy road as I have learned, but it did get us the help we needed to start the new year fully covered.  My thoughts and prayers are with all of you going through this and I will offer my support any way I can.

Karri Kinder

December 22, 2013

The Affordable Care Act is leaving my children uninsured as of January – so how can this law have the word Care in it?

An Open Letter to the Obama Administration and American Citizens:

           

          My family’s journey with securing our new insurance under the Affordable Care Act (ACA) started on October 1, 2013.   I have decided to write this letter to let the American people know what it has been like for us.   We are a family of four, with two little boys’ ages seven years old and three years old.   My husband and I have had full time jobs for 6 years and 13 years respectively.  We have been with the same two companies for those years.  We are a middle class family; we own our three bedroom two bath house, we own two cars, and previously provided our own insurance for the four of us.  We have coverage through Individual Blue from Blue Cross Blue Shield of Alabama until 12/31/13. Our premiums have been $380.00 a month, which also included dental coverage for all four of us. 

On October, 1, 2013 we received our letters like other Alabamians about our new premiums and plans for 2014 from Blue Cross Blue Shield (BCBS) of Alabama.  When I opened our letter to say I had sticker shock was an understatement.   Our premiums for the Blue Saver Silver would now be $753.26. This included the ACA tax but did not include the additional $75.00 we would need to pay in order to keep dental for me and my husband.  So we would need to pay total $828.26 to keep health and dental insurance for the four of us.  This payment is roughly $64.00 less than what we pay for our mortgage each month.  I was outraged that anyone thought we could afford this.  Sure we have some savings, but with that price tag we would whittle it down to almost nothing very quickly.  I consider savings as a rainy day fund, a start to saving for the kid’s college, our retirement, etc.  I never dreamed in a million years we would need to use it to pay our insurance premiums each month – how in the world could this help the economy too? 

Throughout the month of October we read everything we could on what our plan would cover, and tried to get the information we needed about the ACA.  I was also blown away when I realized that my son’s medical care, he has Attention Deficit Hyperactivity Disorder (ADHD), would cost us so much more out of pocket than it was currently costing us.  My son has to go to his doctor every other month for his care.  If we need to see a therapist we do that monthly, so you see on top of the premiums there are other out of pocket cost we have to factor in.  He is also on medication that he takes daily.  His medicine is a life saver for him and helps him function like a normal seven year old, without it he can’t focus, his grades slip and his mind literally goes back to the mind of a three or four year old.  When he was first put on his medicine his reading went up 20 points and he went from writing one to two sentences to paragraphs, all in the course of a week.  He is a straight A student and very bright, but without the proper medical care that could slip away from him.   Under our new plan for 2014 we would need to pay a $55.00 co-pay, and then it would be covered at 80 percent once we reached his deductible, which would be $2,000 individual $4,000 family.  Out of pocket max numbers are $6,350 individual and $12,700 family.  All of this is enough to make anyone’s head spin.  We were then forced to look at other options as none of this was affordable for our family.

              

             I started to dig deeper into healthcare.gov.  I was hearing all the horror stories through the news about the subpar website.  I was reading right off their healthcare.gov Facebook page about other people’s terrible experiences trying to get coverage.   Then the government announces that they are going to be working on the site and making it a better experience as well as making it more secure.  They had already had three years to make this happen but they said would need the month of November to get it running right.  So I waited patiently for them to get the site running so I could see if we would qualify for the subsidy and continue our health insurance through that route.

               

             December 6, 2013 I went to healthcare.gov and started our application.  The process took me over two hours to complete.   Once it was completed it came back with our results.  The results were that my husband and I qualified.  That my three year old qualified for All Kids and that my seven year old did not qualify for anything through the exchange (ACA).  I was so confused, how could a seven year old not qualify for a subsidy?  I was also confused on why they wanted me to enroll one of my children in All Kids?  So, I called the number they provided to speak to a representative.  I was on hold for 20 minutes when a woman answered and offered to help me with the results.  She told me that it is coming back that my seven year old son did not qualify and the only thing I could do was to file an appeal.  I asked her a few more questions about how this could have happened, and I was told “she does not know and that all I can do is file an appeal”.  She was reading her responses to me right off of a chart that I am sure they are given.  So, I ended my conversation with her and proceeded to try to wrap my head around what was happening.  

I decided to call back, this time I waited 15 minutes and spoke to a very nice gentleman who seemed to have an understanding for how the system was working.   He looked up the results and said “this can’t be right, let’s start over and do an application over the phone”.  So again I went through the application process.  The results came back the exact same, we all qualified for something except my seven year old son.  The gentleman could not understand how this could be happening and assured me it had to be a “glitch” in the system.   He placed me on hold so he could speak with his supervisor on how to fix this error.  I waited several minutes and when he came back he said “there was nothing more they could do tonight”.  He said “we are sending your application to two different departments and that one of the departments would get back to me through a phone call with a fix to this problem”.  He also told me “it could take 2-5 days but that I would receive a phone call when they had closed my case”. 

So I waited until Tuesday December 10, 2013, which was day four and called them back.  I was then told it would be 2-5 business days and if I had not heard from them at that time to call back.  So that is what I did, I waited till 9:00 pm on that Friday December 13, 2013 with no phone call.  I called Sunday December 15^th, 2013 and spoke with my 3^rd supervisor who told me “they were very sorry that I had not received a phone call and they were messaging the two departments to give me a call the following day”. He also said to go ahead and file with All Kids in my state because even though they send that information to them, they have no idea when they will receive it. So Monday I went and applied for All Kids for my children, it was a similar application to the healthcare.gov site. I called them to verify that they received my application and was told they cannot access it till sometime in January. They said once they could access it that they would be in touch and if the kids qualified the coverage would retro act to January 1, 2014. So that was a little bit of good news. 

                 

              So here we are December 22, 2013, the day before the December 23^rd deadline to sign up through the Health Insurance Marketplace’s Exchange.   I decide I will call one last time to see what they can tell me about coverage, since I never received a phone call after my last conversation with a supervisor.  I waited on hold for 1 hour and 15 minutes.  I asked to speak with a supervisor and I was transferred.  The supervisor pulled my file and was talking to me when she must have accidentally pressed a button and we got disconnected.  I thought for sure she would call me back.  That is one of the first things they ask for is your phone number.  I did not receive a call back, so I call back and have to be placed on hold again to speak to someone.  I waited another hour and a half before I get connected with a supervisor.   She pulls up my file and tells me “there is nothing they can do and I have to wait the 90 days they have to contact me through the appeals process”.  The supervisor tells me “that this whole time I have been told wrong by numerous people and that I should have been called back but that the two departments could do nothing for me”.   I just have to wait the 90 days.  I asked her, “so yet again an error, due to no fault of my own, has occurred all these times I have been calling and speaking with people and no one can really do anything”?  She said “yes that is correct, I am sorry you have been told something different but that is all I can tell you”. 

               

            I have never been treated so poorly by any insurance company in my whole life.  I have never experienced such terrible customer service in all my years on this earth.  I can’t imagine how long a company would last in this country if they followed the same protocol as the ACA/Health Insurance Marketplace does.   Most companies can fix a glitch in their systems pretty easily, or can connect you to someone who can.  Not the ACA/ Health Insurance Marketplace, you spend all that time on hold to just be told, so sorry but you have to wait for someone to get back to you in a 90 day time span.

                

             What is the most sickening thing to me is that we have been forced into the Health Insurance Marketplace’s Exchange.  We wanted to continue our coverage through BSBC and pay as we always had been.  But, we found out that option would not be affordable under the new Act, which is how we were forced into the Exchange.  Furthermore, not only were we forced into the Exchange, but then forced again to submit an application to ALL Kids for our children.   I just don’t understand how we go from being hard working middle class family who provides everything for our family to where we are today.  I feel like everything that my husband and I have worked hard for is for nothing.  I pray each night that we will get something resolved with our “glitch” in the system so our children will have health insurance coverage in January and by the time I have to purchase my son’s $400 a month ADHD medicine. 

I really don’t know how our government can allow this to be taking place.  What if something happens and one of my boys breaks an arm, or God forbid something worse?  They don’t have insurance, so I guess we will then be paying the hospital monthly if that happens.  We are almost completely debit free currently and now all I see is very large medical bills in our future until the government can fix the issues with the ACA/Exchange.  I would really like them to rename the Affordable Care Act, because from where I am sitting it is anything but affordable or caring for my family.

Sincerely,

Karri Kinder