I hate the ACA

[maize]

 

The implementation of Medicare did not cause drastic healthcare problems for the tens of millions of people enrolled. Why would it cause drastic problems for you and I if we were also enrolled?

 

Because it's too big a change too fast, because it doesn't cover dental and vision care, because drug coverage is separate, because suddenly we would go from a minimal amount of money per paycheck to a much larger one to pay for it since currently everyone pays into it but only the olders get it, because delaying care is often less of a big deal when employment is not in the picture, and again, most importantly, because it's too big a change too fast.

 

 I personally am not comfortable with necessary medical treatment being available only to the privileged. Are you?

 

Of course not, and I have said that many times in this thread.  To ask me that at this point borders on being insulting.

 

If not, how do you propose to create an actual functioning medical system for everyone, employed or not, healthy or not, able to pay or not?

Answered upthread.

 

 

 

So...what do you propose instead?

 

Current health insurance is not a minimal amount per paycheck, either you or your employer is paying a very significant amount per paycheck. Expanding Medicare or implementing a similar program for everyone would take advantage of economies of scale and would almost certainly be less expensive overall to maintain the same level of benefits. Employers and individuals could pay into the government plan rather than all these individual private plans and, based on the costs in other countries, would save a whopping amount in the process. Our total healthcare costs are ridiculous compared to comparable care in other developed countries.

 

You're worried about drug coverage? Great! Make sure your representatives know that any plan implemented must include drug coverage. Same goes for dental and vision, though I'm curious to know if you are aware that most health insurance plans in this country do not cover dental and vision? We pay for dental insurance separately (group plan but we're responsible for the full premium) and pay for vision stuff out of pocket.

 

Delaying care is a problem? Isn't it wonderful then that single payer systems usually have fewer delays than our private insurance system?

 

You have not explained how you plan to create and implement a functional system that will cover everyone, other than assertions that going to single payer is too much too fast. You want a gradual move to..what precisely? How gradual? Are you okay with folks continuing to suffer in the meantime?

Edited December 28, 2016 by maize

[LucyStoner]

Your state law regarding not allowing purchases on non-covered drugs is unconstitutional.

The rules changes for Medicaid here were passed in 2003. States have to seek federal approval for their Medicaid waivers which allow them to have varying laws meaning their rules are subject to federal scrutiny before they become effective.

 

Most states have a set list of medications that are covered without prior authorization (PDL) and some that may be covered with prior authorization for their Medicaid program. They also often require a step trial of a drug on the PDL prior to granting PA for a non-PDL drug. You can't get around the step trial very easily- not even if you will pay for it. So the state can refuse to cover certain drugs and scrutize the sale of those drugs to covered patients. In my mom's situation, despite being a cancer patient with no history of drug abuse, they wanted to limit her to one non-narcotic pain reliever that didn't work well or one narcotic that she couldn't tolerate. A step trial might have lasted the duration of her life. This may be abhorrent but until ruled otherwise, it is legal. I believe this also came up when she wanted to take Chantix to stop smoking. At that time Medicaid didn't cover smoking cessation (seems rather foolish, right?) so we had to obtain the medication from the drug company.

 

I would point out that end stage cancer patients and their families don't get to ponder constitutional law matters. You just do what you have to do to make sure your family member is cared for in the moment, knowing that you can't necessarily expect more than that moment.

 

All that said, on the whole my experience with both Medicaid and Medicare has been positive and I think that fears that the government can't manage to deliver healthcare well are overblown and incorrect. Medicare wouldn't be such a popular program if it was terrible to use or ineffective.

 

The SCHIP application (which is the Medicaid for children the OP mentioned) here is exceedingly easy. And honestly I hear back from someone faster through their ABA benefit program than I do sometimes from my private insurance*. Government can work. Radical opinion, I know.

 

*and our private insurance is what is generally deemed "Cadillac" insurance. Most everything is exempt from the low deductible and there's a low OOP annual max with co-pays that are still just $20 (up from $15 a few years back).

Edited December 28, 2016 by LucyStoner

[Carol in Cal.]

So...what do you propose instead?

 

Again, answered upthread.  I can go find it later on, do not have time right now.

 

Current health insurance is not a minimal amount per paycheck, either you or your employer is paying a very significant amount per paycheck. .

 

Current MEDICARE tax is what I was referring to.

 

You're worried about drug coverage? Great! Make sure your representatives know that any plan implemented must include drug coverage. Same goes for dental and vision, though I'm curious to know if you are aware that most health insurance plans in this country do not cover dental and vision? We pay for dental insurance separately (group plan but we're responsible for the full premium) and pay for vision stuff out of pocket.

 

Most employer plans offer subsidized vision and dental coverage, guarenteed issue, group rates.  Not everyone takes them.  It's disability that is being pulled, usually, ahead of these, and that is a big, though separate problem.

 

Delaying care is a problem? Isn't it wonderful then that single payer systems usually have fewer delays than our private insurance system?

 

This is not what I have heard from those involved.  They indicate that custodial care is easier to get, that wraparound care is more seamless, but that it takes a lot longer to get to specialists, and appointments are a lot more rushed.

 

You have not explained how you plan to create and implement a functional system that will cover everyone, other than assertions that going to single payer is too much too fast. You want a gradual move to..what precisely? How gradual? Are you okay with folks continuing to suffer in the meantime?

Again, answered upthread.  And I'm not OK with the large number of people who are suffering now, many of them as a result of the ACA.  As I have said repeatedly.  Enough with that already.

[ChocolateReignRemix]

The rules changes for Medicaid here were passed in 2003. States have to seek federal approval for their Medicaid waivers which allow them to have varying laws meaning their rules are subject to federal scrutiny before they become effective.

 

Most states have a set list of medications that are covered without prior authorization (PDL) and some that may be covered with prior authorization for their Medicaid program. They also often require a step trial of a drug on the PDL prior to granting PA for a non-PDL drug. You can't get around the step trial very easily- not even if you will pay for it. So the state can refuse to cover certain drugs and scrutize the sale of those drugs to covered patients. In my mom's situation, despite being a cancer patient with no history of drug abuse, they wanted to limit her to one non-narcotic pain reliever that didn't work well or one narcotic that she couldn't tolerate. A step trial might have lasted the duration of her life. This may be abhorrent but until ruled otherwise, it is legal. I believe this also came up when she wanted to take Chantix to stop smoking. At that time Medicaid didn't cover smoking cessation (seems rather foolish, right?) so we had to obtain the medication from the drug company.

 

I would point out that end stage cancer patients and their families don't get to ponder constitutional law matters. You just do what you have to do to make sure your family member is cared for in the moment, knowing that you can't necessarily expect more than that moment.

 

All that said, on the whole my experience with both Medicaid and Medicare has been positive and I think that fears that the government can't manage to deliver healthcare well are overblown and incorrect. Medicare wouldn't be such a popular program if it was terrible to use or ineffective.

 

The SCHIP application (which is the Medicaid for children the OP mentioned) here is exceedingly easy. And honestly I hear back from someone faster through their ABA benefit program than I do sometimes from my private insurance. Government can work. Radical opinion, I know.

What you are describing regarding the availability of a drug is different than my issue with your state reportedly not allowing a private purchase.

[maize]

So...what do you propose instead?

Again, answered upthread. I can go find it later on, do not have time right now.

Current health insurance is not a minimal amount per paycheck, either you or your employer is paying a very significant amount per paycheck. .

Current MEDICARE tax is what I was referring to.

You're worried about drug coverage? Great! Make sure your representatives know that any plan implemented must include drug coverage. Same goes for dental and vision, though I'm curious to know if you are aware that most health insurance plans in this country do not cover dental and vision? We pay for dental insurance separately (group plan but we're responsible for the full premium) and pay for vision stuff out of pocket.

Most employer plans offer subsidized vision and dental coverage, guarenteed issue, group rates. Not everyone takes them. It's disability that is being pulled, usually, ahead of these, and that is a big, though separate problem.

Delaying care is a problem? Isn't it wonderful then that single payer systems usually have fewer delays than our private insurance system?

This is not what I have heard from those involved. They indicate that custodial care is easier to get, that wraparound care is more seamless, but that it takes a lot longer to get to specialists, and appointments are a lot more rushed.

 

You have not explained how you plan to create and implement a functional system that will cover everyone, other than assertions that going to single payer is too much too fast. You want a gradual move to..what precisely? How gradual? Are you okay with folks continuing to suffer in the meantime?

 

Again, answered upthread. And I'm not OK with the large number of people who are suffering now, many of them as a result of the ACA. As I have said repeatedly. Enough with that already.

Yes, I know you were referring to current Medicare tax--but it is obtuse to complain about a potential increase in tax for an expanded Medicare if it is offset completely and then some by a decrease in private insurance premiums.

 

According to this survey report from 2014 only 35% of employers offer any type of vision insurance benefit; there is certainly no reason they could not continue offering that benefit if we had single payer health benefits.

 

http://files.kff.org/attachment/2014-employer-health-benefits-survey-full-report

 

You keep saying too much too soon...but you seem to want MORE not LESS than medicare offers. If you want it for everyone the government is going to have to be involved.

Edited December 28, 2016 by maize

[Janeway]

A separate issue is that a lot of people don't want to break the law. I imagine that that applies to the OP. It's kind of surprising to me that people here were actually arguing that she should go ahead and do so because she won't be financially penalized. Um, really? That's your advice?

Yep. And the extremeness of this paperwork and fear of being prosecuted or what will happen to us or what if I make a mistake led me to have a huge anxiety panic attack today. With all these social workers calling and asking all these questions that go on and on, what if they don't like my answers and take my children away???? I didn't vaccinate the baby!! I only selectively vaccinated my 5yr old. We already recently saw the dentist and the social workers are saying we have to go to their dentists! I don't make my 15 yr old do autism therapy. Are they going to take him and put him in a group home or something because they now make the decisions? In addition to all, my time is considered worthless and I have to do all these meetings. What if a child has a tantrum during a meeting? What happens to us?

 

I don't think low income or no income should mean that the state has the right to control our lives and bodies. I feel like I have lost my rights as a parent now. It has been horrifying. What if one of the many social workers I have to answer to now are against home schooling?

 

Because this medicaid thing has put me through so much, I actually told my husband to call back that one company and see if the job is still available. I have close to a year worth of salary saved up. I have a house worth enough that I could easily live in one half the price here, where I am now. But, because of fear of breaking the law and whatever control the state has over my children now, I am looking at greatly increasing my debt and setting us back financially to escape this control and stress. I am completely folding under this stress. Another social worker is trying to reach me for something. I got MORE paper work in the mail today. I saved hard and have always been frugal to provide for my family at a time like this. This is my husband's 4th lay off. But by law, I no longer have the same parental rights I used to have. And I now answer to social workers, any time of day, any amount of time they want, they own me. They can call me at 2 in the after noon on Christmas Eve and I just have to drop everything to answer their intrusive questions. But, they don't have to tell me if I made a mistake on the paperwork. I start every one of these conversations with "I don't know if I filled it out right, I could have made a mistake." Did you know you can go to JAIL for lying on medicaid paperwork? When I don't even use the medicaid to begin with!

 

edited to add: you know how people say they think we should be free to home school and should not have to answer to school staff for what we teach or how we teach, etc? But this law has made it so that low income people have to let their kids be tracked or be in violation of the law. 

Edited December 28, 2016 by Janeway

[justasque]

Nope, I don't overlook anything, but I think drastic changes lead to drastic problems, every time, and I think the government is not responsible/trustworthy enough to be the only one in charge.  I'd rather have seen them approach the ACA more incrementally, and using its failure as an excuse to do something even bigger is disturbing at best, particularly since we now know for sure that it was sold to us with lies.  Why in the world would we trust the feds after that?

 

Carol, it sounds like you, much like me, have mostly had Cadillac plans.  It is hard when you have a system that mostly works for yourself (myself) to buy into changes where you are lumped in with the non-Cadillac folks.  (I'm not saying that in a negative way - it just is what it is.)  I am wondering if a system where there were more choices would be better.  We actually have quite a few systems in our country.  There is Medicaid, Medicare, the VA for some veterans, Tri-Care for active duty folks and some others, SCHIP for kids, the ACA exchange plans, and employer-based plans.  Do you think it would be good to ease into change, by, for example, extending Medicare down to 55+ folks, expanding Medicaid to include those of somewhat higher incomes (perhaps on a sliding scale), raising the age of young people eligible for SCHIP, and extending who is eligible for the VA and Tri-Care?  

 

I am nervous about National Health, of course, but I assume that since I have employer-based Cadillac care, it would likely transition to an employer-based top-up plan (like some of my relatives in the UK have), so I'd still have quite a bit of choice and could "go private" like my wealthier relatives or stick with National Health like my less-wealthy ones.  Neither my Canadian nor my UK relatives have ever, once, complained about their health care systems.  They get high quality care, in a timely fashion, for significantly cheaper tax rates than we pay.  And never, never does one of their neighbors have to decide whether a child's symptoms are serious enough to warrant paying to be seen - they can always err on the side of caution rather than putting money into the mix.

[maize]

.

Edited December 28, 2016 by maize

[justasque]

Yep. And the extremeness of this paperwork and fear of being prosecuted or what will happen to us or what if I make a mistake led me to have a huge anxiety panic attack today. With all these social workers calling and asking all these questions that go on and on, what if they don't like my answers and take my children away???? I didn't vaccinate the baby!! I only selectively vaccinated my 5yr old. We already recently saw the dentist and the social workers are saying we have to go to their dentists! I don't make my 15 yr old do autism therapy. Are they going to take him and put him in a group home or something because they now make the decisions? In addition to all, my time is considered worthless and I have to do all these meetings. What if a child has a tantrum during a meeting? What happens to us?

 

I don't think low income or no income should mean that the state has the right to control our lives and bodies. I feel like I have lost my rights as a parent now. It has been horrifying. What if one of the many social workers I have to answer to now are against home schooling?

 

Because this medicaid thing has put me through so much, I actually told my husband to call back that one company and see if the job is still available. I have close to a year worth of salary saved up. I have a house worth enough that I could easily live in one half the price here, where I am now. But, because of fear of breaking the law and whatever control the state has over my children now, I am looking at greatly increasing my debt and setting us back financially to escape this control and stress. I am completely folding under this stress. Another social worker is trying to reach me for something. I got MORE paper work in the mail today. I saved hard and have always been frugal to provide for my family at a time like this. This is my husband's 4th lay off. But by law, I no longer have the same parental rights I used to have. And I now answer to social workers, any time of day, any amount of time they want, they own me. They can call me at 2 in the after noon on Christmas Eve and I just have to drop everything to answer their intrusive questions. But, they don't have to tell me if I made a mistake on the paperwork. I start every one of these conversations with "I don't know if I filled it out right, I could have made a mistake." Did you know you can go to JAIL for lying on medicaid paperwork? When I don't even use the medicaid to begin with!

 

I am sorry you are suffering over all of this. Do you have an IRL friend who can help you sit down and work through it all?  There are some realistic fears, and some not so realistic ones that you are expressing here.  I've never heard of anyone having their children taken away because of the way they filled out their medical forms.  Parents have the right to not vax, to homeschool, and to treat or not treat autism.  Sure, SNAFUs can happen, but when dealing with government red tape the best approach is to do the best you can, ask lots of questions, save copies of everything, take notes of every call, get names and call-back numbers, but most of all do it in the most professional, detached manner you can.  Pretend you are a secretary for your family, if it helps you to detach a bit while you're on the phone.  Put aside some time each day to tackle the next thing, but then when it's done, try to focus on other things.  Perhaps your dh can go over forms before you send them in, or otherwise be of some help.  Do not expect yourself to be perfect.  Just do your best.  Hopefully your dh will find work soon and you can move past this.  (Or, perhaps you can find some kind of work, just until he gets something good.  That might help too.)  

[Janeway]

Carol, it sounds like you, much like me, have mostly had Cadillac plans.  It is hard when you have a system that mostly works for yourself (myself) to buy into changes where you are lumped in with the non-Cadillac folks.  (I'm not saying that in a negative way - it just is what it is.)  I am wondering if a system where there were more choices would be better.  We actually have quite a few systems in our country.  There is Medicaid, Medicare, the VA for some veterans, Tri-Care for active duty folks and some others, SCHIP for kids, the ACA exchange plans, and employer-based plans.  Do you think it would be good to ease into change, by, for example, extending Medicare down to 55+ folks, expanding Medicaid to include those of somewhat higher incomes (perhaps on a sliding scale), raising the age of young people eligible for SCHIP, and extending who is eligible for the VA and Tri-Care?  

 

I am nervous about National Health, of course, but I assume that since I have employer-based Cadillac care, it would likely transition to an employer-based top-up plan (like some of my relatives in the UK have), so I'd still have quite a bit of choice and could "go private" like my wealthier relatives or stick with National Health like my less-wealthy ones.  Neither my Canadian nor my UK relatives have ever, once, complained about their health care systems.  They get high quality care, in a timely fashion, for significantly cheaper tax rates than we pay.  And never, never does one of their neighbors have to decide whether a child's symptoms are serious enough to warrant paying to be seen - they can always err on the side of caution rather than putting money into the mix.

Mine have. I do not have many relatives outside of this country, but, the ones I do have, the ones in Canada, had issues recently.  Previously, they always told us how great it was and how much better it is than here, etc. But now, and they are over 70, they recently went and spent the entire day with doctors or whatever. It sounded like some sort of medical complex with a variety of professionals. They had to travel a ways to get to it. I know the husband has chronic medical problems and has had a lot of problems lately.  Realize, I am not there and getting a really deep explanation of everything. Anyway, the medical people said they would not do anything further to treat him for what is wrong. So, he had to go back home and he has been sleeping a lot and in pain. She has gotten very depressed. So she went back for help for her depression and got none. 

 

Anyway, I have not had an update since.

[Janeway]

I am sorry you are suffering over all of this. Do you have an IRL friend who can help you sit down and work through it all?  There are some realistic fears, and some not so realistic ones that you are expressing here.  I've never heard of anyone having their children taken away because of the way they filled out their medical forms.  Parents have the right to not vax, to homeschool, and to treat or not treat autism.  Sure, SNAFUs can happen, but when dealing with government red tape the best approach is to do the best you can, ask lots of questions, save copies of everything, take notes of every call, get names and call-back numbers, but most of all do it in the most professional, detached manner you can.  Pretend you are a secretary for your family, if it helps you to detach a bit while you're on the phone.  Put aside some time each day to tackle the next thing, but then when it's done, try to focus on other things.  Perhaps your dh can go over forms before you send them in, or otherwise be of some help.  Do not expect yourself to be perfect.  Just do your best.  Hopefully your dh will find work soon and you can move past this.  (Or, perhaps you can find some kind of work, just until he gets something good.  That might help too.)  

The one social worker blew up at me and called me argumentative. He demanded I just answer his questions. I did not argue with him at all. Then he informed me that I have to disclose everything for them so they can assign the proper people to treat them, which includes learning disabilities. 

 

Now they are calling again and said I have another 20 minutes per child to answer questions. I told them I am not available until after the holidays. They plan to call back next week and I do not know what I am supposed to do. I will avoid their calls for sure. But I am also worried that if I keep avoiding their calls, they will show up at my door and we will really be screwed.

 

edited to add: I do not know anyone who is on medicaid and home schools and does not vaccinate, in my area. So I have no one to talk to to find out the consequences. 

Edited December 28, 2016 by Janeway

[TechWife]

Our chiropractor has told us that once my husband goes onto Medicare she will no longer be allowed by the government to treat him, even though we pay privately for those treatments, because of Medicare regulations.  We pressed her on that point, because DH has a degenerative back condition and has really benefitted from her specific type of help.  Losing that because of government regs is going to really bite.  Again, we won't even be able to pay privately for this.

 

Here is information on Medicare Part B coverage for chiropractic care. It is very limited. You will note, however, that it clearly states that you can receive non-covered services, but you will have to pay for them. If your chiropractor is choosing not to provide non-covered services, then it's time to find another practitioner. 

[TechWife]

My chiro is pretty welleducated, and not one of the wild haired anti-everything ones.  We have discussed this with her several times over the years.  I know that she believes this, and that she is rational in researching things.  And I know that she would like to keep her clients into their Medicare years, so this is not something that she has benefit from believing.  So I believe her.

 

She's wrong, you shouldn't believe her. You should do your own research about what is and is not covered by Medicare. No one is prevented from getting treatments that aren't covered, you just have to pay for them out of pocket. I have no idea why you are holding on to this falsehood.

[TechWife]

nm 

 

Edited December 28, 2016 by TechWife

[KarenNC]

What's the current recourse for everyone who doesn't have any insurance or only has one provider who decides a procedure is elective?

 

FTR, the ACA did expand Medicaid coverage, except some states sued to block that provision. 

 

 

Well, in the case of a friend who is unable to work at any job that would provide insurance for her (multiple health issues), can't afford to pay for the family option through her husband's insurance, and lives in a state that did not expand Medicaid, the current recourse is a GoFundMe campaign to supplement her own efforts to do everything she can to get enough money to pay half the surgeon's fee upfront so that they will even consider talking to her about scheduling the gallbladder removal. She basically falls through every crack there is.

[Charlie]

Yep. And the extremeness of this paperwork and fear of being prosecuted or what will happen to us or what if I make a mistake led me to have a huge anxiety panic attack today. With all these social workers calling and asking all these questions that go on and on, what if they don't like my answers and take my children away???? I didn't vaccinate the baby!! I only selectively vaccinated my 5yr old. We already recently saw the dentist and the social workers are saying we have to go to their dentists! I don't make my 15 yr old do autism therapy. Are they going to take him and put him in a group home or something because they now make the decisions? In addition to all, my time is considered worthless and I have to do all these meetings. What if a child has a tantrum during a meeting? What happens to us?

 

I don't think low income or no income should mean that the state has the right to control our lives and bodies. I feel like I have lost my rights as a parent now. It has been horrifying. What if one of the many social workers I have to answer to now are against home schooling?

 

Because this medicaid thing has put me through so much, I actually told my husband to call back that one company and see if the job is still available. I have close to a year worth of salary saved up. I have a house worth enough that I could easily live in one half the price here, where I am now. But, because of fear of breaking the law and whatever control the state has over my children now, I am looking at greatly increasing my debt and setting us back financially to escape this control and stress. I am completely folding under this stress. Another social worker is trying to reach me for something. I got MORE paper work in the mail today. I saved hard and have always been frugal to provide for my family at a time like this. This is my husband's 4th lay off. But by law, I no longer have the same parental rights I used to have. And I now answer to social workers, any time of day, any amount of time they want, they own me. They can call me at 2 in the after noon on Christmas Eve and I just have to drop everything to answer their intrusive questions. But, they don't have to tell me if I made a mistake on the paperwork. I start every one of these conversations with "I don't know if I filled it out right, I could have made a mistake." Did you know you can go to JAIL for lying on medicaid paperwork? When I don't even use the medicaid to begin with!

 

edited to add: you know how people say they think we should be free to home school and should not have to answer to school staff for what we teach or how we teach, etc? But this law has made it so that low income people have to let their kids be tracked or be in violation of the law. 

 

These are frightening prospects. I can understand why you're so upset. But I have to admit, they don't make any sense to me. I've never heard of the state having the authority to take children away for bad answers on medicaid forms. How did you hear about these?

 

[Janeway]

These are frightening prospects. I can understand why you're so upset. But I have to admit, they don't make any sense to me. I've never heard of the state having the authority to take children away for bad answers on medicaid forms. How did you hear about these?

 

I mean....like if I refuse to vaccinate or such.

 

They said I had to declare how much money we have. I did not list money in 401K or IRA accounts. That stuff I am worried about criminal charges for.

 

But..I am worried I will lose my children over not having the oldest in any sort of autism treatment program or for refusing to vaccinate my younger children, that sort of thing. The house is messy right now and the older boys got in to an argument where one hit the other earlier today. What if a social worker shows up and sees mess out?

 

 

Edited December 28, 2016 by Janeway

[TechWife]

 

 

They said I had to declare how much money we have. I did not list money in 401K or IRA accounts. That stuff I am worried about criminal charges for.

 

 

 

Unless the application specifically states to exclude these funds, then you need to file an amended application. Because, yes, that is fraud and yes, it is a criminal charge. Why would you risk that? 

[Charlie]

I mean....like if I refuse to vaccinate or such.

 

They said I had to declare how much money we have. I did not list money in 401K or IRA accounts. That stuff I am worried about criminal charges for.

 

But..I am worried I will lose my children over not having the oldest in any sort of autism treatment program or for refusing to vaccinate my younger children, that sort of thing. The house is messy right now and the older boys got in to an argument where one hit the other earlier today. What if a social worker shows up and sees mess out?

 

Making a mistake is not the same as an intentional lie. When you sign at the end saying something like, "I swear this is all true, blah blah blah," you're saying that you're not intentionally falsifying information. People make mistakes all the time, and courts and judges know this.

 

ETA: TechWife has the solution. You made a mistake, you remedy it.

 

You have the right to decide to provide autism treatment at your prerogative, vaccines, too. Unless you have a legitimate hoarding problem and your family is living with trash, or you are unable to feed and clothe your children (in which case, I imagine there are resources to help with that), a mess shouldn't be on their radar. A) They've got too much paper work to worry about getting on your back for something domestic and out of their field, B) They've seen worse.

 

But who is telling you that you might lose your children?

Edited December 28, 2016 by Charlie

[Janeway]

Making a mistake is not the same as an intentional lie. When you sign at the end saying something like, "I swear this is all true, blah blah blah," you're saying that you're not intentionally falsifying information. People make mistakes all the time, and courts and judges know this.

 

ETA: TechWife has the solution. You made a mistake, you remedy it.

 

You have the right to decide to provide autism treatment at your prerogative, vaccines, too. Unless you have a legitimate hoarding problem and your family is living with trash, or you are unable to feed and clothe your children (in which case, I imagine there are resources to help with that), a mess shouldn't be on their radar. A) They've got too much paper work to worry about getting on your back for something domestic and out of their field, B) They've seen worse.

 

But who is telling you that you might lose your children?

The one social worker, who knew I homeschool, demanded that I tell him about stuff like learning disabilities and got very angry with me. Why would the state have to know about learning disabilities? And he said if any of my children had learning disabilities or anything else, each child would be assigned a special social worker to handle their disabilities. Why would I have to disclose learning disabilities? And be assigned a special social worker?

 

edited to add: I am afraid that if I lie to them and do not admit to the ASD, and they find out, I can be prosecuted. But if I tell them about the ASD, I will be forced to answer to another social worker and to do whatever he/she wants with my child with ASD. I do not know if that would involve forcing him in to a treatment program or forcing him to public school or what. And I am also afraid that if I lie to them and tell them my children have all been vaccinated and they find out otherwise, I will be prosecuted. And if I tell them the truth, they will send a social worker to seize my children potentially and force vaccinations on them. 

 

And again, there are NO doctors where we live that take medicaid anyway, so I cannot use it. I could not use it at the pharmacy. I do not want to be forced to answer all these personal questions about my family. This is a big big punishment for losing his job. HUGE. And people just should not be punished like this, for being low income.

Edited December 28, 2016 by Janeway

[Renai]

The one social worker, who knew I homeschool, demanded that I tell him about stuff like learning disabilities and got very angry with me. Why would the state have to know about learning disabilities? And he said if any of my children had learning disabilities or anything else, each child would be assigned a special social worker to handle their disabilities. Why would I have to disclose learning disabilities? And be assigned a special social worker?

 

edited to add: I am afraid that if I lie to them and do not admit to the ASD, and they find out, I can be prosecuted. But if I tell them about the ASD, I will be forced to answer to another social worker and to do whatever he/she wants with my child with ASD. I do not know if that would involve forcing him in to a treatment program or forcing him to public school or what. And I am also afraid that if I lie to them and tell them my children have all been vaccinated and they find out otherwise, I will be prosecuted. And if I tell them the truth, they will send a social worker to seize my children potentially and force vaccinations on them. 

 

And again, there are NO doctors where we live that take medicaid anyway, so I cannot use it. I could not use it at the pharmacy. I do not want to be forced to answer all these personal questions about my family. This is a big big punishment for losing his job. HUGE. And people just should not be punished like this, for being low income.

 

Was this the case worker taking information for the application, or is this after you've been approved? I don't know what state you are in, but here once you are approved you choose the carrier for the insurance - BCBS, or any other that is acceptable in our state. I know that BCBS called us a few times (each renewal) to get medical info and said it was to see if we needed "extra assistance" with any special issues. I was also told it was required, about 15-20 minutes per child (thankfully, I only have two children). After the first time, I finally said we are pretty happy with the services from our provider. I was not asked about things like learning disabilities or ASD. It was more for diabetes, depression, high blood pressure. I'm not stupid; I know how to take a pill. At least one of my children has learning disabilities and another is selectively vaxed. Both are homeschooled. I have never felt threatened because of these issues. It is a decision between we and our doctors. Mostly, they were yes/no questions.

 

You don't have a Walgreens or Walmart with a pharmacy? They should take Medicaid.

[Charlie]

The one social worker, who knew I homeschool, demanded that I tell him about stuff like learning disabilities and got very angry with me. Why would the state have to know about learning disabilities? And he said if any of my children had learning disabilities or anything else, each child would be assigned a special social worker to handle their disabilities. Why would I have to disclose learning disabilities? And be assigned a special social worker?

 

edited to add: I am afraid that if I lie to them and do not admit to the ASD, and they find out, I can be prosecuted. But if I tell them about the ASD, I will be forced to answer to another social worker and to do whatever he/she wants with my child with ASD. I do not know if that would involve forcing him in to a treatment program or forcing him to public school or what. And I am also afraid that if I lie to them and tell them my children have all been vaccinated and they find out otherwise, I will be prosecuted. And if I tell them the truth, they will send a social worker to seize my children potentially and force vaccinations on them. 

 

And again, there are NO doctors where we live that take medicaid anyway, so I cannot use it. I could not use it at the pharmacy. I do not want to be forced to answer all these personal questions about my family. This is a big big punishment for losing his job. HUGE. And people just should not be punished like this, for being low income.

 

You can't be forced to treat autism a certain way. There's no law that says anything remote to that. There are no laws that require vaccinations in order to keep your children. My question is where are you getting these ideas? TV? Websites? Church? Neighbors?

 

To the bold, I don't know but perhaps they want to have as many ducks in a row as possible before people request services paid? Perhaps they need to keep a tally of special medical needs (including mental health) for whatever records they keep? Perhaps they are trying to make this process so stinkin' awful that the next election cycle everyone who had to go through these hoops, and everyone who hears about them, vote it down so legislators can install whatever private alternative will give their sugar daddies the biggest profit possible so the Old Boys Club members get their collective backs greased? It sounds like this is exactly what the legislators in your state want - to push people away through legalized punishment. Other states don't do this. So maybe you see now how this isn't about the ADA, but about the legislators in your state trying to punish the victim again? By the way, if you're comfortable sharing what state you live in, perhaps people can PM you with resources more local to you.

[Corraleno]

They said I had to declare how much money we have. I did not list money in 401K or IRA accounts. That stuff I am worried about criminal charges for.

 

IRA and 401K accounts do need to be reported as assets when applying for Medicaid. Not sure why you chose not to report them before, but as TechWIfe said, you need to amend your application to include these.

 

 

But..I am worried I will lose my children over not having the oldest in any sort of autism treatment program or for refusing to vaccinate my younger children, that sort of thing. The house is messy right now and the older boys got in to an argument where one hit the other earlier today. What if a social worker shows up and sees mess out?

 

I suspect that the social worker just wants to make sure the children have access to all the services they qualify for, including special services available for children with ASD. Ensuring they have the right to access those services does not mean you will be compelled to use them, let alone that the state will seize your children and force them to be vaccinated or go into a group home! 

 

If you really don't want the Medicaid, then you have the right to refuse it. But maybe it will be less stressful in the long run to just answer the questions honestly instead of trying to hide things and then panicking over what will happen if you get caught.

 

ETA: Even though you think this is all pointless because you would never ever use Medicaid anyway, if your kids have no other insurance, then you are basically just one bad car accident or medical emergency away from bankruptcy. That is not a risk worth taking.

Edited December 28, 2016 by Corraleno

[shawthorne44]

Janeway, I know that you don't have money at throw at things.  But, putting together enough money to join hslda.org and maybe that parent one (I read about it on freerangekids.com).   What you need is cheap access to a lawyer(s) that you can call with an SOS if CPS gets overbearing.  It seems to me that the threat of having your kids taken away is like a PP said about a parent with end-stage cancer.   You don't worry about the shoulds and just do what you need to do.  

[Corraleno]

Janeway, I know that you don't have money at throw at things.  But, putting together enough money to join hslda.org and maybe that parent one (I read about it on freerangekids.com).   What you need is cheap access to a lawyer(s) that you can call with an SOS if CPS gets overbearing.  It seems to me that the threat of having your kids taken away is like a PP said about a parent with end-stage cancer.   You don't worry about the shoulds and just do what you need to do.  

 

NO ONE is threatening to take her kids away, and nowhere has she said that CPS has been called. The questions she is being asked pertain to eligibility for free health insurance, and have nothing to do with her right to homeschool or selectively vaccinate kids or treat her child's autism however she sees fit. 

[justasque]

Janeway, I know that you don't have money at throw at things.  But, putting together enough money to join hslda.org and maybe that parent one (I read about it on freerangekids.com).   What you need is cheap access to a lawyer(s) that you can call with an SOS if CPS gets overbearing.  It seems to me that the threat of having your kids taken away is like a PP said about a parent with end-stage cancer.   You don't worry about the shoulds and just do what you need to do.  

 

No.  She is not being threatened with CPS.  She is being interviewed to see if her kids need any special services that can be covered by her health insurance.  It sounds like they are addressing things like whether she would like to have her kids get up to date on their vaccinations, or if she would like to understand the kind of services for children with autism that may be available to her.

 

Spending money on HSLDA membership would not, in my opinion, be a wise use of scarce resources.  

 

Jane, I am sorry you are suffering, and that this process is making you fearful.  Please reach out to someone IRL who can help you with understanding what info they are looking for and how they intend to use it, so that you can give appropriate answers and get access to health care for your kids.  Your reaction to this is out of whack; I understand that it is a challenging process, but it is generating a lot of fear which is unusual.  Please take whatever self-care measures you can, to manage your stress and anxiety.  And seriously consider looking at your own benefits and seeing what kind of mental-health care you can access.  I am saying this not to be critical, but because you are clearly suffering and I believe there are ways out there to help reduce that suffering so I am encouraging you to stay strong and focus on getting some help.

 

And please re-file the financial eligibility paperwork to include retirement accounts, to be sure you've given them a true picture of your situation and to reduce your fear of being found to have given inaccurate info.  

[Scarlett]

Jane I am so sorry you are so stressed. I am sorry but it feels like you are way over reacting to normal red tape. You just answer their questions honestly with as little info as possible....

 

They have no reason to take your children.

[Mergath]

I mean....like if I refuse to vaccinate or such.

 

They said I had to declare how much money we have. I did not list money in 401K or IRA accounts. That stuff I am worried about criminal charges for.

 

But..I am worried I will lose my children over not having the oldest in any sort of autism treatment program or for refusing to vaccinate my younger children, that sort of thing. The house is messy right now and the older boys got in to an argument where one hit the other earlier today. What if a social worker shows up and sees mess out?

 

I agree with the pps- you do need to declare that stuff. I'm not sure why you didn't, but file the amended form ASAP. You won't get in any trouble if you say, "I didn't know that was supposed to be included and I'd like to add that information."

 

As for the rest, I would highly recommend you talk to a doctor about managing your anxiety. Your reactions don't seem proportional to the situation, and I know that's how I get when my anxiety is out of control. Even the smallest thing seems like a potential catastrophe. It's hard to function or make rational decisions when your body is operating under that level of fear.

 

Also, back when my dh's bipolar disorder was uncontrolled and he was unemployed, I had to deal with quite a few social workers in order to apply for benefits. There were times I had to tell them that I worried for my and dd's safety. They never once talked about taking her away, but rather about ways to get dh medical care and therapy so he could manage his bipolar disorder. Regardless of what you might hear on this forum from certain people in shiny hats, social workers don't spend all their waking hours looking for ways to rip families apart just because they hate homeschooling or whatever. They really do want to help you. If they seem short-tempered, try to remember that most of their departments are massively understaffed and each one is probably trying to do the (depressing, soul-sucking) jobs of five people.

[MedicMom]

Unless the application specifically states to exclude these funds, then you need to file an amended application. Because, yes, that is fraud and yes, it is a criminal charge. Why would you risk that?

You have to list all of that. I don't know why you wouldn't?

 

I do agree that in some states the paperwork is ridiculous. Ambulances and Emergency rooms tend to treat the people who have fallen through the cracks, because we are required to treat everyone regardless of insurance status. I've met a lot of people who would qualify for Medicaid, but the amount of paperwork is really onerous for them--so they don't get it, then can't afford their medication or preventative care, and wind up very sick and in my ambulance. When I ask why they went off their diabetes/epilepsy/blood pressure meds, it's always because they can no longer afford it. The process to get Medicaid can be difficult and complicated, especially if you are dealing with outside stressors. Even in 2005, long before ACA, I found it difficult enough that I gave up--I was emotionally and physically exhausted and simply couldn't handle the reams of paperwork required for one person.

 

I'm conservative generally but I strongly believe in a single payer system.

[maize]

(((Janeway)))

 

I'm so sorry this is such a stressful time for you.

 

I agree with other posters that you need to address your own anxiety, that is necessary so that you can function to take care of your family at this time. You need a good therapist and also a doctor who can prescribe medication. I understand how very overwhelming and frightening and insecure everything feels right now.

 

For Medicaid, go ahead and tell them you didn't know you had to include retirement assets on the financial forms and ask how to amend them; no one is going to prosecute you for trying to fix a mistake.

 

Please do not worry about your children being taken away, these social workers are trying to help your family access services, that is their job.

 

You're a good mom, doing what you need to to take care of your family under difficult circumstances. Keep putting one foot in front of the other, but above all please do prioritize taking care of yourself especially in getting professional treatment and support for the serious anxiety you are dealing with.

Edited December 28, 2016 by maize

[chiguirre]

Janeway, don't worry about not having your 15 yo in any ASD therapies. Geezle is 16 and hasn't had any autism specific therapy in years. They're asking because ASD qualifies him for Medicaid even if you don't meet the financial test in TX.

[Bluegoat]

Once it's single payer, there's nowhere for the government to hide.  They can't blame the insurers.  It's just them.  

 

There is massive pressure on the UK government for the NHS to provide everything.  Which is an issue, but a potentially productive one.

 

Yes, this is my experience in Canada.  If there is one area where people pressure government to look out for thir best interests, it's with health care.

 

When there is a problem it actually tends to be with people putting on pressure to pay for questionable things, not the other way round.

 

Competing to offer better care is a huge issue in every election, it is probably the number one area where parties look to outdo each other, even at the federal level which here is not directly responsible for health care.

 

Governments concretely fail to get reelected because of their health care record.

[maize]

Yes, this is my experience in Canada.  If there is one area where people pressure government to look out for thir best interests, it's with health care.

 

When there is a problem it actually tends to be with people putting on pressure to pay for questionable things, not the other way round.

 

Competing to offer better care is a huge issue in every election, it is probably the number one area where parties look to outdo each other, even at the federal level which here is not directly responsible for health care.

 

Governments concretely fail to get reelected because of their health care record.

 

Given the importance of health, this makes sense.

 

Which makes the tendency of many voters in the US to ignore their best interests and fight against good health care reform so incredibly perplexing. 

[Bluegoat]

Given the importance of health, this makes sense.

 

Which makes the tendency of many voters in the US to ignore their best interests and fight against good health care reform so incredibly perplexing. 

 

It's not really about health care, I think, it's all tied up in other issues.

[Janeway]

This is lovely. When calling today to find out how to fix the many mistakes on the paperwork I have, apparently, there is this program..http://gethipptexas.com/common-questions/ That they never told me about. With this program, I might have been able to actually have insurance. From when I applied for medicaid originally, I could have applied for this, but they never told me about this.

 

With all the money they waste on degrading people and being nasty, they could spend money to get advocates to help people figure out what is available and what they can qualify for and how to fill all these papers out. I do not know how many pages it was, but I pulled it up to show my husband and tell him I could not figure out what I am supposed to do to fix it and we figure the criminal fine for not having medicaid was likely less than the cost of the legal bills or an attorney to sort out this application so that I don't go to jail for messing it up.

[regentrude]

This is lovely. When calling today to find out how to fix the many mistakes on the paperwork I have, apparently, there is this program..http://gethipptexas.com/common-questions/ That they never told me about. With this program, I might have been able to actually have insurance. From when I applied for medicaid originally, I could have applied for this, but they never told me about this.

 

 

But the stuff in the link is employer sponsored. How would that work if all family members are unemployed? 

[Janeway]

The one application in there is 196 pages. I can see many mistakes on it. For example, my 15 yr old is listed as my spouse. There are other things in there and there have been multiple phone interviews. The call where I have another interview that is 20 minutes per child is not from the plan but from the medicaid office. It says on the texasbenefits page that I have to make all changes on the application within 10 days of the mistake or it is perjury. But it has already been more than 10 days. 

 

I decided to call THSC. I spoke to them and they are going to call me back.

[Janeway]

But the stuff in the link is employer sponsored. How would that work if all family members are unemployed? 

He was offered Cobra.

[Mergath]

This is lovely. When calling today to find out how to fix the many mistakes on the paperwork I have, apparently, there is this program..http://gethipptexas.com/common-questions/ That they never told me about. With this program, I might have been able to actually have insurance. From when I applied for medicaid originally, I could have applied for this, but they never told me about this.

 

With all the money they waste on degrading people and being nasty, they could spend money to get advocates to help people figure out what is available and what they can qualify for and how to fill all these papers out. I do not know how many pages it was, but I pulled it up to show my husband and tell him I could not figure out what I am supposed to do to fix it and we figure the criminal fine for not having medicaid was likely less than the cost of the legal bills or an attorney to sort out this application so that I don't go to jail for messing it up.

 

Multiple people have told you that you'll be exempt from the fine. I don't know if you're purposely ignoring us or what, but I even posted a link to the exemptions that show you won't have to pay it.

 

Don't take this the wrong way, but based on your posts I really think you should see a doctor ASAP. You don't seem well.

[ktgrok]

This is lovely. When calling today to find out how to fix the many mistakes on the paperwork I have, apparently, there is this program..http://gethipptexas.com/common-questions/ That they never told me about. With this program, I might have been able to actually have insurance. From when I applied for medicaid originally, I could have applied for this, but they never told me about this.

 

With all the money they waste on degrading people and being nasty, they could spend money to get advocates to help people figure out what is available and what they can qualify for and how to fill all these papers out. I do not know how many pages it was, but I pulled it up to show my husband and tell him I could not figure out what I am supposed to do to fix it and we figure the criminal fine for not having medicaid was likely less than the cost of the legal bills or an attorney to sort out this application so that I don't go to jail for messing it up.

 

Honey, people are not going to put you in jail for misunderstanding the form for medicaid. They just aren't. Nor are they going to make your kids be vaccinated not any more than your previous, private insurance did.

 

Finally, again, this is a state issue, not an ACA issue. 

[Lawana]

Janeway, I am sorry you are so stressed. It has been pointed out up thread and I will say it again. Failure to have insurance per ACA requirement *does NOT* carry criminal penalties. The one and only enforcement of any assessed fine is through garnishment of federal income tax refund. You do not even know if you would have a fine since your dh is unemployed.

[Janeway]

Multiple people have told you that you'll be exempt from the fine. I don't know if you're purposely ignoring us or what, but I even posted a link to the exemptions that show you won't have to pay it.

 

Don't take this the wrong way, but based on your posts I really think you should see a doctor ASAP. You don't seem well.

I am not ignoring you. I just got off the phone with healthcare.gov again and they cannot give me exemptions for the kids. And the letter says they have to be on medicaid. You may have pulled a link from the internet that could be interpreted to mean someone can get exempt, but, it does not apply to children. Children have different rules. Healthcare.gove says they cannot help me with the children.

Edited December 28, 2016 by Janeway

[Charlie]

This is lovely. When calling today to find out how to fix the many mistakes on the paperwork I have, apparently, there is this program..http://gethipptexas.com/common-questions/ That they never told me about. With this program, I might have been able to actually have insurance. From when I applied for medicaid originally, I could have applied for this, but they never told me about this.

 

With all the money they waste on degrading people and being nasty, they could spend money to get advocates to help people figure out what is available and what they can qualify for and how to fill all these papers out. I do not know how many pages it was, but I pulled it up to show my husband and tell him I could not figure out what I am supposed to do to fix it and we figure the criminal fine for not having medicaid was likely less than the cost of the legal bills or an attorney to sort out this application so that I don't go to jail for messing it up.

 

So how did you find out about hipp texas? Do you think they train their workers to be degrading and nasty? That sounds... odd. Like, I can't imagine appealing to my supervisor and saying, "You know, we should have orientations for all workers as they go through the state and find people, scare them, degrade them, and be super nasty." "Why Karen, that sounds like a fantastic plan! Get on it right away!"

 

Could it be that the people who are just trying to do their jobs are getting frustrated by you? Because of your response? If I was hired to collect data for some reason and someone kept blowing trying to avoid me, that would make my job hard. If they kept blowing me off with unreasonable excuses, I might loose my patience after a while. Don't you think you might, too under these circumstances?

 

ETA: I do think getting help to take the edge off the anxiety will help clear many of these things up. It frees up the brain to concentrate. If you can't do that, perhaps hire a legal aid to go over this with you in person and answer your questions face to face.

Edited December 28, 2016 by Charlie

[Mergath]

I am not ignoring you. I just got off the phone with healthcare.gov again and they cannot give me exemptions for the kids. And the letter says they have to be on medicaid. You may have pulled a link from the internet that could be interpreted to mean someone can get exempt, but, it does not apply to children. Children have different rules. Healthcare.gove says they cannot help me with the children.

 

The link I posted was from healthcare.gov. And one of the exemptions is that if your children are denied for Medicaid, you are exempt from the fine for that child. So if, for whatever reason, they deny your kids after you fill out all the forms, you won't have to pay a fine. You can't really blame them for wanting you to at least try to get coverage for your children, though.

[Janeway]

The link I posted was from healthcare.gov. And one of the exemptions is that if your children are denied for Medicaid, you are exempt from the fine for that child. So if, for whatever reason, they deny your kids after you fill out all the forms, you won't have to pay a fine. You can't really blame them for wanting you to at least try to get coverage for your children, though.

But they were not denied medicaid. So, I cannot get exempt from the fine.

 

And yeah, I can blame them for mandating a 196 page application and multiple interviews as a punishment for having children and losing a job.

Edited December 28, 2016 by Janeway

[maize]

But they were not denied medicaid. So, I cannot get exempt from the fine.

If they get Medicaid--no fine.

 

If they are denied Medicaid--no fine.

 

Either way, no fine.

 

You're under a lot of stress and experiencing a lot of anxiety, and worrying about things that don't need to be worried about. You can put fear of a fine out of your head at this point.

Edited December 28, 2016 by maize

[Corraleno]

This is lovely. When calling today to find out how to fix the many mistakes on the paperwork I have, apparently, there is this program..http://gethipptexas.com/common-questions/ That they never told me about. With this program, I might have been able to actually have insurance. From when I applied for medicaid originally, I could have applied for this, but they never told me about this.

 

But you need to be either employed or on Cobra, and you already turned down Cobra, didn't you? So if you told the folks at healthcare.gov and/or the state Medicaid people that your DH was unemployed and you had no other insurance, then why would they recommend a program with prerequisites you don't meet?

 

Are you still within the 60 day window to elect Cobra, in order to qualify for the HIPP program? Unless I'm reading the HIPP site wrong, you still need to go through the Medicaid qualification process in order to get HIPP, so it wouldn't save any time or paperwork. And it appears that HIPP is a premium reimbursement program so you would be paying the $2000/mo for Cobra yourself and then filing for reimbursement of whatever portion the HIPP program pays. But as long as you are still eligible for Cobra, you can still apply for the HIPP program if you want to. Although I would first check to be sure that your Cobra rates would qualify for HIPP, because the last thing you'd want would be to start pay $2000/mo for Cobra only to eventually find out that it doesn't qualify, and you're out several thousand dollars.

[Janeway]

If they get Medicaid--no fine.

 

If they are denied Medicaid--no fine.

 

Either way, no fine.

 

You're under a lot of stress and experiencing a lot of anxiety, and worrying about things that don't need to be worried about. You can put fear of a fine out of your head at this point.

I am under stress because...the application is messed up. I never said my son was elderly and disabled and I never said he was my spouse. But he is listed like that. I cannot use medicaid where I live, but because of this law, either all my children go on medicaid or I am fined. I cannot find a way to legally correct this application. And since I did not fix it within 10 days, I could be charged with perjury.

 

Here is a place to look for pharmacies on medicaid... https://tchp.healthtrioconnect.com/public-app/consumer/provdir/entry.page  I have already gone out 20 miles and there are none. I cannot even use medicaid for pharmacy. 

 

The point is simple...I should not be legally required to go through this, based on income. That is discrimination. The medicaid is unusable.  Now I am afraid I will face criminal charges over committing perjury. The application is so long that it is hard to even pin point all the places where perjury has been committed.

 

So the basics is...medicaid is not usable where I live. So my choices are, leave them on medicaid and take chances with being caught for the mistakes on the application, which could mean criminal charges. Or cancel the medicaid and pay the $2000+ fine at the end of the year. All this because of the ACA. When my husband was laid off 10 years ago, we were not fined for it. Life was allowed to go on and we could focus on the kids, our lives, and finding a new job. Heck, we even spent time doing things like playing games with the kids, going to the park, and museums. Now, instead, we spend hours and hours trying to meet the requirements of the ACA and worry about all the criminal penalties we will face for every mistake and there is NO ONE that is there for ME to help me with this application, or the fixing of it.

 

And if this is my punishment just for my husband being unemployed for a few months, I can just imagine the pain people are in who are unemployed or otherwise low income for the long term. 

[Janeway]

But you need to be either employed or on Cobra, and you already turned down Cobra, didn't you? So if you told the folks at healthcare.gov and/or the state Medicaid people that your DH was unemployed and you had no other insurance, then why would they recommend a program with prerequisites you don't meet?

 

Are you still within the 60 day window to elect Cobra, in order to qualify for the HIPP program? Unless I'm reading the HIPP site wrong, you still need to go through the Medicaid qualification process in order to get HIPP, so it wouldn't save any time or paperwork. And it appears that HIPP is a premium reimbursement program so you would be paying the $2000/mo for Cobra yourself and then filing for reimbursement of whatever portion the HIPP program pays. But as long as you are still eligible for Cobra, you can still apply for the HIPP program if you want to. Although I would first check to be sure that your Cobra rates would qualify for HIPP, because the last thing you'd want would be to start pay $2000/mo for Cobra only to eventually find out that it doesn't qualify, and you're out several thousand dollars.

Applied for medicaid before turning down Cobra. Was never told about this program. Did tell the medicaid interrogators that we had to turn down Cobra because we could not afford it.

[Charlie]

I am under stress because...the application is messed up. I never said my son was elderly and disabled and I never said he was my spouse. But he is listed like that. I cannot use medicaid where I live, but because of this law, either all my children go on medicaid or I am fined. I cannot find a way to legally correct this application. And since I did not fix it within 10 days, I could be charged with perjury.

 

Here is a place to look for pharmacies on medicaid... https://tchp.healthtrioconnect.com/public-app/consumer/provdir/entry.page  I have already gone out 20 miles and there are none. I cannot even use medicaid for pharmacy. 

 

The point is simple...I should not be legally required to go through this, based on income. That is discrimination. The medicaid is unusable.  Now I am afraid I will face criminal charges over committing perjury. The application is so long that it is hard to even pin point all the places where perjury has been committed.

 

So the basics is...medicaid is not usable where I live. So my choices are, leave them on medicaid and take chances with being caught for the mistakes on the application, which could mean criminal charges. Or cancel the medicaid and pay the $2000+ fine at the end of the year. All this because of the ACA. When my husband was laid off 10 years ago, we were not fined for it. Life was allowed to go on and we could focus on the kids, our lives, and finding a new job. Heck, we even spent time doing things like playing games with the kids, going to the park, and museums. Now, instead, we spend hours and hours trying to meet the requirements of the ACA and worry about all the criminal penalties we will face for every mistake and there is NO ONE that is there for ME to help me with this application, or the fixing of it.

 

And if this is my punishment just for my husband being unemployed for a few months, I can just imagine the pain people are in who are unemployed or otherwise low income for the long term. 

 

Don't you have the choice of calling your rep and fixing the mistake on the application?

 

When you speak to the reps, do you ask these questions?

 

Honestly, Janeway, this isn't about the ADA, it's about you being confused and frustrated and frightened.

 

People keep showing you the information you need to reduce this fear and you ignore it. It seems to me like your brain is stuck in a feedback loop, kind of like a mental OCD tick. If you can't get out of it using your own resources, would you consider going to someone who has different resources? This stress isn't good for you or your family. I worry about you because I can relate to this fear, I know how deep it can go. I want you to find peace. But you have to stop for a second and take a breath and consider the things people are telling you. Write it down if you have to, so you can refer to it when your emotions get going again. Whatever it takes to help yourself just like you help your children when they need it.