The People I See

Mr. Poe is a veteran. To be eligible for subsidies on the Marketplace, you cannot have access to other, comparably comprehensive coverage. Mr. Poe has been receiving subsidies, but has been asked to prove that he is not eligible for VA benefits. Mr. Poe cannot go forward with his 2017 application until he proves this. Mr. Poe believes he has sent in all proof needed to establish that he is not eligible for VA benefits. We call the Marketplace to see what’s up. We are informed that in fact Mr. Poe did not reconcile his subsidies on his 2015 tax return, which is what is holding up his application and subsidy. When you enroll in Marketplace coverage, you confirm several times that agree to reconcile the subsidy on your tax return. Mr. Poe failed to do this, and now his subsidy is in jeopardy. He becomes irate because no one ever told him to do this. Boy is Mr. Poe thankful that President Trump is going to strip away this awful law. I ask Mr. Poe if he means that he doesn’t want health coverage. “Of course I want coverage! I have health problems!” he says. I smile and tell him to go file his reconciliation so he doesn’t lose his subsidy.

We’re having an event so people can come sign up for coverage at a central location in town, after work hours, for the convenience of the consumer. A woman comes and sits down at my table and says she needs medical coverage. I explain that I am happy to help her look at her expanded Medicaid and Marketplace options. “Is this Obamacare?” she asks. I tell her it is coverage offered under the Affordable Care Act, which is also known as Obamacare. She gets up and leaves.

I just had a gentleman come see me about getting health insurance. He is 50 and a lifelong smoker. Last night he ended up in the ER, and a CT scan showed a large mass in his left lung. His girlfriend asked if he could be denied or forced to wait for coverage due to his new condition. I explained that no, under the ACA that type of thing is no longer allowed. He was hoping for Medicaid coverage, for which the income cap is $1366 per month for a single person. He makes $3270 per month. I showed him his Marketplace options, with a small subsidy, which ranged from $350-$700/mo, due to his age, income, and tobacco status. He was outraged, appalled, and grateful that Trump is going to come in and fix all this. He hasn’t been to a doctor in 20 years, he said. He doesn’t use medical services. I stared at him for a minute, asked him to call me if he decided he wanted coverage, and showed him out.

Woman calls and would like to know if she can get health insurance for herself and her husband. I ask if they have recently lost coverage. She replies that her husband was let go a year ago and the employer ended his coverage at that time. I ask what the household monthly income is, to determine if they might qualify for Medicaid, since they don’t appear to be eligible for an SEP on the MP. $3,000/month for a household of 2 (cutoff for Medicaid is $1,842). I ask if husband’s current employer offers coverage. No. I explain that the family does not appear to be eligible for Medicaid, and that the Marketplace enrollment period closed on January 31. Woman begins laughing. I explain that unless someone has a child, moves, or loses coverage (within 60 days), they cannot purchase Marketplace insurance with subsidies outside of OE. Woman says that’s ridiculous and continues to laugh. I explain that her family would qualify for subsidies, and that she should consider enrolling when OE comes around in November. She continues to laugh and adds, you mean you can only buy insurance once a year? I explain this is how it works with all health insurance, even through an employer or private market. She states that she has worked hard her whole life, can’t qualify for Medicaid, isn’t eligible for Medicare, and can’t even buy insurance when she needs it. I tell her she can speak with a broker about purchasing a limited benefits plan if she needs to. She says she’s spoken to a broker before, and declines to elaborate. I encourage her to consider enrolling next OE. She continues to laugh. I ask if there is anything else I can do for her, she says “no” and hangs up.

Woman approaches me at the public library where I’m doing outreach. She asks me what I am doing here. I explain that I am ensuring that everyone has access to health coverage and health care. She tells me I shouldn’t be here. I stare at her. She tells me that this is a public space and I should not be selling health insurance. I assure her I am not selling anything and I am grant funded through a nonprofit. She says that “those” people came after her and my presence at the library makes her uncomfortable and I shouldn’t be telling people what to do. I apologize. She tells me again that I shouldn’t be there and walks off.

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