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The [Monday] Papers

"[B]y endorsing and expanding the complex new policies promoted by the health care industry, [Obamacare] may in some ways be undermining its signature promise: health care that is accessible and affordable for all," Elisabeth Rosenthal writes for the New York Times.

I'd say she's putting it charitably. It's a disaster.

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"Officials at the Illinois Department of Healthcare and Family Services say they have tried to avoid disruptions of care as the state shifts 2.2 million of its 3.1 million Medicaid patients to managed care, a system in which the state pays a fixed amount for each patient instead of reimbursing providers for each test and treatment," the Tribune reports.

"But some patients are reporting difficulties keeping their doctors and confusion navigating plans as they try to make the shift.

"The reports include wrong information on websites for insurance plans and hospitals; hours on the phone with insurers, hospitals and a state contractor who helps with enrollment; conflicting letters in the mail; changes to prescriptions, and other frustrations . . .

"Some doctors say the state is reassigning their patients to new offices and has created new administrative requirements that burden their practices, delay care for patients and slow payments from insurers."

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I qualify for Medicaid in Illinois under its expansion through Obamacare. I was supposed to have coverage starting January 1, 2014. I still don't have a plan. My favorite part of the bureaucratic odyssey was when I got a "redetermination" letter in the mail saying I had to be verified all over again for Medicaid. Oh, so you're going to double-check that I qualify for the health care that I never got in the first place? Go for it!

As I was instructed to do, I called up the redetermination people, only to be told that I would no longer be redetermined because they determined that I wasn't enrolled in Medicaid. It wasn't for lack of trying!

Instead, they said, I had County Care, which is offered through Cook County. This was news to me. It was also news to County Care, who told me that, no, I just had straight Medicaid.

In reality, I had neither. Or, nothing, to be more exact.

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The redetermination folks, by the way, are a third party - yes, it was outsourced - who don't know what the hell they're doing. A customer rep there insisted to me that expanded Medicaid had nothing to do with Obamacare. After failing to reason with him, I called back and asked to speak to a supervisor. Guess who I was handed to? The same dude!

ME: So now you're a supervisor?

HIM: Yes.

ME: But when I talked to you a few minutes ago, you were just a customer service rep.

HIM: Yes.

ME: So if I had asked you to hand me to a supervisor, you would have handed the phone to yourself?

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He also insisted that one had to be elderly or disabled to qualify for Medicaid. I explained to him that one could qualify by income - and that the Obamacare expansion expanded the range to include more people, like me. He insisted this wasn't true. I read him a paragraph from the Illinois Department of Healthcare and Family Services.

HIM: Where are you reading that from?

ME: The Illinois Department of Healthcare and Family Services' website.

HIM: Well, anyone can put anything they want on a website.

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The only upside is that I discovered my Medicaid "card," which finally arrived in the mail a year late and isn't really a card but a scrap of paper, actually works for getting prescriptions at Walgreens, even though it's not supposed to work until you actually choose a plan.

Previously, I had called up one day and said, Hey, I still don't have my Medicaid card. The woman on the line took my information and said she pushed all the right buttons to have it sent out. It arrived about six months later, and not at her behest, I'm fairly certain. I think the County Care guy sent it out. Anyway, then this conversation ensued:

HER: Now you have to choose a plan.

ME: Okay.

HER: I'm going to go through for you 16 different plans to choose from.

ME: You mean you're going to read to me 16 different plans right here over the phone?

HER: Yes.

ME: I don't think so.

That's when I asked her to just mail out the information instead. It never arrived.

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My view is that everyone should be automatically enrolled in health care when they are born - just like Social Security. You start out on your parents' plan, or a plan for those whose parents aren't covered, and at 18 or 26 or whatever, you choose your own plan. Some might call that . . . Medicare-for-all.

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I think I also might have said something at some point about "redeterminating your ass!" but I also think I had hung up the phone by then.

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By the way, Get Covered Illinois has been equally as maddening and worthless.

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I'll return to city politics tomorrow. Or, actually, later today as I complete this weekend's Beachwood Radio Hour.

Speaking of which . . .

* The Beachwood Radio Sports Hour #37: The Big Gloom.

The Post-Super Bowl, pre-baseball depression. Plus: The Gloomy Bulls; The Sunny Blackhawks; Bears Draft Mockery; Mocking The NFL Draft; and Joe Maddon vs. Kris Bryant.

* Beachwood Radio Special Edition: Diary Of A Lost Pregnancy.

At the conclusion of our series last week, I spoke to our very own Natasha Julius about both the experience of a lost pregnancy and the experience of writing about it.

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A Ruinous Rule
How the filibuster may have just killed 1,000 of our veterans.

By the author of the forthcoming Unlock Congress: Reform the Rules - Restore the System, due out by WhyNotBooks on April 15.

I assisted in the editing of the book. To learn more, go to UnlockCongress.com.

They Said No To Torture
True American heroes tell their stories.

ICYMI: The Week In Chicago Rock
Featuring: Low Swans, Robbie Fulks, Lydia Loveless, Steve Dawson, Steve Earle, New Orleans Suspects, and Periphery.

The Weekend In Chicago Rock
Featuring: Alestorm, Crybaby, Jonny Craig, The Chris Robinson Brotherhood, Sleeping With Sirens, PVRIS, and Pierce The Veil.

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BeachBook
* Avondale Neighbors Come Together To Fight 'Disgraceful' Dibs.

* Some Other Tall Tales Brian Williams Might Want To Apologize For.

* Did Rahm Emanuel Kill Helen Morley?

* Former Bear Alan Page Plans Life After The Minnesota Supreme Court.

* Coffee Shop-Looking Cafe Casinos Take Hold In The Suburbs.

You know what are sure-fire ways to make money? Gambling and credit. The mob knew that a long time ago. Also: sex, drugs and war.

* For Most Of Us, There's Not A 'Recovery.'

* ESPN's Dan Dakich Gets In Twitter Fight With Mayor Of Champaign.

* Big Crowds Cause Al's Italian Beef In Texas To Run Out Of Food.

'Semis of beef' on the way.

* Hockey City Classic At Soldier Field Full Of Problems.

* Chicago-Area Company To Sell Iconic Hospital Blankets To Public.

* Kanye's Mom Wouldn't Let Him Ride The 'El' Because People Were Getting Killed Over Sneakers.

* Wisconsin Firefighters Return To Finish Shoveling Heart Attack Victim's Driveway.

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TweetWood
A sampling.

Daddy, tell me the story again about who paid for our baseball field . . .

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The Beachwood Tip Line: Once upon a time.



Permalink

Posted on February 9, 2015


MUSIC - The Weekend In Chicago Rock.
TV - FCC [Hearts] Sinclair.
POLITICS - Police Stood By In Charlottesville.
SPORTS - Why Colin Kaepernick Matters.

BOOKS - Windy City Blues.

PEOPLE PLACES & THINGS - Fish Unboxing.


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