James Baar: Nightmare at the Exchange

healthsource-nightmare

Ask Christine Ferguson, Director of Rhode Island’s very own ObamaCare Exchange, HealthSource RI, and she will tell you it is “one of the most successful in the nation.”

Erik Brown, President of Erik Brown Photography, LLC, a small business that was one of HealthSource’s early clients, would disagree.

“I have never dealt with a worse run company in my life,” he says.  “Their gross incompetence put me through a four month nightmare.”

Here is how Brown, known for his wedding pictures and portraits, bitterly describes what the business schools call his “customer experience.”

In December, he enrolled online, swapping his private-sector Blue Cross health insurance policy for a Blue Cross policy through the exchange.  OK, his new deductible would jump from $5,000 to $8,000 per person.  OK, he found enrolling “so slow as if the data entered was being written down by someone and reentered with numerous errors.”  But he was lured by an approximately 30% subsidy on his premium.

In January and February, he had to guess when to pay his premiums, in the teeth of changing due dates appearing only on the Internet and the issuance of repeatedly incorrect receipts. Then in mid-February the exchange eliminated his subsidy without explanation.

In early March, he reluctantly paid his higher premium, which now equaled the premium on his old Blue Cross policy.  Then, when he bought prescriptions and sought medical service, he was informed by providers that he had no coverage.  An exchange “call center” staffer laughed and told him “not to worry; just a mistake; you are insured.”   But his “health providers” disagreed.

Finding HealthSource RI “call center” staffers “uninformed, useless or both,” he fought his way to their supervisors, who were also useless. Unable   to get through to Director Ferguson, Brown went directly to Governor Chafee’s office. There, all was “very relaxed, quiet, polite.”  The governor’s constituent affairs functionaries said Brown should be talking to the Exchange Management Office and put him in contact there.  Despite numerous phone calls, nothing happened.

Brown went to the RI attorney general and said he wanted to file a complaint.  No luck. The constituent affairs functionaries said “the AG had no jurisdiction,” but helpfully suggested that Brown file his complaint with the RI health insurance commissioner. Still no luck.  The health insurance commissioner’s office said “they had no jurisdiction,” but helpfully passed the complaint to, get ready for it, the Exchange Management Office.

In April, Brown gave up.  He reapplied to Blue Cross for his old private sector policy which now contained “unwanted additions” in line with Obamacare regulations.  But Blue Cross refused him because, despite all that had passed, records said he was still registered as a policy holder with Blue Cross through the exchange. A HealthSource RI staffer explained that, although his payments had been “delinquent,” they now were credited to him, making him paid-up through April.

Brown immediately went back to “Go.” He signed up again with private sector Blue Cross beginning in May. He cancelled his exchange-based Blue Cross effective April 30. And he has been left with allegedly “uncovered” medical claims totaling more than $2,500 plus $1,400 in mystery bills from his exchange-based plan.  The reason for the rejection:  The exchange Blue Cross agent said they had no record from HealthSource RI that Brown was insured when the medical services were provided.

In retrospect, now that he is again insured by private sector Blue Cross, Brown hopes that the story of his “customer experience” with the exchange will be a flashing warning to other Rhode Islanders.

He says when you deal with the exchange you learn quickly that it  is “a totally inept  operation” packaged in bureaucratic glue for which “no one in Rhode Island — not the governor, not the attorney general, not the health insurance commissioner — is accountable.”

But Brown notes with deep irony that HealthSource RI wants Rhode Island taxpayers to spend $17 to possibly $25 million to keep it alive in the future.

Asked what he thought should be done with the exchange, Brown suggested early mercy killing.

 

James Baar is an author and communications consultant residing in Providence and on his Web site, jamesbaarbooks.net.



  • John

    This needs to be a story on the front page of the Sunday Projo!

  • SteveK

    Surprise, surprise…I love how Christine Ferguson will point to the website and say “See, it’s there, it’s working great” without a clue (or she’s lying) about how the back end is working.

    This story is being played out numerous times a day across the country and at the federal level. But getting into the details of how something is working, not working, supposed to work, etc isn’t something the mainstream media wants to report. Too detailed, requires more than just cursory knowledge or talking points.

    That subsidy that lured him in, that’s the next mess about to unfold. The granting of those subsidies, the subsequent reporting and checking of amounts granted vs income reported and the gradual reductions/phase outs in future years is going to result in people being hit with back tax bills.

    How much money was spent? Still needs to be spent?How many additional people were hired to staff and run it? And what exactly was accomplished that couldn’t have been accomplished before by simply picking up the phone and speaking to an insurance broker?

    Govt design/implementation and the Peter Principle in action and on full display for all to see. And there are people in this state who think the state should be more involved in running our lives. Yeah, right.

  • SteveK
  • SteveK

    And before anyone responds and says “the law won’t allow the IRS to claw back the money”, I say baloney.

    They will try to demonstrate fraud in income reporting and will go after people. As the overall amount of overpayment grows they will change the law.

    One other thing, the system at the federal level to verify income and subsidy amount/eligibility hasn’t even been built yet.

  • David McDonald

    My wife and I had a similar experience.

    We applied for insurance via the exchange, were accepted and paid our first premium in early November 2013. In late November 2013 we were asked for additional documentation and learned that I had inadvertently mistyped my wife's SSN. Upon calling HealthSourceRI we were told that could not be corrected and they would have to delete our account and we would have to start the application process over again.

    We told the customer service rep that we would not go through all that again and would purchase insurance directly through Blue Cross Blue Shield and to please refund the payment we had made. The next five months were a nightmare.

    HealthSourceRI kept sending us bills. Blue Cross Blue Shield sent us new cards telling us we had 2 insurance policies – one that we purchased directly and one through HealthSourceRI. We contacted numerous offices within HealthSourceRI and kept being told the problem was solved and then the next month another bill would appear. We wrote directly to Christine Ferguson but received no response whatsoever.

    The problem was not solved until we contacted the Call to Action group at Channel 12. Turns out HealthSourceRI had deleted our customer record but not the associated accounting record.

    In our experience, the customer service reps, the supervisors, and the administration of HealthSourceRI were incompetent, rude, unresponsive, and completely unconcerned about solving the problem.

    Christine Ferguson claims that HealthSourceRI will reduce health insurance/care costs but there is no evidence that will happen.HealthSourceRI provides NO added value, save for offering a federal subsidy. The projected cost to operate HealthSourceRI keeps changing so no one can trust anything Christine Ferguson says. Why would the State consider spending $17+ to operate HealthSourceRI just to offer subsidy that can be obtained via the federal exhcnage?

  • Chris Gorham

    The Exchange is still in dive mode….no one can help a problem, no one (if they answer the phone at all) will accept responsibility and the whole org. is hoping you go away while they collect a pay stub.

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