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Yesterday, I took my first stab at browsing the NY healthcare exchange website. Unlike many states, NY set up it's own healthcare exchange at https://nystateofhealth.ny.gov/. So this is NY's version of "Obamacare", and NY residents use this website for enrolling in mandated insurance plans, rather than using the now-infamous 'healthcare.gov'.

So I went through entering all my personal information, family information and verifying my identity. Then i started browsing the many, many plans open to me based on the information I entered. I had just started browsing and was not ready to purchase anything at this point. I just clicked through the first plan to try to look at what kind of things would come up about the details of each plan.

To this point, the site had never asked me about my income or raised the issue of subsidies - a central feature of Obamacare for which most people will be eligible. And the premiums for all the plans that came up after I'd entered the personal info were much higher than what I was expecting. So I assumed that it must be that the issue of subsidies will come up at some point as i click through the details of an individual plan.

Nope. Instead, as I clicked through the screens of the first plan I was browsing I suddenly found that I'd agreed to buy that plan. Nothing about income ever came up. Nothing about subsidies ever came up. I used the 'chat' feature to speak with someone for help, and sure enough I'd enrolled in that plan and could not change it. I'd have to call on Monday to try to unenroll.

Shocked, I then asked where on the site does the issue of income or subsidies come up. And the chat person told me that in one of the early pages of the personal info forms, and before you see any of the price tags, there's a question with a tick-box that says:

"Do you need help paying for your health insurance?"

As I was just browsing through entering personal info at this point i didn't really notice this tick-box or realize how crucial it was, and did not click it. But if you do not tick this box, the website never asks you about your income, and never mentions anything about subsidies. Only if you tick that box does any of this ever come up.

This strikes me as highly misleading in several ways. First, it is not up to me whether I "need help". The law determines whether I get a subsidy or not, based on my income situation. Their design of the website puts the burden - shifts the burden I'd say - onto each individual to know that subsidies exist, to know that they're eligible for them, and to proactively ask to receive them by declaring they "need help" at the outset.

Second, framing the subsidies as "needing help" is also manipulative in my opinion. The subsidies in Obamacare are unlike almost any other kind of government "help" or public assistance. For most people eligible for a health insurance subsidy under Obamacare, these are people that never get government "help" for paying for anything else. And of course unless people have followed the ins and outs of this very complex law they would not even know that they are in fact - like most people - eligible for some kind of subsidy ("need help").

Many people have a natural aversion to asking for "help" in the first place. And many people would not even know they are entitled to it under this law.

Rather than informing people about the subsidies, the design of the NY exchange site puts the burden on each user to first declare that they "need help" paying for health insurance. In effect, it's kind of like asking each person to declare that they need "welfare" or "government assistance", rather than informing them that they are entitled to a subsidy under the law. Recall that the subsidies are a crucial part of the deal here with Obamacare. We're now being forced to buy a product that we may not even want, but a crucial trade-off built into the law is that the government is going to help most people pay for it. And most people eligible for these subsidies are never eligible for any other kind of government "help" in paying bills in any other context.

So I - like I expect many people - did not notice this box. I then wound up seeing price tags much higher than I was anticipating. But that's only because I follow sites like Kos and know about the subsidies, know that I do qualify for it and know to look for it. This led me to keep clicking through the screens thinking I'd eventually come up to the subsidy part of the application, but by doing so I then wound up inadvertently buying a plan with no subsidy.

But what about other people who are less informed about the subsidies than I am? Would they even realize that something was missing here? Would they realize that these premiums being offered were way too high? I almost think that NY state is hoping that many people out there won't even realize any of this, and will just assume that this is what they have to pay now, and will effectively lose their subsidy because they did not realize how crucial was that early "I need help" tick box on the website.

To me, this seems like a site designed and worded in such a way as to trick many people out of receiving their subsidies and that NY state needs to be called on it.

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Comment Preferences

  •  I was able to change my plan and I accidentally (7+ / 0-)

    ordered the same one twice.  A phone call will fix that.  The customer service people on the phone have been wonderful. They will cancel what you have chosen and enter the correct information.  

    If you think the website is complicated, wait until you ask the insurance companies for their network of providers or their "Formularies" for prescription drugs.  

    It is worth the effort however, to stay with the research until you get it right. Even in my small county, where there are only three providers who will be offering plans, there was enough difference to make the time spent comparing plans worth it.

    If love could have saved you, you would have lived forever. & http://www.dailykos.com/blog/Okiciyap

    by weck on Sun Nov 03, 2013 at 04:58:43 AM PST

  •  I agree that "do you need help paying" sucks! it (11+ / 0-)

    should simply be something like "find out if you are eligible for a subsidy here."  

    Alternatively, it should be built into the process, so everyone automatically is told of any subsidy they are eligible for.

    I would def provide feedback via the site if you can AND anywhere else - dept of health, local paper.  

    How stupid - they are just asking for trouble with that set up.

    "Don't Bet Against Us" - President Barack Obama

    by MRA NY on Sun Nov 03, 2013 at 05:42:33 AM PST

  •  Your point is well taken. (2+ / 0-)
    Recommended by:
    weck, Calamity Jean

    The truth is that our system of government is set up to respond to complaints. The squeaky wheel gets the grease. Neither the Constitution nor any function are self-enforcing. Those who do not complain, get no response. That's true in regards to law enforcement and everything else.
    Which is why so much effort goes into using propaganda to render people compliant.
    I'm almost tempted to suggest that the culture of obedience aims mainly to gain compliance so public officials are insulated from complaints.

    Look at those two words!

    Complaint
    Compliant

    The ACA is an initial response to citizen complaints. However, if there is no follow-through, the implementation is likely to halt. We have to keep on complaining until we are satisfied.

  •  I tried a few weeks ago (1+ / 0-)
    Recommended by:
    Naniboujou

    I just wanted to see what was available but was uncomfortable providing social security numbers. I was declared ineligible. I attempted to add the social security numbers but was unable to do so. Haven't been back to the site since but I did see the question about whether I would like help paying for health care.  

  •  I think at healthcare .gov the question is (1+ / 0-)
    Recommended by:
    Calamity Jean

    phrased "would you like help paying your premiums?" but at that time they were asking you before you even had a chance to look at the plans and the costs. There might be some people who would qualify for a subsidy that can afford the premium out of pocket and might just prefer to pay and get a tax credit later or something. I know people like that.

    In my unsuccessful foray on healthcare.gov
    I skipped a pop-up box that was quite critical, never dreaming that I would never see the box again and have the opportunity to answer and would not be able to backtrack and bring it up again. I think the question was "Will your income in 2014 be different than 2012? and I wasn't completely prepared to answer that question (did it have to be EXACTLY the same? How much higher or lower was different?) So I checked no, thinking I could come back to it when I could answer it more clearly. Well, never saw it again and there was no way to re-open it and I had since figured out that there would be a substantial difference between the 2 returns and NEEDED to answer the question.

    The design of Healthcare.gov is terrible in that kind of way. They DO NOT prep you for the questions ahead that I could see, so you are set-up for failure before you begin. In my case it was also not retaining edits and changes I was trying to make.

    And as tons of people have noted and which has been changed, I believe, it was completely inane that they did not simply let one plug in age and zip code and shop plans and see what was available and at what costs without subsidy without being FORCED to apply first and then having the application process so screwed up.

    Why didn't they simply hire the Turbo Tax people or use their model? That is a comprehensive, well-thought out program that allows you to save, back-up, review, edit and change as many times as you could possibly need before you are ready to commit to your return as being absolutely the best and most accurate you could possibly make it. You would think they would want the healthcare applications to have the same rigor.

    I was kind of calm originally about the massive clusterf!@k but I think it bothers me more the more I think about it. And no, I have yet successfully enrolled.

    Even at this late date, there is NOTHING preventing the administration from sending out a comprehensive booklet to every household explaining the ins and outs of Obamacare with a written application inside.

    “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR

    by Phoebe Loosinhouse on Sun Nov 03, 2013 at 09:41:43 AM PST

  •  Maybe they can change that... (0+ / 0-)

    ...perhaps you should request that they make this clearer on the website, next time you speak with someone?

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