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Read On: An unhealthy backlog on insurance

January 18, 2014|By Ray Richmond

A Southland health insurance broker named Brad Reichman — whose clients run from Santa Barbara to the Inland Empire and include Burbank, Glendale and La Canada — called me the other day to share a horror story borne out of the Affordable Care Act.

He had helped a 29-year-old female heart patient get insurance late last year. Her mother had to rush her to the hospital this past week with breathing problems, an outgrowth of her chronic affliction. But while checking in at Ronald Reagan UCLA Medical Center, the clerk abruptly told her she couldn’t be seen and would have to leave the facility. It seemed she had no health insurance.

What happened?

The woman had applied for insurance in plenty of time last year to be effective on Jan. 1, Reichman explained. But after signing up at the new California insurance website www.CoveredCA.com, she never received an invoice.

Without an invoice, no membership ID is generated. Without a membership ID, you can’t make payment. Without making payment, you are not in the system. If you aren’t in the system, you aren’t seen as being insured. And there is no way to prove it.

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“Once the website has processed the application, it’s up to the insurance companies like Anthem Blue Cross to process them and send the bill,” Reichman says. “But they have such a backlog of applications that it’s taking weeks and, in some cases, months to process them. And meanwhile, people in desperate need of insurance are getting screwed.”

You can call the Covered California hotline. But that introduces you to a whole different version of hell. I placed a call and was told I was “Caller No. 478” in line. Approximate wait time: Longer than two hours.

“But even when you get through,” Reichman added, “they can’t really do anything for you. The system is the system, and right now it isn’t working. It’s seemingly designed to be backlogged.”

Yes, Reichman believes that Anthem Blue Cross and Blue Shield essentially did this on purpose. They understood that a huge influx of new customers would be coming and yet failed to adequately staff up. Why? Well, maybe they know they couldn’t lose and the blame would be affixed to President Obama, anyway.

Reichman thinks the companies likely figured that the influx of new customers would be temporary and thus felt little need to train and hire new people for three or four months of processing overflow.

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