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Why I will not purchase health insurance through the exchange

Health insurance open enrollment is over. Maybe? For the most part assisting people to sign up for insurance went smoothly except for a few problem cases and system glitches. Overall helping others attempt to solve their issues with the exchanges helped me to make the above decision not to purchase my health insurance through the exchange.


I did sign up for a plan this year but terminated it when my health insurance company informed me that we can keep our plans until September 2017. I’m thankful that the company that I’m with is choosing to fight so we can keep what we have instead of forcing us into a system we do not want to be in. Either way they are still collecting premiums and still making a profit.

So why don’t I want to purchase from the exchange? First if you purchase an exchange plan you cannot cancel it with most companies by making a simple phone call. Clicking the terminate button in your exchange account is not a guarantee that the insurance company will get the memo that you do not want your insurance plan anymore. In most cases when you call the company they will say that “We cannot cancel your plan. That can only be done through the Marketplace.” Once you call the Federal Marketplace they will do what they call an Escalation of the case to inform your insurance company that you want to cancel your plan. Like you can’t speak for yourself. Then they will inform you that the process can take up to 30 days. In the meantime you are being charged for something you do not want and there is nothing you can do about it. If the escalation is not successful you will need to keep repeating this step until your issue is resolved. Which means another 30 days of pain. Depending on how long they take to resolve your issue paying the tax penalty could be a better option. In my opinion this is an unfair penalty. Wouldn’t a phone call or an email be more effective?

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Second I want to be free to make as much or as little money as I want without having to report it to a third party. If I accept a subsidy to help pay for my health insurance and my income goes up I need to report it each time it changes. If I do not go through this process then I will pay another penalty in the form of having to return the excess subsidy money to the government. I’d rather know what I have to pay rather than deal with all of the other calculations. As long as subsidies and premiums are based on the unknown estimated future income model it’s a recipe for disaster and unexpected debt.

Third I do not want a third party handling my affairs. I want to cancel a policy on my own terms. When important matters such as cancelations are handled by the Federal Marketplace exchange you do not receive any type of confirmation number or case number up front. You have to call back in a week and hope they will give you a case number. In the real world when you order something you get a confirmation number. Likewise when you cancel something you get confirmation of the transaction. Not so with transactions between you and the Federal Marketplace. So if the representative does not write any notes on your case or does not save them properly and you state you’ve called several times to solve a problem if there are no notes it becomes your word against theirs. If you are not a fighter you do not have to guess who will win the fight.

So does this mean I will go without health insurance? No. For now I’m keeping my old policy for as long as my company continues to fight to allow us to keep them which is a choice that all companies could have made. Once I cannot keep this plan I will buy the cheapest ACA plan that has doctor copays directly from the company without a subsidy. If that is not affordable I will calculate my penalty and the cost of a good Short Term Major Medical plan from the company that I’m with now. If the cost of the premium and the penalty are less than the ACA yearly premium for me the choice is obvious but at least the choice is mine.