Healthcare dot Digital Homework

Posted by on Nov 14, 2013 in Local-Sustainable Living | Comments Off on Healthcare dot Digital Homework

Healthcare dot Digital Homework

You may not be in school anymore but we all do “digital homework”, all the time.

You know what I mean.  It goes a little something like this.

“Hey,  you should really call my friend who can give you a job.  Her name is Sally and her phone number is – “

And before you can finish the person says, “Oh great!  Can you email that to me?”

Its all moving the stuff of pencil and paper, human face-to-face interaction to a redundant digital realm.  Its a time suck, and note stealer.  Often it leads to even more emailing.

I love notes.
Post-its, to-do lists, those old matchbooks with phone numbers on them… the stuff of memories and memory-building, tiny scraps of paper forcing us to recall.
But I love free time even more.
And having to go online to say something I’ve already conveyed, is driving a wedge between all of us and our beloved discretionary hours on earth.

Applying to Healthcare dot gov can’t be done on a Post-it, for sure.

enroll to do listYou gotta write-up a lot of information, and with that information about you they figure out how much, if any “tax credit” you will get, that you can apply as a discount on your monthly payment.

People bellyache about having to establish who they are BEFORE they can shop for a plan.
I’ve heard people say its a hindrance.


People should just be allowed to shop, dammit!

But these people don’t get the system, and most of all they don’t understand how it works for poor people.

For those of us who live below the poverty line (i.e. and cannot afford health insurance) getting to nail down who we are is our greatest advantage on Healthcare dot gov.  Here’s why:

If Healthcare dot gov knows who you are and can confirm how much you make (or really don’t make), the system can give you the option to take more money off your monthly health insurance bill with the “tax credit.”

They call this a “tax credit.”  Did I mention its a “tax credit”?  Yes, “tax credit.”

Got it? “Tax credit.”  Remember that.

Simple example:  You go on Healthcare dot gov and apply, and they ask you to tell them what you are gonna make next year.  You type in, on a guess, that you will make 28K.
You get a $250 ish “tax credit” which is like a discount you can apply to the monthly bill of $450 ish (for a gold plan – more on that later).
Okay, great.

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And so you apply the whole discount (that is not really a discount but a “credit”).
And you get a lot of money off  your monthly bill.  Awesome.
Your health insurance is really low.  Fantastic.

Then you make more money for the year, and guess what?  You owe the alleged discount back to the government.

Did I mention it was a “tax credit”?
Yes, even though it appears like money off your bill, like a discount,
Its not.
And its on you to estimate it right, so you don’t take too much.

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Its oh so tempting to take the whole discount!  Er, “tax credit.”
I mean, who wants to pay more when money off is staring you in the face?
Even though you gave it your best shot and estimated what you just might make, your income estimate might be too high or too low or you just have no idea.
And, you just want insurance that is affordable! 

Yep, and this is where this whole deal gets really *#! – ed up, for people who are poor.

1) What you told them you would make for the upcoming year (estimated income) on your application may change (because your job may be seasonal or unstable).

2) You have never estimated what you will make for the year (find this preposterous – well, if you are an hourly worker with a job that is not stable with guaranteed hours, you may find it hard to estimate what you will make for the upcoming year).

3) You have never filed taxes so have no concept of a “tax credit.”

And here is where the digital homework comes in…


If any of the above changes, which prolly will for someone with an unstable job, you have to go back on the website and update your application!

Report a life change

And that, my dear reader is digital homework.  

And its frankly, preposterous to expect anyone with insecure work to go back on the website, several times per year, and update the application, when they have no real concrete way of knowing where their next paycheck is coming from.


Potentially owing this “tax credit” back to the government makes the whole thing feel like the plan no one wanted.

Allegedly, no one wanted anyone paying the government for health insurance: the federally provided plan was shot down.  But if I am paying an owed “tax credit” to the government that was for my health insurance, aren’t I paying them for health insurance anyway?


What about the folks who wont ever pay that “tax credit” money back, and/or wont file taxes?  That just boggles the mind, how the government will keep track of all those poor folks who wanted health insurance so they applied but then never bothered to file taxes, which would confirm their estimated income for the year.


I estimated my income based on my past tax returns.  This was easy for me because my income is fairly stable (knock wood).

It was kind of mind-blowing to see my monthly premium get cut in half, from nearly $900 a month, to $450 ish under the Healthcare dot gov Gold Plan (the one I selected which was better than the Platinum beleive-it-or not).

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After applying the whole “tax credit”, my monthly health insurance bill went down to $250 ish.

2010-2012 I played the Russian-Roulette of not having health insurance.  So, being able to sign up for health insurance that I can afford is pretty awesome.


I found the system easy to use.  It was time consuming but overall not too hard given my computer literacy.

For those without computer access or literacy, there is a phone number they can call instead.  I cannot imagine how a person would compare the nitty-gritty details of these plans on the telephone.  One would surely need the plan details in writing to really compare.


This “tax credit” deal is a pretty awkward solution.  Maybe its a step toward a Federally provided healthcare system, paid for by our taxes?  I can only hope.  If people get real about where the “credit” is coming from they will see it as that.  

The upside to Healthcare dot gov is what we all know: no one can be denied insurance for any reason.  Pre-existing conditions like illness or pregnancy (yes, pregnancy is considered a pre-ex) cannot be denied coverage.  That is all great.

Hopefully as this system gets refined, the politicians will find a way to get poor people into the design process, and not just computer programmers.

There has been such focus on the Healthcare dot gov site working or not, literally the servers being up or down, the databases talking to each other.  

There has been zero focus on whether or not the system as a tool, for those who are actually able to get on it, is working for the people who need it, in a way that meets them where they are in terms of financial literacy, access to stable work, and willingness to file taxes each year, as well as having the ability to pay back that “credit” if needed.  

Healthcare dot gov is potentially one big federal assumption of digital homework.  And I wonder, will everyone have the capacity to complete the task?