Earlier this month, a reader called reporter Frank Gluck of the Fort Myers News-Press complaining of troubles getting the paperwork for newly-purchased insurance. Gluck called the health insurance navigators for southwest Flordia and they, too, had heard complaints. Still, Gluck wanted to know how widespread these proof-of-coverage issues were—something beyond a few anecdotes. An open records request to the Florida Division of Consumer Services indicated 42 Floridians had made formal complaints about Florida Blue’s back-end enrollment issues issues between December 1 and January 21. That’s not a small number, Gluck reasoned, especially when he found a total of five complaints filed against four other large insurers during that period. And what about consumers who didn’t—perhaps didn’t know to—file formal complaints? He also learned Florida Blue had been telling customers to submit their complaints to a company website. He checked it out and, yep, lots of people were complaining (as of this writing, 144 comments—including the company’s responses—have been posted since January 11). In short, the News-Press gave readers a more complete picture of what’s going on than did the Inquirer or WNYC.
Historically, when consumers have had insurance complaints, they’ve gone to their state insurance departments—and often got help resolving their problems. I phoned the New York Department of Financial Services whose insurance division I assumed knew something about Obamacare complaints. No one returned my call. I checked out the “How to File A Complaint” section of the department’s website, and learned the department gathers information on compliance with insurance rules but “cannot attempt to resolve or otherwise handle every individual complaint.” There’s not much help there.
The Pennsylvania Insurance Department did return my call, and press secretary Rosanne Placey tried to answer my questions. “Since the roll out of the exchanges, the health bureau of our consumer services unit has been receiving about 40 to 70 calls a day,” she said, adding they have been about everything from non-functioning websites to cancellation notices. “This has been a time of unprecedented confusion for healthcare consumers,” she said. The department tells consumers to first try to resolve the problem with the carrier, but if they can’t, they can contact her department. The regulator will try to resolve the complaint with the insurer. “We don’t ever offer complaint tallies from the consumer division that are company-specific.”
This little exercise suggests another under-explored story thread: What protections or recourse do Obamacare shoppers have when things go wrong? Where can they turn in this “time of unprecedented confusion,” as Placey put it, if not the insurance carriers or the state insurance regulators? I’ll discuss that in another post.
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