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Renae Poseley suffers from severe pain in her right hip. Last year, her doctor told her to see a specialist because it appeared that a medical implant in her back was malfunctioning. She probably needs surgery.
Poseley, who lives in Mountain Home, was uninsured for most of 2021. She purchased a plan through Your Health Idaho – the insurance marketplace created by Idaho under the Health Act. affordable care – before the market closes in December. With constant pain, she couldn’t wait to finally make an appointment.
But when the Idaho Capital Sun contacted her by phone last week, Poseley was still awaiting word on her candidacy.
“I’ve been living in this excruciating pain for two months, because I can’t get insurance,” she said.
The problem is, his health insurance is there, just waiting to be claimed. She just couldn’t get in because her application is one of many retained at Your Health Idaho.
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The problem is bigger than Poseley. According to YourHealthIdaho.org — the exchange’s website — as of Friday, new applications submitted after Dec. 3 have not yet been processed.
About 8% of registrations were still in the queue on Friday.
“We’ve created a bit of a perfect storm,” said Pat Kelly, executive director of Your Health Idaho insurance exchange.
The Perfect Storm: Delivering health insurance during a pandemic and absorbing the work of another overstretched state agency — the Idaho Department of Health and Wellness — at a time when hiring more staff is a challenge.
Awaiting medical attention in 2021, and again in 2022
Poseley’s situation is complicated. She had health insurance for a time last year, but the plan she chose would not cover medical care through St. Luke’s Health System – which owns the hospital in the community where Poseley lives.
Then, she said, she was approved for disability but has a long waiting period for health coverage. She also had pension income that made her ineligible for Medicaid. So his only insurance option was exchange. She bided her time until Your Health Idaho opened in the fall.
In the meantime, she says, she developed a kidney stone. She waited two months to see a doctor – by then the stone was so big it had to be surgically removed, she said.
Poseley said she tried to book an appointment while her insurance plan was in limbo, but was told she had to pay upfront.
“I don’t have that kind of money, so I’m sitting here waiting, and waiting, and it’s very frustrating and painful, not only mentally but also physically,” she said. “This is a serious medical emergency for me. It might not be for someone else, but it’s for me because it hurts.
Are you waiting for health insurance?
If you are one of the applicants who has not received health insurance coverage information from Your Health Idaho, you can contact your insurance agent or the exchange at [email protected] for information.
Meanwhile, health insurance companies selling plans on the exchange are aware of the problem, and anyone who applied by the Dec. 22 deadline can use their health insurance, says Pat Kelly, executive director of Your Health Idaho.
But, to do so, they will have to choose a plan without knowing exactly what part of the premium will cover their income-based subsidy.
“Your Health Idaho has worked with insurance companies to establish extended grace periods for consumers to pay their monthly premiums,” a YHI spokesperson said in an email. “In the event that the process extends beyond this grace period, policies are in place to ensure coverage and any applicable tax credits can be backdated, and the consumer will not be without coverage due to processing delays.”
What happens when low unemployment meets a labor shortage
The exchange “has seen unprecedented demand for health insurance this year,” Kelly said. This is due in part to temporary federal assistance that has brought subsidized health insurance within reach of high-income Idahoans and reduced the cost of monthly premiums by about a third.
“I also think we’ve been more successful in getting the word out…and people understand that comprehensive health insurance is a big part of the toolkit as we come out of the pandemic,” Kelly said.
Kelly explained that the Idaho Department of Health and Wellness used to do the behind-the-scenes work of reviewing an Idahoan’s application and determining what kind of financial aid they were on. Eligible: Medicaid coverage or premium subsidy for Your Health Idaho plans, or nothing.
Your Health Idaho has made the decision to resume this work for the 2022 enrollment season.
But the “Great Resignation” had other plans. Your Health Idaho could not find enough people to hire.
We suffer the same as other employers. … We have personnel problems.
– Pat Kelly, Executive Director, Your Health Idaho
The exchange typically increases its staff when it opens in the fall. She’s hiring 30-40% more people to answer the phone, handle customer service issues and help process job applications.
Last year they added “somewhere between about 5% to 10%” additional staff, he said. It meant doing a lot more work, with a lot less people.
The exchange asked Health and Welfare to help manage the flood of applications, “and they gave us whatever help they could,” Kelly said.
Health and wellness, however, is facing its own staffing challenges and entering the third year of managing Idaho’s pandemic response.
“We pride ourselves on providing exceptional customer service, and to be honest with you, we fell short this year,” Kelly said in an interview last week. “We know our customers deserve better.”
Staff at Your Health Idaho work from 6 a.m. to 8 p.m. daily, trying to clear the backlog, he said.
The plan is to “be caught up by the end of the month,” he said. “We are doing absolutely everything we can to achieve that.”
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