Man Who Signed Up for Obamacare Now Owes $407,000 in Medical Bills

The promise and peril of the state exchanges
401(K) 2013/flickr

Larry Basich is what you would call an upstanding citizen. He is not some young invincible, fecklessly refusing to sign up for Obamacare despite the looming March 31 deadline. 

No, Basich, a 62-year-old who lives in Las Vegas, did as the White House said and tried to sign up for Obamacare on October 1, the day the insurance exchanges went live. It was mid-November before he was able to get all the way through the sign-up process, because of site glitches. He picked a plan, UnitedHealthcare’s MyHPNSilver1, and paid his premium. His insurance coverage was scheduled to start on January 1, according to this Las Vegas Review-Journal account. In short, he was the very model of the modern Obamacare enrollee.

And then ... silence. No insurance card in the mail. No "Welcome to UnitedHealthcare" packet adorned with pictures of vegetables and joggers. The state insurance exchange, Nevada Health Link, "kept telling him he was enrolled, but UnitedHealthcare said he wasn’t in their system," the Review-Journal notes.

Then things went from bad to worse.

Basich’s predicament went critical on Dec. 31, when he had a heart attack. His treatment, which included a triple bypass on Jan. 3, resulted in $407,000 in medical bills in January and February that no insurer is covering.

Basich and his insurance broker, Tamar Burch of Branch Benefits Consultants, said the issue appears to be confusion at the state exchange. Xerox’s system says Basich chose a plan from another insurer, Nevada Health CO-OP, even though Basich has paperwork that shows he selected MyHPNSilver1. In short, [state insurance contractor] Xerox can’t seem to decide where Basich belongs, Burch said.

Xerox, the contractor for the exchange, is still trying to sort out Basich's dilemma, but it's pinning the problem on the fact that Basich filled out four separate applications while he was signing up. But then again, so did many customers who faced an error-prone website and were desperate for coverage. One broker told the Las Vegas paper that more than 20 of its customers had an issue similar to Basich's.

Basich has now suffered months of Job-like tribulations at the hands of Nevada's insurance gods. But how did everything go so wrong?

His story is part of a broader narrative about the fallibility of the state-based health insurance exchanges, which were at one point were thought to be working better than their federal counterpart, Healthcare.gov. Last month, the Nevada exchange admitted it has had, "website problems, long wait times at the call center, frustrated partners, frustrated consumers and low enrollment." Marie Kerr, one of the members of the Silver State Health Insurance Exchange board, called it "kind of a mess." 

It's not just Nevada: Oregon has been almost entirely reliant on paper applications. Maryland will likely dump its entire site after it failed massively. Massachusetts' site, which is still not functional, was built by CGI, the same contractor behind the bug-addled Healthcare.gov.

Of course, prior to the ACA, a 62-year-old man with heart issues would have faced steep odds trying to get health insurance in the first place. And insurance has never been an especially pleasant process to negotiate. But stories like Basich's underscore just how rapidly and broadly our healthcare system is changing—and what can go awry in the process. It may be months before all the misdirected applications, lost premiums, and retroactive payments are restored.

And now, the saddest quote you'll ever hear about what brought this beleaguered Coen brothers character to Nevada to begin with: 

“All I wanted to do when I moved here was buy a house, get a dog, and go to some spring training games for the Dodgers," Basich said.

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Olga Khazan is a staff writer at The Atlantic, where she covers health.

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