24 April 2014

Connect For Health Colorado Finally Delivers (Sort Of)

To recap the saga:

In late October of 2013, my wife set up an account at Connect For Health Colorado including a lengthy and intrusive application for Medicaid, even though we knew that we didn't qualify for it.  Sometime after Thanksgiving, after many catastrophic system failures at Connect For Health, we finally get our Medicaid application rejection and are allowed to access the part of the website that allows you to compare and contrast health insurance plans.

There are lots of plans and lots of details involved, but eventually, we pick a no deductible "gold plan" with CIGNA that will be hundreds of dollars cheaper than the health insurance that I have from Anthem (Blue Cross-Blue Shield) through the Colorado Bar Association (after Obamacare subsidies) has a $5,000 deductible for in network services, per person, and will no longer be available starting May 1, 2014 since it doesn't comply with Obamacare requirements.  We submit our plan on the December 23, 2013 deadline to choose plans effective January 1, 2014.

A day or two before January 29, 2014, we finally get an invoice from CIGNA for the health insurance we were unable to utilize from January 1, 2014 through January 31, 2014, because we had no health insurance cards and no one at CIGNA could confirm that we had health insurance from them.  Some of the delay was due to Connect for Health not being able to get our information to CIGNA in a timely fashion, and some of the delay was due to CIGNA's failure to process the information in a timely fashion once it was received from Connect for Health.

In order to try to avoid this kind of overlap of coverage, on January 29, 2014, we make a simple request that is supposed to take two weeks to fulfill.  We change our start date from January 1, 2014 to March 1, 2014, allowing an ample thirty days for the change to be processed, so that we can pay our premium and have health insurance cards in hand when our new CIGNA coverage begins.  Silly us.

Earlier this week (i.e. April 23), about twelve weeks after our requested change in start date and four months after we chose our health insurance plan, we finally are given the opportunity to pay our March premium for CIGNA and get into their system, and have been promised that we will received temporary health insurance cards tomorrow.

In the intervening twelve weeks, we had dozens of phone conversations with almost as many Connect For Health and CIGNA representatives (several times on conference calls involving representatives of both), about half of them managers and devoted probably thirty hours to the problem - hold times of half an hour to an hour were common.  Sometimes they would talk to me about the health insurance application submitted by my wife for our family without question, other times, they refused to talk to me citing confidentiality requirements.  We were told that there are hundreds of similarly situated people in the Connect For Health system and that there is no process for escalation of problem cases like ours to higher levels.  Connect For Health representatives swore that they'd sent information to CIGNA that was actually never sent several times.  We were promised calls back from Connect For Health representatives about ten or twelve times, and only received return calls two or three times.  One of the two times we were given a direct line for a particular person, Connect for Health refused to connect us to that person when we called back.  Threats of lawsuits and legislative intervention were to no avail.  I was promised a response from someone outside the call center, but got no response, although I did get a name and address.

Connect for Health mostly refuses to do business by mail, by e-mail, or in person, despite being supposedly a Colorado specific operation and their call centers are all across the United States.

Eventually, my wife's dire and disgruntled posts all over the Connect for Health website got us a call from someone in the Connect for Health organization with a direct line, e-mail and apparently, the ability to finally get the job done in just a few days.

One can get health insurance directly from a health insurance company, but doing so means that you forfeit the Obamacare premium subsidy, which Connect for Health has a monopoly upon.  But, in the end, we will have ended up paying for my old health insurance from January through April, coming within a week of having no health insurance at all, and also paying for the new health insurance for March and April despite the fact that we won't have any opportunity to use until the last week of April.

We were given an opportunity to move back the start date to May, and just like the first time we did it, we were told that it would just take two weeks.  But, that would leave us uninsured for the first week of May and the last time we were told it would just take two weeks it actually took twelve, so we declined that opportunity.

Connect for Health tells you that you can take a screen shot of your Connect for Health application and get health care from medical providers, but this is just a plain and simple lie, and one that health insurers are ill advised to participate in because, a screen shot is too early in the process to guarantee that a health insurance policy will actually be generated.  A process that routinely encourages people to pay for health insurance that they didn't receive is fundamentally fraudulent.

Connect for Health's insanely incompetent bumbling has cost my family about $2,500-$3,000 that we wouldn't have paid if they'd been doing their job, which eats up almost all of the economic benefits we would have received from Obamacare in the first year.  All told, the process has taken about 70 hours of our time, more than half of which was due to various screw ups by Connect for Health, and I fully anticipate that we will have about 15 hours or more dealing with the health care billing screwups caused by having two health insurance policies in place for the same time for March and April.

Assuming that our experience is typical of the hundreds of majorly screwed up cases in the system, Connect for Health has caused several hundreds of thousands of dollars to a million dollars of direct economic harm to people trying to sign up for health insurance, and thousands of hours of time for people trying to deal with their screw ups.  Worse still, some of those people were probably denied necessary health care as a result of their bumbling and suffered much more serious harm as a result.

I am currently exploring filing a class action lawsuit against Connect for Health seeking money damages for the class of people harmed by their failure to live up to their promises upon which people have relied and their contacts with health insurers and governments, as well as seeking injunctive relief to address the problems causing the damages.

The irony of it is that I am a big supporter of Obamacare as public policy.  Expanded Medicaid coverage, subsidized mandatory individual coverage for the more affluent uninsured in a well regulated market, and a largely unchanged situation for Medicare and group health care, may be an ugly kludge, but it dramatically reduces the ranks of the uninsured, substantively hurts almost no one, and meaningfully dents health care costs for those who pay most dearly for it under the old system, like self-employed people.  But, the implementation of health insurance exchanges like Connect for Health has been so abysmally incompetent, that this little detail has tarnished the entire program.  It is a problem that can and should be fixed.  Nothing that Connect for Health is charged with doing is very difficult.  But, because they have utterly fucked up this task, the promise of Obamacare has not been fully realized yet and immense problems have been created.

21 April 2014

How many attorneys are there in Colorado?

As of December 31, 2013, there were 25,496 active attorneys in Colorado and 12,196 inactive attorneys in the state.  I always knew that there were a significant number of inactive attorneys' in the state, but had never imagined that it was 32.4% of the total (almost a third).

Over the course of the year, the state added 1,877 new attorneys and lost 983 attorneys (mostly to death).  Of the new attorneys', however, 560 were admitted on a limited basis for a single client only, as pro hac vice attorneys in a single case, or in one case, as a temporary law processor for the duration of his or her tenure.

After removing those attorneys from the rolls, the number of new attorneys net of lost attorneys was only 334, an increase of 1.3% which is slightly less than the 1.5% growth in population that Colorado experienced in that year.

Larimer County Judge Is Suspended, Publicly Censured And Resigns

Larimer County, Colorado Judge Robert A. Rand was suspended on July 3, 2013 and then accepted a resolution of his case in which he received a public censure (in case 13SA172) from the Colorado Supreme Court, and resigned on February 10, 2014.  Somehow, I managed to miss the news when it happened.

The censure identifies seven instances when he made inappropriate joking comments about people who encountered in the court, six of which were sexist.  It identifies two instances of inappropriate ex parte communications, one as a result of technological ignorance about how to do a conference call and a more serious case where he talked to a former paralegal related to a married couple coming before him as criminal defendants and failed to recuse himself.  It also identifies numerous inappropriate, off the record discussions with criminal defendants after proceedings ended.

The disciplinary counsel has identified problems created by the excessive confidentiality requirements involved in the formal judicial disciplinary process that is rarely invoked.

On the whole, it is reassuring that Colorado's judicial disciplinary process manage to bring about the resignation of a judge who engaged in repeated, albeit minor, judicial ethics violations, without the intense political tussle of a legislative impeachment proceeding or cumbersome and not always well informed process of a retention election.

Pot Liberalization Not Linked To More Crime

[A] new report contends that fourteen years later, even after Colorado legalized the sale of small amounts of marijuana for recreational use on Jan. 1 of this year, violent and property crime rates in the city are actually falling.

According to data from the Denver Police Department, violent crime (including homicide, sexual assault, robbery, and aggravated assault) fell by 6.9% in the first quarter of 2014, compared with the same period in 2013. Property crime (including burglary, larceny, auto theft, theft from motor vehicle and arson) dropped by 11.1%.

A study looking at the legalization of medical marijuana nationwide, published late last month in the journal PLOS ONE, found that the trend holds: Not only does medical marijuana legalization not correlate with an uptick in crime, researchers from the University of Texas at Dallas argue it may actually reduce it. Using statistics from the FBI’s Uniform Crime Report and controlling for variables like the unemployment and poverty rates; per capita income; age of residents; proportion of residents with college degree; number of police officers and prisoners; and even beer consumption, researchers analyzed data from all 50 states between 1990 and 2006....

“The central finding gleaned from the present study was that MML (medical marijuana legalization) is not predictive of higher crime rates and may be related to reductions in rates of homicide and assault. Interestingly, robbery and burglary rates were unaffected by medicinal marijuana legislation, which runs counter to the claim that dispensaries and grow houses lead to an increase in victimization due to the opportunity structures linked to the amount of drugs and cash that are present.”
From here.


* Yesterday was the 100th anniversary of the Ludlow Massacre in Colorado in which:
[A] gunfight broke out between members of the Colorado National Guard and striking coal miners employed by the Colorado Fuel and Iron Company near Trinidad, Colorado. During the fighting in and around a tent encampment of striking miners, eleven children and two women were killed when the tent above a pit they were taking shelter from the fighting in was set on fire. This event became known as the Ludlow Massacre, and shocked the nation into a greater awareness of the poor working conditions and exploitative "company town" economic predation faced by coal miners.
Today, all mine workers in the U.S. have a right to unionize and a very large percentage do (unlike the bulk of the private sector work force in which unionization is at pre-labor law lows), and safety standards in mining are much higher, mostly as a result of the Mine Safety and Health Administration which rivals the National Transportation Safety Board which regulated air and rail traffic safety, for its effectiveness (in stark contrast to the largely ineffectual (outside of manufacturing) Occupational Health and Safety Administration, OSHA, which has never had sufficient funding relative to its regulatory jurisdiction to make much of a difference).

The creation of a "company union" in the wake of the Ludlow massacre by Rockefeller's Colorado Fuel and Iron Company to prevent a real union with a more aggressive stance from filling the vacuum is one of the reasons that current U.S. law prohibits such unions which are common in places like Japan.

But, coal mining remains a very dangerous profession relative to most other professions even today. There are far more coal mining and transportation and power plant deaths than there are deaths from nuclear power to workers and non-workers alike, for example. In recent years, many of the reduced deaths are due to automation rather than improved safety standards. Abroad, for example in China, safety standards for miners are much lower and there are many deaths.

Worker's compensation, another aftermath of that era has been a mixed blessing, making some compensation for injured or killed workers almost automatic, but providing stingy amounts of compensation that are overrun with red tape.

I can't recall the last time that the National Guard was called upon in any state to put down union activity, and the Kent State shooting of war protesters in Ohio, on May 4, 1970, before I was born, is one of the last notable times the National Guard killed U.S. civilians, although the National Guard was called upon to provide civil security in the wake 9-11 at airports and has been called upon to deal with civil unrest now and then on many occasions, generally under the direction of state governors rather than when called up to federal duty when the Posse Comitatus Act (arguably one of the most important parts of the "unwritten constitution" in the United States) applies.

* It was also the day critical in the marijuana subculture, that evolved from a group of kids who smoked pot in California after school at that time in 1971, after which the number began to be associated with marijuana generally, and then morphed into a month and day instead of an hour and minute. One of the biggest events honoring this date in the Denver area was the Cannabis Cup at the Denver Merchandise Mart organized by High Times magazine, which had thousands of visitors paying $40 or so a head to get into to see the vendors and events. It was the 40th time the event was held and the first in a state with legalized recreational marijuana. The crowd was well behaved and there were few incidents of note.

* It was also Hitler's birthday,

* And, this year, it was Easter.  Incidentally, one of the main historical investments of the Roman Catholic Church in astronomy (which continues to this day) originally involved the effort to correctly determine the date of Easter. The Vatican observatory is one of the reasons that this Christian denomination embraces the Big Bang and an allegorical, rather than literal, reading of the creation story in the Bible.