This story comes from Kaiser Health News.
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The son of Joseph Daskalakis was born on New Year, just over a week in the world today. Government judgmentand about 10 weeks before he was expected.
Little Oliver has been found in a specialized neonatal intensive care unit, the only one able to look after him near their home in Lakeville, Minnesota.
33-year-old Air Traffic Controller Daskalakis has another concern: the hospital where the newborn is being treated is not part of his current insurer's network and the partial closure of the government prevents him from completing the formalities necessary to change the insurer, as it would otherwise be. allowed to do. He could be on the hook for a hefty bill – while not receiving a salary. Daskalakis is just one example of federal officials for whom the inability to make changes to their health plans really matter.
Although the approximately 800,000 government employees affected by the closure will not lose their health insurance, an unknown number are in limbo, like Daskalakis, unable to change insurer due to unforeseen circumstances; add family members such as spouses, newborns or adopted children to an existing health plan; or deal with other issues that may arise.
Federal workers fired and elected officials hold a protest rally in Independence Hall on January 8, 2019 in Philadelphia.
"With 800,000 employees, I imagine that it's not an isolated event," said Dan Blair, Acting Director and Deputy Director of the Federal Office. Personnel Management (OPM) in the early 2000s. Senior Advisor to the Bipartisan Policy Center. "The longer it lasts, the more we'll see these types of occurrences."
As Oliver gets stronger every day – he is now out of the ISU, according to the local union representative from Daskalakis – the impact of the situation on his family's finances is unclear.
This is because off-grid charges are typically much higher than network costs and NICU care is extremely expensive in all circumstances. These bills could add up, especially since his current insurance provides for a maximum of $ 12,000 per year. As Oliver was born before the new year, the family could face this amount for 2018 – and 2019.
Daskalakis is not paid either.
"I do not know when I can change my insurance or when I will be paid again," said Senator Tina Smith (D-Minn.), Who shared his letter on Facebook and in front of the Senate last week.
Other families also worry about paperwork delays and the financial and medical consequences that a prolonged stoppage might have.
Dania Palanker, a health policy researcher at the Georgetown Health Insurance Reform Center, is studying what happens when families face insurance difficulties. Now she lives it too.
After taking steps to reduce his hours of work due to health problems, Palanker knew that his family would not be eligible for coverage through his academic work. No problem, she thought, as she began her family's registration process in December on the coverage offered by her husband's work in the federal government.
"We could not get the paperwork in time to make a special application for registration with the government and have it processed before closing," said Palanker.
Georgetown has allowed her to work longer this month to keep her family insured until January, but Georgetown's offer will end in February.
Her treatments are expensive, so she runs the risk of reaching or exceeding her annual deductible of $ 2,000 in January, then starting again with another annual deductible once the family has taken out a new coverage.
"I postpone the treatment in the hope that it only stays a month and I'm back on the federal plan in February, but I can not postpone it indefinitely because my condition "Health will worsen," said Palanker, suffering from an autoimmune disease. which causes nerve damage.
The monitoring of federal health benefit programs is the responsibility of the OPM, whose data center is operational, according to a spokesperson. But getting information about this data center to make the kind of changes that Daskalakis, Palanker and others need depends on individual agencies that employ government employees.
The OPM told government agencies "that they should have human resources staff available, especially to deal with" these demands, called "life qualifying events," said the spokeswoman.
In a statement written Wednesday, Smith said: "The story of Oliver is a powerful reminder that hundreds of thousands of real families have seen their financial and personal lives turned upside down by this pointless stopping." She called on the president to resume negotiations. table.
For Daskalakis, there is good news.
Tony Walsh, his union representative, said that both the OPM website and the Daskalakis insurer had both indicated that the air traffic controller's request to change carrier so that the carrier would be able to do so. Hospital in the network would be retroactive to Oliver's birthday, and that off-grid costs might not play a role.
Just to be sure, "Joe is currently working on a call for insurance based on the lack of care in the network. [being available]Walsh said in an e-mail statement The family has already received an initial $ 6,000 bill from the hospital, said Walsh, noting that the charges do not include costs related to Oliver's birth or his stay in the intensive care unit.
Walsh said the closure was affecting a wide range of employees as many lawmakers had never anticipated.
Workers "are essential to the system, and it is unfair, they are treated in this way," he said.