Affordable Care Act signup over but headaches continue for patients paying the wrong subsidy

Appeals process just starting

WEST PALM BEACH, Fla. - Jim Chaconas is used to a challenge. He's battled heart problems. His wife cancer, but the challenges of getting health care Chaconas can afford is more than he bargained for.

"I think they don't want to help me," explained Chaconas.

The government is helping taxpayers pay for health coverage through subsidies based on family income. When Chaconas signed up, the couple was getting unemployment. It's since run out, so Chaconas wants his subsidy adjusted to cover more of the cost.

"Is there anything less complicated than that?" questioned Chaconas.

Chaconas tried for six weeks to get his subsidy fixed. Healthcare.gov said it's sent the premium adjustment to Florida Blue.

"They adjusted it $136," Chaconas explained.

But, the change wasn't made on his bills.

"I'm getting the same answers over and over again that they don't have it," said Chaconas.

"I think the system is not communicating," explained Legal Aid Attorney & Lead Navigator Vicki Tucci.

Tucci saw communication errors throughout enrollment.  Transfer of data between Healthcare.gov and the insurance company was slow.

"The insurance company knows only so much as the information they are getting," explained Tucci.

Customers like Chaconas, who can't get answers, can file an appeal by filling out a seven page form.

Legal Aid has filled out many because it feels some subsidies were miscalculated during signup.

"I have one woman who received 5 different calculations through her five months of trying to apply," explained Tucci.

"I think it's a larger problem than we realized yet," explained Tucci.

The problem is -- an appeal can take several months which may require a hearing in front of a federal officer in D.C.

Many customers will be navigating this legal process on their own.

"What we really need is extra funding so we can provide counsel," explained Tucci.

Chaconas is worried his personal funds will run out before he gets an answer. So he called the Consumer Watchdog.

"I have more confidence in your ability to get something done so right now I am feeling hopeful," explained Chaconas.

After our calls to Florida Blue, the company adjusted Chaconas's policy retroactively to March 1st when the change was supposed to start. Experts say many people really won't know if they were given the right subsidy until next tax time.

That's when you'll have to verify you got the right subsidy with the IRS.

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