Opinion: Pennie and York County DHS –“No Harm, No Foul?” (Part 1)

“There really is no wrong door…” –

-paraphrase from a statement made this YouTube Video
(will link full video again at the end of this piece)

If there’s anything I hate, it is forms of corruption and being caught up in situational black holes and potentially off-the-radar protocols (the proverbial unofficial, tacit “office memo”) and backroom handshakes, so-to-speak. The feeling of powerlessness I have felt in such situations during my lifetime, in a number of contexts, leaves me very angry and understandably, increases my anxiety.

The following commentary is primarily opinion and my own speculations, reasonable questions and ponderings about a terrible situation I recently found myself in relating to my health care coverage through the Pennie website. While I will incorporate some facts and other public information about the situation, along with the gist (or in some cases, verbatim quotes I took note of) of various conflicting–even inaccurate or potentially false–statements made to me or put on documents, my primary purpose here is to raise awareness.

I would welcome any readers who are in a position to dig more deeply into this overall situation (or my specifics) to feel free to reach out to me. Surely I cannot be the only person who has had a similar experience, or possibly fits into some patterned, documentable situation that encompasses a larger number of people in whatever category/reasons may have propelled me into this scenario.

It will help me here to organize the most important details of the situation, and, I do intend to contact the Medicaid Fraud Tipline (Officer of Inspector General) at 1-844-347-8477. Yesterday, when I attempted to see if I could somehow log into the COMPASS website to view whatever “application” had allegedly been computer-automated on my behalf via Pennie (without my notification, knowledge or consent), I tried to create an account.

When I put in my logical username (eileenslifer) it said that this username was already taken. I then called the COMPASS helpline at 1-800-692-7462 and I explained the situation to the agent. Since there was no way for me to know the password that was somehow created with my username, I inquired what would happen if I created an account with (eileenslifer1) and my social security number, etc. I asked if I could then see the details of whatever application was supposedly auto-filed that put me into my current mess.

The agent told me that if I made a different account, even if I used my social security number, that it would not show the application. After being verified, the agent told me he could see the application on his end, and I asked if it could be emailed to me, which he was helpful and happy to do. I asked a few more questions about what kinds of records might be available to me under the “freedom to know” act. (Actually, I see this is called “the Commonwealth’s Right-to-Know Law”).

I can’t recall his exact response but instead, he was helpful in giving me the Medicaid Fraud Tipline info above, and told me to enter “recipient” when I called. This agent’s response of giving me this information was based on just a few comments/statements I made as I was finishing up the call.

Ever since I learned of this situation on March 11, regarding my health care coverage, I have been trying to dig and gather information and wrap my head around it. At first, my goal was simply to make it stop. To just get the matter resolved, and to move on. But, as it wouldn’t easily stop and only deepened, I then began to read about various potential things involved (I will link a number of relevant articles in my footnotes), and to make phone calls and to download all my Pennie applications and documents that are relevant.

I now have a thick notebook with the official applications and correspondence in as good of a sequence as possible. It is unwieldy; and, I have also circled, underlined and made other notes and questions in these 140 or so pages (with a red marker).

Last Tuesday, March 26, after several calls to the York Human Services case worker center number I had been given March 12 (1-877-395-8930) and getting the name of (apparently the “last” case worker who had handled my “case” and made a decision), and having left a message for them and being told they would have three days to respond, I decided to just drive into York in person.

It was my understanding that an appointment could not be made, but the office was open until 5 pm. I asked how busy it was and was told it varies, and that I could come and wait and speak to someone.

When I got there last Tuesday (March 26), I was a little relieved that the line seemed very short (different from today) and once at the counter I asked if I might speak to “(the name of this case worker).” I was asked to take a seat, and about ten minutes or so later someone came out from the back office area and called my name.

This person ushered me back into the rear cubicle-office area, and asked how they could help me. We never sat down, but I stood there about 45 minutes or so, hoping to give enough overview and sense of not only my situation but the kind of person I consider myself to be (hard-working, college educated…someone who has gone through an extremely difficult divorce at the end of 2019 and having to relocate my life and my business 800 miles back north during a pandemic). I was trying to help them understand my particulars, in hopes that they would better understand not only my Schedule C but the nature of my situation and heavy cost of investments these past several years to re-establish my business and work spaces locally here in PA.

I showed some of the correspondence received and had printed out my first quarter self-employment records from 2024, my 4th quarter from 2023, and a summary (including all detailed spreadsheet info) of first quarters of 2022, 2021, 2020. I thought surely they will understand there has been some obvious mistake, and this should be a simple matter to correct (by a human being).

I also found myself (probably due to both my communication-anxiety-stress as well as my natural quick-wit and dark humor) making various edgy-dry-humored remarks that were both of a personal social-banter nature and a bit political.

Things like, “You look like you went to college, I bet you can understand my spreadsheet. I use Open Office because I can’t afford Excel…and…I think maybe Biden is eligible for Medicaid.”

But probably the best (and arguably controversial remark) that I made was:
“I can almost guarantee I’m the only person in this office trying to prove that I am NOT eligible (nor do I want nor will I accept) for Medicaid.”

I actually think I may have mildly amused this particular case worker. I was studying their face for micro-expressions. They were pleasant, and I think they understood me. They took my updating documents and scanned them, while I waited. As I left, I ask for their name. I was given a first name.

When I put a call in for this person last week on Wednesday or Thursday, the case worker call center said they didn’t know anyone by that name. I described the person. And even though I was told they didn’t know who this was, I asked to leave a message for the person and someone took the message to have them call me.

(Today, another case worker gave me that person’s last name. Not that it matters, but I feel a need to have a paper trail of notes involving all of this.)

On Tuesday (April 2) this past week, I received a phone call from DHS by another case worker and I asked their name. This call came at 1:43 pm, as I was out working in my art studio. The case worker told me they had a message from the call center to call me. Since I had been on the phone at that point with someone in Senator Mike Regan’s office earlier Tuesday morning, that I went over the situation with and was told they would look into the matter further, I then asked this DHS case worker if they were calling me because they had been contacted by someone in that office. (I was told there were liaisons that might help me.)

The DHS case worker told me that they had not been contacted by that Senator’s office. At this point, I was pretty angry and took the posture of being direct and forceful in my manner of speaking. I really hate (as I started in the beginning of this piece) being put into a position where I have to “fight” for something–“fight” in a somewhat unbecoming manner, for help.

I’ve had a variety of traumatic situations during my lifetime, and the idea of the Pyrrhic victory is one that I’ve blogged about before. For me, that’s when my naturally agreeable, peaceable nature must take the posture of aggression and argumentation…because I’m in some situation where I believe being passive and agreeable will not bring me the rightful relief needed. I’m not saying that my anger and intensity necessarily help the outcome; I’m just saying that these type of situations cause me a lot of distress and struggles with anger.

Years ago a good friend said that I was one of the most stubborn people she knows–and I’ve had other versions of that spoken to me before by a few–but honestly (and OK, I could be wrong on this!) I only take the posture of that kind of “stubbornness” when I know I’m (at least generally…perhaps not on every point) in the right.

In fact, I go to great lengths to research and ponder things before taking such stands (generally). If I’m going to press some issue, I want to have a reasonably good sense that I have something to stand upon. And then…I can be extremely uncompromising until my points and facts are made abundantly clear to those involved.

And you know…that’s not a fun position to be in. I certainly don’t relish it or go looking for it; however, I’m a person of principles and convictions, and I don’t easily back down in some situations. And even if there is a “win” in the end, it is what a therapist told me when back in my twenties…it is a “hollow victory.” I’ve always chalked that term away in my brain. That person expounded that it is a victory that feels hollow because of all the undue stress it took to achieve. In recent years, I’ve learn the term is “Phyrric victory.”

“A Pyrrhic victory (/ˈpɪrɪk/ ^ⓘ PIRR-ik) is a victory that inflicts such a
devastating toll on the victor that it is tantamount to defeat.^[1] 
Such a victory negates any true sense of achievement or damages long-term progress.
The phrase originates from a quote from Pyrrhus of Epirus, whose triumph against the Romans in the Battle of Asculum in 279 BC destroyed much of his forces, forcing the end of his campaign.”

– Wikipedia

Before I get back to where I was in this account (the phone call at 1:43 pm Tuesday by a DHS case worker) I want to share what I learned this morning through an 8 am-returned phone call from someone in the Office of Chief Counsel, Pennsylvania Insurance Department. I had left a voice mail yesterday, wondering what types of public records (and my own relevant records) should be made available to me, and how to get access.

This call was made after being on the phone with a Pennie agent who put me on hold several times to get answers. What I was asking for was whether they could email or otherwise supply me with a summary of every call I’ve made to Pennie since 2021. The date/time and any notes made. I was wondering, because when I’ve recently called and had seemingly conflicting information and answers, some of the agents (and their supervisors I’ve asked to speak with) have referenced “notes” from previous calls.

The Pennie agent told me that these records were not available to me. After a discussion why, the basic summary is that “only by warrant” (those were the agent’s exact words, rather than “subpoena”). The agent was not hostile to me, they were simply answering my questions.

So this morning, I learned that when the PA Legislators created “Pennie” back around 2021 to be the arm of Pennsylvania that manages/interfaces with the ACA (Affordable Healthcare Act and its regulations) that it “exempted itself” from the “right to know” act. In other words, whatever this agency does behind the scenes or with my application and “agreeing” to all the required fine print “gobbledygook,” I have no recourse to obtain any documents, paper trail or explanation beyond what is in my Log-in Pennie Dashboard. (and a lot of my 140+ pages printed this past week came from there–whatever I could download to show what I put on applications, and what dates various applications were filed, and what communications Pennie sent me in my Inbox as well as what was not sent to me in terms of notification).

The Pennie agent told me that I could “take my own notes” of course–and I asked for their name.

I later called back to the contact at the Office of Chief Counsel/Pennsylvania Insurance Department to ask a few more questions (after I was more awake and had my coffee) and was sent the following information:

• Below is the link to the Pennie enabling law – you should reference Section 9307 for Pennie’s exclusion from the RTKL: https://agency.pennie.com/wp-content/uploads/Act-42-Codified.pdf

• The following is a link to the Commonwealth’s Office of Open Records that explains how to file a request for public records under the Commonwealth’s Right-to-Know Law: https://www.openrecords.pa.gov/RTKL/About.cfm

Back to the phone call Tuesday…after 8 minutes and 47 seconds with that first DHS case worker, I think I made some comments/raised some questions that prompted the person to tell me they would have to refer this to their supervisor. I can’t say for sure, but it kinda seemed they half hung up on me. I admit, I made it clear I was upset and wanted this resolved. And, I wanted answers to my “why” and “what if” questions, if possible.

One of several things I said was that I have read that there may be a move toward automatic voter registration through Medicaid enrollment, and that I thought I read somewhere that Medicaid gets greater money for new, adult enrollees that are not disabled and do not have children. (I would love to find the source of that again; unfortunately I had so many different tabs and searches going on recently with both my phone and computer that it is hard to locate every source and the exact parts from the lengthy readings…).

I got the name of this first agent, and after the call ended I reached back out to Senator Regan’s office to talk about the call, as well as to ask if they had contacted DHS that day. They had not. I didn’t know what to expect, so I asked. I then learned that they had reached out to Pennie regarding some general questions, not mentioning my situation specifically, and that it might take a couple days for a response.

With that, I resumed working on a funeral flower preservation that had wet glue drying on me, while I had taken that phone call from DHS (caller ID is COPA).

By 2:30 pm, I had another incoming call from COPA. This time, I spoke 54 minutes and 38 seconds, and by the end, we agreed that I would come in to the office today for a noon appointment. I had become increasingly angry and upset on that 54-minute call and the agent felt I was “arguing” with him and “talking over him.” I was in fact–at points–doing just that. Because, I did not feel heard, and the methodic attempt to recount the sequence of this situation was naturally confusing by phone. I felt unheard. And I said that if I could put the documents on their desk to refer to, it would be much better. They assured me that though they were very overloaded, they would make “all the time” I needed to explain things to me or have me ask questions, at the appointment.

I was out in my studio, and I didn’t have my tax return in front of me, and I felt my head spinning with various numbers being thrown around at me by this case worker, and interpreted in a certain manner that seemed not only wrong but illogical. I kept trying to assert a number of true things such as it is not the purview of DHS to analyze and “tell me” what my income is based on some false “concept” the case worker seemed to be creating, regarding my income numbers and situation.

I made such statements as:

• According to the ACA guidelines for reporting self-employment, I get to project my own income for the coming year based on my records, my knowledge of my own business, realistic expectations and other information. My eligibility for ACA Health Coverage/ACA subsidy determination is based on my best prediction about 2024, not on anything in 2023 per se.

• I explained to this case worker (by phone on Tuesday) that I was in a “post-divorce” recovery situation that was complicated–that I had made an 800 mile relocation back north in 2020 (during a pandemic) after being in Alabama for eight years. I told the case worker that I was not “new” to this profession, that I had started my business in Delaware in 1989 and had lived my whole life in that state until 2012, and had done my business for 35 years and generally knew what to expect (if it weren’t for the state of our economy and post-pandemic abnormalities, which were beyond my control).
• I explained to the case worker that in addition to deducting cost of materials, advertising and other expenses related to running (two) home-based businesses, that a number of these costs included various “one-time” expenses during the past several years aimed at the physical re-establishment of my workspaces here.
• I explained that my first quarter 2024 showed 5x net profit than that of first quarter 2023 (the case worker seemed to interrupt me on this and tell me I then needed to subtract “expense figures” from last year in my current predictions. I kept trying to explain that these were not identical and theoretically I didn’t “have” to deduct anything. I said that if I chose to take a portion of my profits and re-invest in some way (in hopes that it would gain me MORE income in the future, that was my prerogative and it was still fair for me to consider my overall cash flow and potential “choice” whether to not expend in 2024 in the same exact manner/pattern. (Actually, this is right–why should I pre-estimate losses in order to get on welfare?) I said that I should expect that the remaining quarters generate my estimate of self-employment income for 2024. I said that my figure was reasonable and if there was a discrepancy either way, that the ACA required me to reconcile it each year on my taxes since the money is Federal, not from Pennsylvania. And, that I have done that previously without any issue.
• The agent was taking the total taxable income (after even my “standard deduction” as a single person) and telling me that was my net income. They seemed to be taking the figure of 2023’s “loss” on my Schedule C and then deducting that figure from the small pension I have from my first marriage, and then, deducting the standard deduction. And then…I “think”…they were trying to tell me that gets subtracted from what I showed I earned this first quarter of 2024! (I don’t know…I could not follow it in the moment…it made my head spin…and was really confusing…)
• I attempted to explain the sequence of the alleged computer-based initiatives by Pennie which pushed me into DHS to the agent, and at one point as he kept wanting me to answer “yes” or “no” “did I make or did I not make ‘(negative________)’ in income last year (from line 15 on my 2023 Form 1040)” I began to ask if they understood why I was even on the phone with them at this point. They didn’t want to answer that nor to acknowledge my (valid) line of thought which (if this was a normal situation) might have put a quick end to the entire matter. My point was that if Pennie’s system had not auto-filed a 2nd auto-enrollment application on November 20 that pre-empted my interaction on Pennie’s site during Open Enrollment, on November 28, that I would not even need to be going through all this on the phone with them.
  
  I just didn’t understand why someone in Pennie or at Medicaid could just “undo” this sequence of things. I was also told on the phone by the case worker that since I had (quickly) supplied my tax form from 2023, that revising based on 2024 business records was no longer an option for me. That is what I understood from them, when I stated that if I had fully read through all the fine print on other pages on March 12, I could have opted to just supply a current business ledger. And (maybe?) the matter would have been ended.
  
  

_____________________________

So, here is the sequence of things as I currently know and have record of:

There is an application dated April 18, 2023 in my Pennie dashboard. Earlier today before my appointment, an agent told me that it was opened by a representative and was prompted by a call from me to “update income” for a 1095A. This makes no sense to me. While I may have made a call (I do recall when I did my taxes last year trying to decipher the IRS form tax credit reconciliation) to inquire about how to get that information, I am not sure why another application would need to be opened. But, as I recall, the 1095A was in my Message Inbox. Honestly, if I weren’t scrutinizing everything now on Pennie, I wouldn’t wonder. Prior to this current situation, I would have said I was very pleased overall with Pennie. Except for one issue in 2020 that essentially caused me to lose around $6000 in 2021.*

There is another application in Pennie dated October 3, 2023. I did check back in 2022, and a similar computer-automated “auto-enroll” application was made on October 5 of that year. Last year, this automated, auto-enroll application made in Pennie’s system in October (apparently, I checked off “auto-enroll” but did not understand/or was not informed that in doing this, it might pre-empt my right to go in and put my own info/select my plan during Open Enrollment. This preliminary auto-application done by Pennie prior to Open Enrollment, had presumed my reported self-employment income estimate would be identical (for 2024) to what I stated on my 2022 fall application for 2023 coverage. It rightly removed my temporary “rehabilitative alimony” awarded me in Alabama due to the particular, extenuating circumstances which related to that marriage, relocation and divorce and especially, the disparities inherent in my being able to regain myself and my business in a situation similar to what I had relinquished when I re-married and relocated from Delaware to Alabama. So, Pennie’s system accurately removed alimony income for 2023 at a mid-year point which I had previously supplied on my 2022 fall application. (That was because in fall 2022, I stated on the application for 2023 an end-date mid year for alimony. On the application, there is a monthly column and start/end dates (if applicable). Pennie’s system also retained the dollar figure of a small pension I receive from my first marriage of 20 years, from State of Delaware.

This automated income information then put me just slightly below the eligibility for Pennie coverage, and was seemingly auto-filed by Pennie’s system at midnight beginning November 1, 2023–the first day of enrollment. In my dashboard, this application showed that I was eligible for Pennie ACA subsidy, as normal, and enrolled me initially for 2024 into my same Highmark plan, etc. In fact, had I not found myself in this situation, I don’t think I would have known that Pennie auto-filed this.

On November 28, 2023, I went in to the Pennie system and updated my projected self-employment income for 2024 to a figure that was about 60% greater than what was in their system from 2022. I had firmed up my clerical records and most receipts (not the kind of expenses I download when I fully prepare for my taxes–bank fees, business insurance, shipping costs/history from my shipping account, etc) but enough to get me to that point so that I could also analyze my gross receipts, too, in order to make a reasonable projection, again, according to these ACA guidelines. I remember looking over plans, and making a call to a Pennie agent for help (and Highmark, too…in order to understand if my doctors were in a plan that cost less–a similar but preferred provider plan). After being assured by Highmark that my primary care doctor, dentist and therapist were “in network,” and that my out-of-pocket premium would be much less AND some of my copays less, it seemed like a good choice. As I recall, a Pennie agent helped me firm up my plan selection/application, etc and I submitted it. Again, this was on November 28, 2023 during Open Enrollment. I often get help navigating the “shop for a plan” section–which was clearly showing the cost to me that included my ACA credit. After submitting this application, I received confirmation that I was enrolled in this plan.

On December 1, I did receive a Pennie inbox message that at first confused me. The language said I was “unenrolled” from my Highmark plan. But I looked it over then (as well as yesterday) and confirmed this was the 2023 plan and I figured it was the way Pennie worked…it said my coverage on that plan would end Jan 1, and in other Pennie dashboard areas it showed I was still currently enrolled in my new Highmark plan for 2024. Most likely I even called Pennie to confirm, but I know I was really busy around that time. Since I saw I was enrolled in the new plan, I concluded this was some type of “technical” notification of plan change that I initiated. To my knowledge, that is actually the case. The plan specified in that notice is NOT my 2024 plan. Although, since DHS has backdated my Medicaid (applied for without my express knowledge, consent or notification) to November 20, I must now wonder if they took it upon themselves to “unenroll” me from a month of 2023 Highmark. I’ve not received notice there was any issue there, and my premium was paid and claims paid. (the reader should realize how deep of a financial/legal mess these un-notified actions by Pennie and Medicaid might have in terms of financial ramifications for me). When I left the York office today I made a comment that it was “illegal” to have two insurance coverage and the first case work I had appointment with stated “that was not true.” (Probably meaning one can have supplemental insurance…however, my point is that I don’t think it is legal to be enrolled in Medicaid–and for PA to be receiving money for MY ENROLLMENT while I continue to not know this fact and to use my contracted insurance with Highmark. This just cannot be right.)

Here’s a speculation: Did Medicaid receive Federal funds for “my” enrollment going back to November, but Highmark has been paying all my claims during that period? I don’t know. But if so, wouldn’t that be like “free money” into the welfare system?

Again, I’m an artist and a gardener…not an accountant. (Per se.)

My recently stated “life goal” is to “create as much art and beauty as possible” in this world,
in a variety of ways, with whatever time I have left!

(That said, if the Good Lord calls me to be some type of conceptual whistle-blower…then…so be it!)

I received the usual communications from Highmark once my new plan was in their system last December, and I made the new payment to them in December as required, to activate my coverage to begin on January 1, 2024. It actually seemed to go more quickly/smoothly that time into Highmark’s system, and I was receiving accurate bill reminders and paying promptly through the most recent reminder last week; my premium with Highmark is current and paid through end of this month (April).

After my November 28, 2023 application and approval, and the December 1 message, I received no other significant communications from Pennie. Just general stuff, including my 1095-A form for my taxes. In fact, until I received a letter from York DHS mailed on February 29, 2024 which arrived while I was out of town for a week-long trip to Delaware (I opened this March 12), I had no notification of what Pennie and DHS had done without my express consent/notification. (I now know that in the fine print, Pennie can legally do this, but I wonder why they are NOT required to notify the consumer?)

I suppose my naivete shows here. I did not even know what the abbreviation “MA/CHIP” on the form letter/request meant, nor that the “Pennsylvania Department of Human Services” related to Medicaid. I saw the words “Health Care” that I have “applied for or are receiving” and the request to document my pension and self-employment (letter opened March 12, mailed February 29, DUE March 11) and wrongly presumed this related to my Pennie coverage with Highmark. I figured it was normal to have to document stuff if requested. I had a lot to deal with after my trip (with work and otherwise) and worried, because of the quick and official due date and request for me to “mail it.” On March 12, I called the number and received an email address where I could send the information.

Since I had recently filed my IRS Tax Return for 2023, I figured all they wanted to know was that I was, in fact, running a business. I did not read over all the finer print on other pages which would have permitted me to send my Business records/spreadsheets (like I later took into the DHS office last Tuesday) rather than my tax return (with all the somewhat confusing Schedule C stuff). In my 3 emails on March 12 (I had the confirmations they were received) I composed a message and said “if you need anything else, please let me know.”

So…and now for the rest of the story…as Paul Harvey would say.

Little did I know that last year on November 20, according to a Pennie agent, there was some kind of “system update” which caused Pennie to determine I was eligible for Medicaid and they sent my information to Medicaid, without notifying me. For those following this closely…Pennie auto-applied for me on November 1, then their system kicked me to Medicaid on November 20 without telling me, and on November 28 I went in during Open Enrollment (the consumer has until December 15) and entered my own income projection (which would disqualify me from Medicaid) and I successful re-enrolled in Highmark.

After I submitted documents on March 12 by email to DHS, I received a notice mailed March 22 by that office that I was now “enrolled” in Medicaid. When I was confused and contacted Pennie, I learned of this behind-the-scenes process. As I recall, the first Pennie agent told me that “because of my age” and the income figures, it automatically sent me to Medicaid. (When I went into the York office on March 26, the case worker said it had nothing to do with my age.) When I later called Pennie again after reviewing my applications and asking the agent why their “system update” and automated application (I had asked “who applied for this on my behalf” and was told it wasn’t any human agent, it was entirely by computer) took precedence over my own, manual entry of my more accurate figures on November 28, the Pennie agent kept trying to tell me it was not that it “took precedence” but that it was filed on November 20 prior to my personal application.

I felt we were mincing words, so I re-stated to the Pennie agent: “What you mean is that because your computer automatically filed applications on both November 1 and November 20 prior to my filing, that this action pre-dated (pre-empted??) and therefore ‘took precedence’ over my own application on November 28.”

This seemed to be a point the Pennie agent either could not understand, or would not acknowledge. I kept thinking, Pennie can clearly see that my income reporting on November 28 would make me ineligible for Medicaid–why can’t a human supervisor at Pennie see what happened and just “withdraw back” that kickoff of me into the Medicaid arena? It just seemed so clear, and so simple of a matter.

But the Pennie agent(s) told me that they were not permitted to do that. They stated that once “their system” sent me into Medicaid application that only a letter from Medicaid stating that I was “ineligible” would allow me back into Pennie. I don’t think I can even change the “auto-enroll” feature (opt out) right now. While I can still access my Dashboard which is showing current Highmark coverage, it has left me very confused and angry at the situation and not knowing what to do–other than what I am currently doing.

This is a matter I can’t simply ignore–it has many legal and personal (medical care) ramifications for me, and I’m too responsible of a person not to immediately drop almost everything else right now to deal with this. It has put me into quite a predicament in a number of ways.

And this is what prompted me to spend most of my Monday, March 25, trying to look at/firm up my first quarter 2024 receipts/expenses and analyze/test my previous income projection for 2024, and take these line-by-line business records in to the York office on March 26. I keep my receipts in a box and am generally too busy doing what is involved in my actual work and very difficult situation here (trying to get a faster response to all my promotions, etc, during a post-pandemic and tanking economy….requiring me to seemingly work 10-16 hour days 7 days a week…being home-based and being alone here, I go in and out of continual tasks here aimed to earn money–completing existing work as well as promoting and doing other things in hopes of future “fruits of my seemingly endless labors…”) so that I normally only do my clerical records every few weeks based on receipts and other electronic records…when I receive cash, which is rare…I record that fairly immediately…at least on some sticky note somewhere til I get to my computer.

All this to say, I keep a running tally of receipts/expenses/profits in a calculating spreadsheet, and though I have a general sense throughout the year, it isn’t until it is all said and done December 31 and then every receipt/PayPal fee, etc thoroughly accounted for that I get a firm total. And then of course, I get to deduct my mileage and a few other expenses not in my main records.

What I told the first and second case workers that called me this past Tuesday (April 2) was along the lines of: “I imagine some of your Medicaid and welfare recipients (just like non-recipients) could very well be running some ‘illegal’ business from their home (meaning, drugs, etc). And, do you scrutinize their Schedule C’s on this? NO. Because I have the unfortunate position of owning property and running an actual business and reporting my income and taking allowable expenses (even if I show temporary losses during this initial time following my 2nd divorce, that should gradually lessen in the future…) and therefore you are applying a standard to me that is FORCING me–theoretically–into the social welfare system, while you are NOT applying this deep dig into those who may not be self-employed and who may not qualify and unlike me, WANT to be on Medicaid.” (I have expounded on that in this paragraph to be very clear what I am thinking…though I may not have been as successful by phone in my articulation).

Actually, perhaps I was successful. I was told by one agent (I believe the 2nd, whom entered the situation when I raised political questions such as this to the first, who half-hung up on me) that they were “not permitted” to have a political conversation with me. That, “even if they agreed” they could not. Which actually is very understandable. And I attempted at that point to stay to the particulars of my situation and my goal. However, I did indicate that once my issue was resolved, I would continue exploring/seeking answers, because I was beginning to wonder if this was somehow politically driven.

I don’t know, of course. “No harm, no foul?”

In the course of the two Tuesday calls, I also raised some points about it being an election year, and voter and other potential factors. I will state here that I confirmed yesterday I was still registered to vote–I registered in 2020 as an independent–and for current religious/conscience sake I opted to refrain from voting in 2022 (a kind of sabbatical until I could better wrap my head around my rapidly evolving/changing political views). Whether I will continue to do that in 2024 fall I don’t know for sure; I have at least temporarily opted to simply write about/raise awareness/pray/be vocal on a number of political/religious issues here on my blog, and otherwise, but take a “non-partisan” almost conscientious- objecting view of literally casting a vote (it ALL feels so corrupt to me…and I think of the film Hacksaw Ridge…how Desmond Doss cared about the “war” and issues but refused to “carry a weapon” yet made such an amazing impact…that’s how I currently feel and, that may evolve by November, too…I don’t want to be presumed in lock-step with any one political platform…I hold non-conforming beliefs about a number of things…and…I will not keep silent. Writing may be more effective than voting…let “voters” read my writings and hopefully, they will be part of fixing this country’s immense issues…).

So yes, I am still registered. I note this, because included in my Medicaid enrollment letter with plastic “access card” (which I cut up prior to going to the noon appointment today and by the end of that hour meeting, had signed a form to “unenroll” me from Medicaid) there was also included a Voter Registration Form. I learned something else new this week. Since I’m registered independent, I cannot vote in the primary. But, I have until April 8 to change my registration and specify a political party. Note…this packet from DHS came to me last week around March 27 or 28th…

We live in a post-truth society, and there are a number of things at play that I have been increasingly passionate about. In most recent months, I have come to believe we must love the truth and truth-telling (I was very inspired by a recent talk You Need to Love the Truth by James Lindsay in which he challenges Christians and others to love the truth, and to the point that if we must step into the role of a whistleblower in some matter, in our resistance of increasing encroachments upon our society and from within both governmental and church actions, then so be it).

Basically, we must live with a willingness to be truth-tellers. In other words, we cannot Live By Lies. (That was a title of a book I listened to last fall.)

I am not finished with this story. I want to tell of my experience in the York office earlier today, and make a few other factual comments. But, this seems like a good place to break this Part I…here is the next link for Opinion: Pennie and York County DHS — “No Harm, No Foul?” (Part 2).

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Footnotes:

Biden officials keep states waiting on expanding Medicaid voter registration

Reporting self-employment income to the Marketplace

Medicaid’s Endless Expansion

Medicaid Financing: The Basics

Fact Sheet: Understanding Medicaid in Pennsylvania

HOW IS MEDICAID FINANCED?
The Annual Renewal Process on HealthCare.gov

Medicaid Automatic Voter Registration Background and Overview

Automatic re-enrollment keeps you covered
(Below, screen shot of image from above linked information on healthcare.gov)

* I lost about $6,000 in 2021 due to inability to understand/navigate a single question on the Pennie website during Open Enrollment 2020. When my divorce was final in December 2019 in Alabama, someone told me I should be able to get health insurance “for free” through “Obamacare” given my income level at that point (I was a 2nd income and took care of many things in the home/property in Alabama). I said I didn’t think so–I knew the process somewhat and had already consulted someone–since I was only going to be in Alabama a few months at max after the divorce, and then would be temporarily in Delaware a few months until I could locate/purchase/settle on a property in Pennsylvania, and I didn’t want to “go on and off” three different state health exchanges. I had the option of taking COBRA coverage through my former husband’s company for up to three years. But, I had to decide within 30 days or I would lose that option. I decided to continue my Cigna coverage through COBRA at around $718 a month. At that time, I was hopeful about a number of things in 2020; this was in January, prior to the pandemic. I felt I could afford that the first year, from my rehabilitative settlement and temporary alimony that ended in 2023. When I went on the Pennie site during fall 2020, I thought I was “shopping” and comparing. I filled out the application and there was ONE SPECIFIC question about “do you have coverage that will continue past January 1 (2021)” or something along those lines. I could say “yes” or “no.” I thought about the question and interpreted “yes.” Because theoretically if I did nothing to stop Cigna, I would remain covered for another two years. When my application was submitted, it was showing premiums of similar plans at around $1400-$1500 a month. It didn’t make sense to me…how was that more affordable? So, I stayed with Cigna for 2021. When Open Enrollment for 2022 came…after the terrible ride through the pandemic to that point and other things, I reached out to a professional to discuss why the Pennie site was of no help to me, seemingly. They took my information and told me from their calculations, I should be receiving a considerable subsidy, bringing the premium to around $220 a month rather than $718-ish to Cigna. I called Pennie, and was actually happy an agent spent an hour trying to figure out the issue. We went through every single question on the application, and when it asked if I had coverage that continued after Jan 1, they said that the correct answer should be “no.” Once that question was changed, the application submitted and suddenly “populated” with MY cost (with ACA credit) to purchase various healthcare plans. I spent a lot of time researching the pros/cons of each and decided upon Highmark. One of their reps was very helpful by phone, explaining why a certain plan was best for me, given the types of expenses I generally had, and the types I did not have. I’m in relatively good health for age 60 and have very few/no “serious” conditions–mainly blood pressure, monitoring of my A1C, need for occasional talk therapy post-divorce, arthritis in my hand, and vision/dental needs. But given all things at this point, I really wish I had saved that $6,000 during 2021. Unfortunately, that simple error for Pennie users (to understand the questions/implications/correct response) came at a high price tag in my case.

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Screenshot below (in case this video were to ever be removed from YouTube):