Too much and too little: part I

I have a collection, not of coins or stamps or action figures still in the original packaging, thank heavens. My collection is one of ironies and absurdities, stories that often begin mundanely—then curl in a way you couldn’t have predicted. My favorites then keep curling, maybe bursting out to twist around a new axis, ultimately evolving into strange involute objects you can’t help but marvel at. Maybe I collect them in part because I hope I’ll use one or two someday in something I write. Are they all true, these stories? Most of them come from things I read, but part of what makes the stories appeal to me to begin with is that regardless of whether they are true per se, they ring of truth. Perhaps they didn’t happen exactly as related—maybe they didn’t happen at all—but those involute corners, the strangenesses are of a type that make you say “ah, look: this is precisely how the world operates. This is too real not to be true!”

Many of the stories in my collection come from others, but I’ve come across one recently from my own life that, due to the magnitude of its irony, has left me truly in awe. The setting: I have a job I started in October. It is, by any reasonable measure, not a great job. It’s what’s called an LTE position, Limited-Term Employment, meaning I’m capped at working 1,039 hours a year. That might seem like a strange number, but as far as I can work out, anyone employed for 1,040 hours or more a year must be offered benefits like health insurance, retirement plan contributions, paid time off, etc. As an LTE, however, you just manage to dodge all those bothersome benefits. The pay is also worse for an LTE, with the result that the other people doing the same work as me receive more money every paycheck as well more in-kind pay in the form of health insurance and so forth. That’s frustrating, but heck, so is a lot in our modern, post-barbaric society. The real trouble has come up thanks to this troublesome thing having a job leads to: income.

I’ve been covered by state insurance for a few years as I attempt a career change from scientist to writer/artist. Neither writers nor artists are typically overburdened by income, so I qualified for my state’s version of Medicaid or subsidized health insurance. However, I received an email on the evening of December 19th informing me that the pay from my job put me over the Medicaid income cap, and I’d be uninsured come January 1st. An astute observer might notice there aren’t many days between December 19th and January 1st. Twelve, in fact. And an even more observant person might recognize that a few of these days are holidays. Also, weekends exist. Altogether, I had six business days to figure something out, four if I needed to work with any state-level agencies because Christmas Eve and New Year’s Eve are state holidays here. I take two medications every morning just to feel like a human and not an empty suit of skin wandering lifeless streets. I meet with a therapist once a week and a psychiatrist every couple months. I’d guess each of those appointments would cost me several hundred dollars without insurance—if I could even continue to get appointments. Between medications and appointments, I could well be paying thousands of dollars a month if I couldn’t figure something out. Four to six business days isn’t a long time to extricate yourself from a bureaucratic predicament.

But that’s actually just the beginning, the point where the story takes a wonderful turn and the good part truly begins. I called the Medicaid office, where a lovely annoyed lady told me that sure, the fact my job is temporary might mean my income would be under the annual cap for Medicaid, and sure, all the documentation they ask for (tax returns, etc.) is used to verify annual income, but—and this was enunciated clearly and slowly—my monthly income exceeded the monthly cap. I was ineligible. I checked to make sure I understood her correctly:

“So as long as I have this job, I can’t get Medicaid because my income’s too high?”

“Yes.”

“But if you calculate my income for the year, it’s not too high?”

“Correct.”

“It’s only too high for the months I’m working?”

“Yes.”

A possibility occurred to me then, one too stupid to conceivably be viable:

“What if I quit my job? Then I’d have no monthly income. Would I be eligible again?”

“Yes.”

“Huh,” I said.

“Huh?”

“Yeah. Huh.”

So the problem has a simple solution: as long as I reduce my income, preferably to zero, I’m fine. Never mind the fact that while I work, I’m contributing more, more in taxes, more to Social Security, more to the community. I’m contributing more to the Great American System. I suddenly have a peculiar financial incentive to not work.

I didn’t bother the nice irascible lady with any of my silly logic. I thanked her, hung up, and stared for a while at a dark corner of the living room ceiling because I couldn’t quite figure out what to do next.

Brian the LTE, I’d learned, is simply too well off to get insurance.

A few days passed, including some of those holidays that happen this time of year. Between spending time with friends and serving as a substrate for the cat, who gets cuddly in cold weather, I made calls, left messages, searched online, made more calls, and so on. I finally submitted an application to the health insurance marketplace, which had come to seem the best solution. I estimated my annual income for 2025 based on guesses about this job. One nice thing about the insurance marketplace: you immediately get a letter telling you what financial assistance you might be eligible for and how to go about narrowing your search for insurance plans. I opened that letter in my email. I read it twice to make sure I hadn’t been mistaken. My estimated annual income was too low, the letter told me, to be eligible for any financial assistance. Too low. I read that part a few more times. It didn’t change.

So Brian the LTE, who is too well off for state insurance, doesn’t make enough to qualify for any financial assistance. He has to pay full price for a regular policy—or stop working, and get insurance for free.

That’s the first twist in the story, which by itself makes this one worthy of my collection. But we still have more to go. Recall I was informed I was ineligible for state insurance on December 19th. The official cutoff to enroll in marketplace insurance plans that would begin January 1st (the date my existing insurance would now end) was December 15th. That same astute observer from earlier might, after a moment’s consideration, realize that December 19th is after December 15th. I found out I was ineligible for January insurance after the cutoff to buy other insurance for January. I was, for the first month of the year, quite elegantly screwed. But, as the wonderful irascible lady on the phone told me, if I did happen to leave my job and reapply for state insurance anytime in January (and my application was approved), I would receive insurance backdated to the beginning of the month. So even better: the only way to get any health insurance for January was to quit my job. Stop working, and my problems would solve themselves.

And now the final twist: I called the phone number for the federal insurance marketplace without any real hope they’d be able to help me. I explained my situation to a tired-sounding man.

“You didn’t know?” he said. I admitted I didn’t know whatever he meant. “Oh, man. So the deadline for January enrollment was actually postponed this year. There were so many people calling about insurance, the deadline was moved back—to December 19th. If you’d called the day you found out—that’s why we tell people to notify us immediately of any changes to their circumstances.”

We talked a little longer before agreeing that yeah, because I hadn’t called immediately on December 19th, I was, come January 1st, quite elegantly screwed.

This is, truly, a story to put behind glass as part of my personal collection, but despite how remarkable, how utterly awe-inspiring it may be in its irony and absurdity, it is ultimately tiny compared to many other stories about the flesh-hungry system of American healthcare and health insurance. I am fine—I will be fine. My mental health group has a fund designed to cover situations exactly like this. They’ll cover me for January. I’ll pay for my medications but nothing more. I’m astoundingly lucky compared to so many other people whose lives have been methodically ground to dust by a system too absurd yet too entrenched to realize its own absurdity. I’ve found myself quite elegantly screwed and yet I am, at the same time, exceptionally fortunate.