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Affordable Care Act Not Working For North Texas Man

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(credit: KTVT/KTXA) Steve Pickett
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DALLAS (CBSDFW.COM) - There are two and a half weeks left before all Americans must have health insurance or face a fine.

Fewer than 300-thousand Texans have signed up for healthcare in the federally-subsidized marketplace. For those who have, not everything went exactly as planned.

One North Texas man says he signed up for coverage and has been paying his premiums, but the private company he signed up with is not providing him the coverage he needs.

Former pastor Lawrence Harrison has been unemployed for 18 months. He dabbles in landscaping to make a living and lives with several medical issues.

“I’ve already had surgery on my neck because of degenerative arthritis. I have a rod in my neck,” he explained.

Harrison lived without medical coverage until the Affordable Care Act was initiated. He said he was excited when Healthcare.gov was established, because it meant he could get insurance coverage.

The Rowlett resident says he used Healthcare.gov to sign up for health insurance in October.

“I accidentally signed up for the HMO, cancelled it the same day, and signed up for the PPO, so I could go to the doctors I’ve been seeing for the last 11 years.”

Harrison chose Blue Cross Blue Shield of Texas, but claims the company is not covering his care, even though he’s paying his bill.  When it was time to see his doctors, the coverage didn’t match.  For 60 days, Harrison fought to access the health coverage he signed up for under the Affordable Care Act exchange.

“I’m still paying premiums. If I stop, they’ll cancel my coverage, even though I’m not getting what I’m covered for.”

Due to privacy laws, a Blue Cross Blue Shield spokesperson declined to discuss the specifics of Harrison’s coverage complaints, but acknowledged the surge of medical coverage sign-ups has created challenges for the insurance provider.

The company released a statement today that reads in part, “We regret any delays our members have experienced in reaching our customer service team.”

Two days after CBS 11’s initial meeting with Harrison, Blue Cross officials confirmed the coverage Harrison wants and has been paying for.

“I am finally enrolled in the program that I signed up for,” said Harrison.

“If I’m experiencing this, how many other people are in the same exact position, and why does it take an investigation by the news station to get something like this done?” he asked.

Blue Cross Blue Shield has also agreed to reimburse Harrison for his out of pocket medical expenses that should’ve been covered under the insurance he’s been paying for.

(©2014 CBS Local Media, a division of CBS Radio Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)

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