A call center helps Americans access Obamacare. They struggle to afford their own insurance.

 

"It's a hard pill to swallow," a frustrated Maximus call center worker said.

It has been, in the words of one unhappy Mississippi call center worker, “a hard pill to swallow.”

Every day Lanycha Hall, who works for the federal contractor Maximus at its facility in Hattiesburg, helps people enroll in Affordable Care Act health insurance plans.

But Hall said she can’t afford her own company-sponsored health insurance.

“When I realized I couldn’t afford that because my deductible was so high, I just had to take a day off because I just couldn’t focus on helping everyone while I couldn’t afford my own medicine,” she said.

Hall’s co-worker Sherry Collier said they “work for a vendor who is offering help to the general public, but we, as employees, can’t get the affordable insurance we need.”

“I’m helping people making under $25,000, and I’m making under $25,000,” Collier said. “Their co-payments are like $25, and their premiums per month may be zero dollars, and I’m paying $4,500 for a premium per year. How can that be? That’s just totally ridiculous.”

Maximus call center worker Trinity Davis said she loves helping people enroll in Obamacare, but her days at the company may be numbered if the health care costs don’t go down. She said she already moonlights as a food delivery driver to keep herself afloat. She said she is seriously considering going back to her awful old job because the benefits were better.

“I slung chicken for about four years,” Davis said, using slang to describe working in a chicken processing plant. “And I don’t know if any of you guys have done that type of work, that is a miserable job. It’s a hostile work environment.”

Anger over high-cost health insurance, coupled with other long-standing workplace issues, has helped fuel the ongoing drive by the Communication Workers of America to unionize call center workers like those employed at the Maximus facility in Hattiesburg.

Three-quarters of these workers are women and between 45 and 55 percent of the total workforce are parents, the CWA says.

Last year, Maximus was accused by a whistleblower of endangering call center workers in Hattiesburg by failing to follow federal Centers for Disease Control and Prevention rules by making them work in crowded conditions.

Part of the job is to provide callers with CDC guidance information on how to stay safe during a pandemic by wearing masks and social distancing.

In the end, Maximus employees who were worried about working in crowded conditions were allowed to work from home and were provided with the equipment to do so.

Maximus call center workers “have helped millions of Americans access affordable health care,” Sanchioni Butler of the Mississippi AFL-CIO said in a video prepared by the CWA. “They are struggling to afford their own. Let that sink in for a minute.”

In response, a Maximus spokeswoman said that when the company took over the call center in 2018, it inherited an expensive health insurance contract that expired in December and has been replaced by a much cheaper plan.

"Employees can choose between a plan that has a $1,500 annual deductible with an employee contribution of $75 per paycheck," Eileen Rivera said in an email. "We also offer another plan that has no monthly premium and has a $4,500 deductible."

Rivera also denied that Maximus doubled the deductible while in the midst of the pandemic.

"The fact is, and contrary to these assertions, Maximus actually lowered the annual deductible from $2,500 under the previous inherited plan to $1,500," Rivera said.

The amounts cited by Rivera are for individuals, not for families, according the Maximus benefits guide for 2022 viewed by NBC News.

There are two plan options: the core plan and the buy-up plan. One has a lower deductible but higher employee contributions. The core plan has a $4,500 deductible for individuals, but that amount doubles to $9,000 for families. Once that’s met, employees are on the hook for 30 percent of additional costs until they meet the “annual out-of-pocket maximum” of $12,000. Under the other plan, the individual deductible is $1,500 and $3,000 for families.

“Once you reach the out-of-pocket maximum, the plan will pay for 100% of your health care services for the rest of the year,” the plan stated.

Biweekly payroll deductions for families under the core plan are $574.77, and they are $791.13 for the buy-up plan.

Just one of the Maximus call center workers interviewed by NBC News is enrolled in an individual plan, and all three have chronic health issues that make having affordable insurance a must.

Collier, who is a married 58-year-old mother of two grown children, has diabetes. Hall is 48, married with three children and legally blind.

Davis, 43, is not married and has no children. But she is diabetic and said the cost of her prescriptions, under the Maximus plan, skyrocketed in recent years from $30 to $400 a month, and she makes just $11 an hour.

Maximus, in a directive to workers in the plan overview, also made clear that employees have essentially no choice but to sign up for its health insurance.

“You will only be able to opt out of medical coverage if you have acceptable medical coverage from another source or person, such as your spouse,” it said.

Collier said one of the side effects of her diabetes is leg pain, for which her doctor sent her to a specialist. That co-pay was $125, she said.

“I got sent for an X-ray, and that was an extra $325,” she said. “I just got two bills. I can’t afford to pay them, but I can’t afford to not go to the doctor.”

Being on Maximus’ insurance has forced Collier to consider other, unproven options to lower her blood sugar level, she said.

“I’m looking into maybe self-medicating with apple cider vinegar,” Collier said.

The jury is still out on whether apple cider vinegar actually helps people with diabetes.

Hall, who has been working for the company since 2018, became eligible for Medicare in 2020. She said she gets an injection in her right eye every 30 days that costs $1,500.

Under Medicare, Hall said she’d be able to afford it. But under the Maximus plan, any worker who is on Medicare or Medicaid has to give it up and enroll in the company plan.

Hall said she was warned that she would be “double-dipping” if she went with Medicare or tried to enroll her own family in a plan through the Affordable Care Act marketplace.

“That is ridiculous,” Hall said. “With my income, I would have to pay little to no premium or get on Medicaid because my wages are considered below poverty level. I certainly cannot afford family coverage through Maximus.”

Hall said she spoke to her supervisors and the company’s human resources representative about her predicament last year.

“With no help. I emailed Bruce Caswell asking for help,” she said.

Caswell is the company president.

“Mr. Caswell responded by apologizing and connecting me with the person who does the negotiations for Maximus insurance,” Hall said. “She told me there was nothing she could do to help me at the current time but that she would be mindful of my concerns for the upcoming 2021 year.”

Caswell could not be reached for comment, but Rivera confirmed that Hall emailed him and that a member of the company's human resources team called Hall on July 13, 2020 and "spent some time walking her through the benefits."

Karen Pollitz, a senior fellow at the Kaiser Family Foundation and an expert on health reform and private insurance, declined to comment specifically about the insurance that Maximus offers its employees.

But in an email, Pollitz said under the current rules, people who are offered a company plan are not eligible for ACA subsidies unless their insurance is unaffordable or inadequate.

“A $4,000 deductible does not render a policy inadequate under the ACA rules,” Pollitz wrote. “If the plan’s out-of-pocket maximum is $8,700-a-year or less (twice that for a family policy), and if the policy covers hospitalization and medical visits, then it passes the minimum value test.”

That said, “under these thresholds, it is definitely possible that workers at Maximus or other employers could, by the numbers, get a better deal through a subsidized ACA marketplace plan,” Pollitz wrote. “But for now, that ‘firewall’ blocks their eligibility for ACA marketplace subsidies.”

Under President Joe Biden’s proposed Build Back Better plan, there is a provision that would slightly reduce the cost for workers enrolled in company-sponsored plans, but it would not eliminate the firewall, Pollitz said.

“I love my job. I love doing what I do. I love being able to help the beneficiaries,” Davis said. But she said the insurance Maximus provides the workers who help people enroll in ACA plans is “a slap in the face.”