Federal workers areworried about paperwork delays, and the financial and medicaleffects a prolonged shutdown could cause. (Photo:Shutterstock)

Joseph Daskalakis' son was born New Year's Eve, a little over aweek into the current government shutdown, and about 10 weeks beforehe was expected.

Little Oliver ended up in a specialized neonatal intensive careunit, the only one that could care for him near their home inLakeville, Minn.

But air traffic controller Daskalakis, 33, has an additionalworry: The hospital where the newborn is being treated is not partof his current insurer's network and the partialgovernment shutdown prevents him from filing the paperworknecessary to switch insurers, as he would otherwise be allowed todo. He could be on the hook for a hefty bill — while not receiving pay.Daskalakis is just one example of federal employees for whom beingunable to make changes to their health plans really matters.

Related: How the shutdown affects healthprograms

Although the estimated 800,000 government workers affected bythe shutdown won't lose their health insurance, an unknown number are inlimbo, like Daskalakis, unable to change insurers because ofunforeseen circumstances; add family members such as spouses,newborns or adopted children to an existing health plan; or dealwith other issues that might arise.

“With 800,000 employees out there, I imagine that this is not aone-off event,” said Dan Blair, who served as both acting directorand deputy director of the federal Office of Personnel Management(OPM) during the early 2000s and is now senior counselor at theBipartisan Policy Center. “The longer this goes on, the more wewill see these types of occurrences.”

While Oliver is getting stronger every day — he's now out of theICU, according to Daskalakis' local air traffic unionrepresentative — it's unclear how the situation will affect hisfamily's finances.

That's because out-of-network charges are generally far higherthan being in-network, and NICU care is enormously expensive nomatter what. Those bills could add up, especially as his currentinsurance has an out-of-pocket maximum of $12,000 annually. BecauseOliver was born before the new year, the family could face thatamount for 2018 — and 2019.

Daskalakis isn't getting paid, either.

“I don't know when I'll be able to change my insurance, or whenI'll get paid again,” Daskalakis wrote Sen. Tina Smith (D-Minn.),who shared his letter on Facebook and before the Senate lastweek.

Other families are also worried about paperwork delays, and thefinancial and medical effects a prolonged shutdown could cause.

Dania Palanker, a health policy researcher at Georgetown'sCenter on Health Insurance Reforms, studies what happens whenfamilies face insurance difficulties. Now she's also living it.

After arranging to reduce her work hours because of healthproblems, Palanker knew her family would not qualify for coveragethrough her university job. No problem, she thought, as she beganthe process in December to enroll her family into coverage offeredby her husband's job with the federal government.

“We could not get the paperwork in time to apply for specialenrollment through the government and get it processed before theshutdown,” Palanker said.

Georgetown allowed her to boost her work hours this month tokeep the family insured through January, but Georgetown's share ofher coverage will end in February.

Her treatments are expensive, so she is likely to hit or exceedher annual $2,000 deductible in January — then start over withanother annual deductible once the family secures new coverage.

“I'm postponing treatment in hopes that it is just a month andI'm back on the federal plan in February, but I can't postponeindefinitely, as my condition will get worse,” said Palanker, whohas an autoimmune disease that causes nerve damage.

Overseeing federal health benefits programs is within thepurview of the OPM, whose data hub is operational, according to aspokeswoman. But getting information to that data hub to make thekind of changes Daskalakis, Palanker and others need depends on theindividual agencies that employ government workers.

The OPM has told government agencies “that they should have HRstaff available during the lapse, specifically to process” suchrequests, which are called “qualifying life events,” thespokeswoman said.

Workers enrolled in plansunder the Blue Cross Blue Shield Association, which covers about 5million federal workers and retirees in the Federal EmployeesHealth Benefits Program, can make qualifying life event changesdirectly with the insurer if they can't get it processed by theirworkplace, an association spokesman said on Friday.

In a written statement Wednesday, Smith said: “Oliver's story isa powerful reminder that hundreds of thousands of real familieshave had their financial and personal lives turned upside down bythis unnecessary shutdown.” She called on the president to comeback to the negotiating table.

For Daskalakis, there is some good news.

Tony Walsh, his union rep, said the OPM website and Daskalakis'insurer both indicated that the air traffic controller's request tochange carriers so the hospital will be in-network will beretroactive to Oliver's birthday, and the out-of-network chargesmay not play a role.

Just to be safe, “Joe is currently working on an insuranceappeal based on no in-network care [being available],” Walsh saidin an emailed statement. The family has already received an initial$6,000 bill from the hospital, Walsh noted, saying the charges donot include costs associated with Oliver's birth or his stay in theintensive care unit.

Walsh said the shutdown is affecting a broad swath of employeesin ways many lawmakers had never anticipated.

The workers “are essential to the system, and it's unfair theyare being treated this way,” he said.

Kaiser Health News isa nonprofit news service covering health issues. It is aneditorially independent program of the Kaiser Family Foundation,which is not affiliated with Kaiser Permanente.

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