Facebook Twitter



Michelle Hofeling didn't have health insurance on the day she faced a medical crisis.

But this isn't a story about people who are uninsured or the state's plans for health-care reform.It's the story of one woman's battle to hold government agencies accountable for their actions. And it's the story of that woman's thus-far fruitless search for someone - anyone - who will take responsibility.

She wasn't sure where to turn for help, so she went to a health department office, where she was examined and staff wanted to call an ambulance to take her to the hospital.

She had heard how much an ambulance ride costs, so she got a friend to take her to the hospital. There, they ran tests, found nothing, gave her a painkiller and sent her home to wait for a several-hundred-dollar bill for medical treatment.

She is slowly paying off that debt. It took extraordinary measures, but she and the hospital finally arrived at a monthly payment figure she can meet - for years to come.

The story might have ended there, but she had tried to get some help with the crisis. And she's now engaged in a back-and-forth letter war - albeit a civil one.

The experience has left her with a lot of questions that have never been answered. She shared it with the media in the hopes that others will at least have a different and easier experience.

Hofeling applied for retroactive medical assistance through Medicaid. At the time of application, she was asked to provide proof of income and other documentation.

She gathered the material together and took it into the application office, where she left it with a secretary, since her eligibility worker was unavailable.

She talked to him after that and was never told that her application had been denied. Only later did she learn, rather inadvertently, that she had been turned down, ostensibly because she'd failed to provide the information requested. She didn't receive the usual written notice that her application was denied. To her regret, she didn't get a receipt for the material she turned in.

That might have ended it, but she appealed. She couldn't, she said, understand how she could be turned down for not providing information she hand delivered.

An odd thing happened during her appeal, she said. The hearing officer called it a "finding of fact" that she didn't receive notification of the denial of her application. Then he denied her appeal because she hadn't filed it within the allotted time after the denial of which she was not informed.

She started writing letters in search of an explanation of the whole chain of events. She's still writing them, but getting no satisfaction.

She's written to officials at several levels, from state to federal government. She contacted her congressman.

A funny thing happened in the correspondence, too.

A July 7 response from Rozann Abato, acting director of the Medicaid Bureau in Maryland, said: "I am sorry I cannot be of assistance to you in the matter you wrote about. This is an issue which comes under the jurisdiction of the state and is not subject to federal authority."

So she wrote to the state. And guess what? A letter from the Office of Family Support informed her that the state isn't responsible: "Our policy," it said, "is governed by federal regulations."

What that means seems to be what many people have long - and only somewhat jokingly - suspected. No one in government is responsible. By their own admission.

At this point, Hofeling and her husband, Keven, are less concerned about getting help to pay the medical bill than they are with holding the government and its representatives accountable for their actions.

The Hofelings wonder why no one in the bureaucracy could offer more than meaningless platitudes and "thanks" for the information, which may help serve others better.

At least, Michelle Hofeling says, the government agencies could communicate with each other and get their stories straight.

She wants answers, but they seem unlikely. Answers "not only for myself, but for your other clients and the taxpayers of Utah as well."