This is my Obamacare story: What’s yours?

Posted: June 24, 2015 in Affordable Care Act, Obamacare
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There are probably a million health care stories similar to mine. I wish the Supreme Court could hear them all before it rules on whether federal subsidies for the Affordable Care Act are legal. But when the ruling comes out in the next few days I’m sure it will have been made without regard to personal stories such as mine.

A couple of weeks ago I paid off the physician’s bill for a trip to a Kansas emergency room in 2012. I am still paying the hospital emergency room bill from that trip and should have it paid off in a couple of years. I didn’t have health insurance at that time even though I had recently started a full-time job so I felt the full weight of both the ambulance and emergency room bills totaling around $5,000.

I didn’t choose to go to the emergency room, but I passed out at work and I wasn’t in any shape to disagree with my supervisor’s decision to call an ambulance to take me there. Now I know in the scheme of things $5,000 for an emergency room visit may not seem like all that much money to some, but I was coming off of five years of forced unemployment and my then-current job would pay less than $12,000 a year. I already had a stack of credit card bills, much of that debt having to do with medical co-payments, deductibles, dental and starting over after serious illness and divorce bills. I had and have a sizeable student loan.

I had recently started a job and it would be a while before I would be eligible for health insurance. So the first job I had been able to find in five years would eventually provide health insurance at a very reasonable cost but not in time to keep me from going further into debt.

Make no mistake about it. The Catholic hospital I was taken to did not care that my wages were near poverty levels and it had no intention of eating or negotiating on the costs. The charitable hospital’s answer for my financial straits was for me to give them money from the $8,000 in savings I had brought with me to live for a year or, in the alternative, raid my retirement account to pay the bill.

The Sisters of Charity said we don’t care if you can’t eat tomorrow, we need to be paid today. We don’t care if the few dollars you have in the bank won’t even make up for the fact that you aren’t earning enough money to pay the rent and feed yourself for the next year. We don’t care that you’d have to pay a penalty to take money from your retirement account to pay us because you’re not old enough to retire.

Yes, I could have done that. Spent my savings and not had enough money to live on for the rest of the year, which as it turns out $8,000 didn’t come close to providing even with my job. Yes, I could have taken the hit on my retirement account and lived with the anxiety that comes from tapping into my future. I don’t know how many years I have left but I do know I have a limited number of dollars with which to live them. We eventually worked out a payment plan.

Still I know I am in better shape than many. Unlike many, due to a divorce settlement I have a retirement account. Will it be enough to take me through my golden years? I don’t know but it likely won’t be if I have to use it to survive today, which brings me back to Obamacare.

I have long been subject to the vagaries of the health care system as I have several pre-existing conditions. In 2007 I was diagnosed with and successfully treated for cancer. Coming off cancer surgery it was critical that I have access to oncologists, as well as other specialists and a primary care physician for my myriad health issues.

In 2008 I moved from Texas to Massachusetts. I didn’t have a job. I couldn’t find a job. I was only able to put together less than $10,000 in income my first year there and not much more the years I lived there. Fortunately, I had a sister who gave me a place to live and I had access to affordable health care because I had moved to the state that was the model for Obamacare.

By 2012, when it became apparent that I was not going to find a job in Massachusetts,  and I began considering moving and applying for jobs elsewhere, obtaining healthcare was an issue, but it was nowhere near the issue it was when I was considering my options in 2008 and certainly not the issue it was back in 2005 when I owned by own law practice and wanted to provide health insurance for my employees. The difference was that by 2012 the Affordable Care Act, otherwise known as Obamacare, had been enacted, so I could be assured of finding healthcare even if I moved to a state that had rejected the law’s implementation. Federal subsidies put insurance premiums that were once outside of my reach within the realm of possibility. Federal law also assured the coverage I needed couldn’t be denied because of pre-existing conditions and I could stop fearing the cancer would come back and I’d max out my coverage.

So I moved to Kansas, a hardcore Republican state and a state that does not have a state-run healthcare exchange. I lived on my savings, without health insurance, playing the odds. I paid cash for my doctor’s visits and prescriptions, which meant I skimped on my lifesaving medications some of which cost hundreds of dollars. I filled only half of my refills at a time and took my blood pressure, migraine and other pills only every other day.

I was finally lucky enough to find a job, albeit a poorly paid one, within a couple of weeks of moving there but I wasn’t making enough money to pay for housing, food, transportation and my medical and other expenses in the long term. I found I had to spend the rest of my savings within four months of moving there just to maintain a minimum level of existence.

Over the next two years I applied for positions that would have brought in more money but nothing panned out, so when I got the opportunity to move to Texas to be near my family I took it, even though it meant I would be giving up the great health insurance deal I had. I had no job prospects. I’d gotten no takers on the applications and resumes I’d sent to Texas but the point is I could move to Texas because I knew I’d be able to purchase health insurance even though, just like Kansas, the state government there did not set up a healthcare exchange. But I knew Federal subsidies were available that could help me offset the cost. So, while I was about to go from paying less than $30 a month to several hundred dollars the important point is that I could have the insurance I needed even though I had no job or prospects.

So I moved to red-state Texas. Pieced together a bit of income and, reluctantly, began drawing from my retirement income to make up the difference of what I need to live. I purchased healthcare insurance through the insurance exchange.

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-Photo by Chris Potter/ Without Obamacare I would struggle to pay for the numerous medications I need to survive.

I’d prefer a PPO but found an HMO with no deductible, a reasonable yearly maximum and manageable premiums…with the Federal government subsidy. That first year my premium was $606 and my payment was $386. That was in December. I have had no trouble finding competent, caring doctors and have had no super long waits to get in to see an internist or specialist. Most of my medications are covered and the insurance company worked with me on the one it didn’t want to initially cover. I’ve seen no death panels.

One of my only complaints is that my premium went up with the new year and my subsidy went down, presumably because my income went up. It’s a huge balancing act for me. My healthcare subsidy is based in large part on how much money I take from my retirement account. How much money I take from my retirement account is based on how much money I think I will need for my health care premium, copays, medications and taxes.

In January my premium amount jumped to $740.  My subsidy went down to $330. I thought briefly about changing insurance companies. I wasn’t happy that my plan premium went up so quickly, but in the scheme of things I’m still better off than I ever was before Obamacare so I’ll live with the increase. It’s still a decent plan as long as I get help with the premium and the premium doesn’t keep going up. And if later I decide I don’t like the rates or I don’t continue to like the plan there are plenty of other plans from which to choose next enrollment period.

Any problem I have with the ACA at this point is miniscule compared with the problems I would have if I didn’t have the subsidy or if I didn’t have insurance at all. Take away either the subsidy or the Act itself and I’d be in more than a little bit of trouble.

Opponents of the Act don’t think about the many ways they’ve benefitted from it. I think about it almost daily because it’s been both a life and budget saver for me.

Before the Affordable Care Act I worried that I would become uninsurable because of pre-existing conditions, even if I could afford insurance. No longer can insurance companies tell me you’ve cost us too much money and we’ve spent all we are going to on you. Too bad, go off somewhere and die.

Many procedures that once added to my costs are now free to me. I no longer have to pay for my annual physical exam. That call from my gynecologist’s office last Friday when she told me my cancer is still gone, didn’t cost me a cent because under Obamacare annual pap smears are free to patients. Yesterday’s letter from the radiologist telling me that I have no signs of breast cancer…also free.  I’m counting every penny, so these things mean a lot to me.

I would love to not have to rely on the federal government for health care subsidies. I would prefer to be working a full-time job that provided health insurance but that didn’t work out for me. I’d prefer we have universal healthcare but we have what we have and I’m grateful.

This is my Obamacare story.

Rep. Paul Ryan told Fox News that Republicans want to give people like me “freedom” from Obamacare. I have a message for Mr. Ryan and the rest of his Republican cohorts in Congress and in every state that refuses to implement the Affordable Care Act. I want the US Supreme Court to hear as well. I don’t want your idea of freedom. I want life. Stop trying to take it away from me.


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