In response to today’s ruling by the US Supreme Court regarding the constitutionality of the Affordable Care Act, I am posting the same blog on both my medical/health website: themedicalmysterytour.com and my political website: progressiveviewfromthemiddle.com. Today’s ruling encompasses components of both health and politics, and I have a personal stake in today’s outcome.
Those who know me on a personal level know two things about me. They know that I left my job of 18 years at a not for profit almost two years ago to be at home with my husband who is disabled, and most recently diagnosed with stage 4 bladder cancer; and they know I have Rheumatoid Arthritis. I had coverage for my own health care needs at my job, and before leaving that job to be at home full time with my husband, I investigated whether or not I had options for health insurance once my COBRA benefits ceased. Through my university alumni association there was a group plan I was eligible for, and they did not deny based on my diagnosis of RA. For me, having health insurance was a necessity, and the determining factor on whether I could leave my job to be at home.
Before my benefits expired, I began the application process for my new coverage. I received my letter saying I was accepted, and I thought it was a done deal. And it was until I received the letter about my deductible…or maybe I should say my OTHER deductible. In addition to the standard deduction on the plan this company was going to charge me a $65,000 deductible, per year, for anything related to the Rheumatoid Arthritis diagnosis. They weren’t going to deny coverage; they were just going to make it prohibitive for me to use it for what I needed it for to remain independent and healthy.
I feel compelled to let those of you who don’t know me know my attitude toward health and personal responsibility. I have been a vegetarian for 34 years, I have never smoked cigarettes, and I rarely ever drink. My blood sugars and pressure are low, and my cholesterol is within normal ranges. My weight is 126 pounds, and I’m 5’5”. I have always taken personal responsibility for my own body, and have a primary care physician and rheumatologist who work with me to allow me the final decision. I never take a prescription drug as my first choice for treatment, and they allow me that discretion. Even before my husband’s health began the 12 year assault on him that prompted me to leave my job, I have always taken my health seriously, and never for granted.
I know that I have a disease that currently has no cure, and can eventually kill. But all of my life I’ve tried to take care of myself and that seemed to be fulfilling my end of the bargain as a health insurance customer. They looked at it differently. They changed the rules in the middle of the game, and gave me no options.
I contacted my state department on insurance, and they verified for me that with a pre-existing condition I was at the mercy of these companies. The high risk plan the state has available has about a $1500 per month premium, so that wasn’t even a consideration. They confirmed I didn’t have any other options for coverage other than the federal plan accepting the pre-existing conditions. To be eligible for that plan, I had to go without any coverage for six months before I could apply. I’ve tried my entire life to have health insurance, even when it wasn’t offered at my workplace. To have been responsible all of my life and then denied because they could, was an insult.
To make matters worse, had the Supreme Court ruled against the Affordable Care Act today and struck it all down, I would have been unable to get insurance of any kind. Most companies these days do not want customers who have had lapses in coverage. You can change from one plan to another, but if you do as I’m doing and go without, then they can choose not to accept you. The one company I could find was willing to take me because my coverage was transferring. Now that advantage is gone.
Today’s ruling did more than just elicit a sigh of relief from me regarding my future healthcare needs. I was surprised at how emotional I was, and found tears streaming down my face. It took me a few minutes to fully appreciate the other overwhelming outcome of today’s announcement. It served to restore my faith, just a bit, that it is possible for the right thing to be done for the right reasons by a major institution that had previously lost the confidence of the American public. With so many of our foundations suffering cracks like an ineffectual Congress, or Wall Street, or the Catholic Church, or even Penn State failing to recognize and do the right thing, too many Americans were becoming disillusioned and disenfranchised. The Supreme Court was probably cognizant of its own disapproval due to its ruling on Citizens United, and wanted to ensure the right decision was handed down. I believe they did make the right decision.
If you’re fortunate enough to have health insurance that meets the needs of you and your family, then you need to know nothing about today changes that. But for those of us needing a miracle, we got one, and the future of this great nation will be altered forever as a result. People will no longer be bankrupted due to medical events, and individuals will have the power and ability to choose the company, rather than hold their breath in hoping the company will cover them.
You don’t have to like today’s decision, but you need to understand its importance. It says people matter. And I happen to agree wholeheartedly with that.