Three years ago, she nearly died because of an extraordinarily rare lung disease caused by, of all things, a freak reaction to birds. Yes, birds. Flash forward several months after the diagnosis and there was my mother, who never smoked a cigarette a day in her life, missing half a lung and on 24/7 oxygen.
Life isn't always fair, you know.
But she's one of the very lucky ones. As it turns out, her form of the illness meant she would eventually get better. And get better she did, after a year's long grueling rehab program, to the point where she didn't need all of that oxygen and could almost get back to the way things were.
When a medical diagnosis or emergency happens in life, it's doubly tragic. Not only do you ask "why" ("why did this happen to me?") but you're forced to ask "how" ("how am a I going to pay for all of this?"). Anyone who's been through a health crisis knows the answer: you don't care about money right away. The only thing that matters is surviving, cost be damned. "Fix me, whatever it takes."
The costs, however, aren't damned away into non-existence. Scroll below the fold for the full story.
MY PARENTS' CRAPPY, NO-GOOD, MAY-AS-WELL-NOT-HAVE-INSURANCE PLAN
My parents are too young for Medicare, too rich for Medicaid, and right at the age when one develops conditions that must be "managed" and not just cured with a week's worth of antibiotics. When my mother was in the ICU, they gave her steroids to save her life, leaving her with steroids-induced diabetes. My dad, a mechanic who's worked 12+ hours a day since he was a teenager, has high blood pressure. Their conditions are the usual suspects for the 60s set.
My parents were never politically active before. As immigrants, they voted but didn't really follow the ins and out of the process. That changed as I became more politically involved. When my mother voted for Barack Obama (this was before she got sick), she said she was voting for him mainly because of his health insurance ideas. "He better keep his promise. If he doesn't," she told me, "I want you to write him a letter."
I've typed up many a complaint letter for my mom. Trust me, you don't want to be on the receiving end of one of her letters.
Health care reform was the issue for my parents in the voting booth. They were, after all, spending most of their income on health insurance and health care costs.
To say my parents' health insurance before Obamacare was a ripoff would be like saying that the universe is kind of large and filled with some stars.
Their premium is $710 a month. Their deductible is $10,000 a year. Their medications are expensive. As a result, they've forgone a lot of preventative care and generally avoid doctor's visits. Here's the breakdown:
$8,520 - premiums
$10,000 - deductible
$18,520 out of pocket, not including coinsurance.
That's an obscenity that has no place in a modern, civilized society.
As their premiums have increased year after year, they've tried to shop around for better rates. Almost no one else would take them. If a company was open to taking on a couple with so many pre-existing conditions, it took advantage of the situation and quoted them prices that would have required them both to work two jobs. Ridiculous, to say the least.
Of course, I've tried to defray their costs over the years, as have my sisters. But my parents are very, very proud and refused to accept help, choosing instead to do what millions around the country have been forced to do: build a family budget around the costs of health insurance and hope that they don't get sick(er).
TRYING TO GET ENROLLED UNDER THE ACA: THE GOOD, THE BAD, AND THE VERY, VERY UGLY
As a digital strategist, I've produced more than enough websites to know how the launch process works. It's complicated, glitchy and no matter how well you test beforehand, something always goes wrong.
I was on healthcare.gov right when it officially launched around midnight, even tweeting out a picture of the site when it quietly went live.
I tried creating an account and hit the security question wall and couldn't get past it. I knew that glitches are part and parcel of any site launch. Time to wait it out.
Hours of glitches turned into days of defects, which turned into weeks of malfunction. I must have tried logging in/working the application dozens of times (no exaggeration). I'm no tech dummie, so I kept trying across browsers, clearing my cache/cookies, etc.
I finally managed to get my mother into the application phase, but her identity could not be proofed. I uploaded her ID and waited. After a week or so, I called the Marketplace again.
I will say this for the call desk workers at the Marketplace: generally, they could not have been more polite. Every person I spoke too was remarkably friendly, apologetic and understanding.
For all the hype in the press, it’s indisputable that the site has been getting better by the day. Every day, I was able to go a little further in the process.
On my mom's birthday, I asked her half-jokingly if she wanted to try logging in once more to get herself the Best Birthday Present Ever.
I sat down with her and we tried again. And finally, it worked.
THE REAL RATE SHOCK: BETTER HEALTH CARE FOR $53 A MONTH
Let there be no mistake, health insurance in this country is still outrageously expensive. At first launch, the marketplace isn't going to dramatically decrease the actual premiums set by the insurance companies. You'll still see those wince-inducing numbers on the screen as you research your choices.
The difference is that now, you may also see your taxes at work. If you're like my parents, you'll see a premium subsidy that takes the bite out of the insurance company price-gouging.
For my parents, their subsidy is a hefty one. They choose a silver plan where the premium will now be $53 a month.
Their new plan covers my mom's pulmonary specialist, all of her screenings (x-rays, CTs, etc), requires only a $1,500 deductible and $4,500 max out of pocket cost and the insurance company kicks in 100 percent after the deductible is met.
Granted, there are still glitches. Although she wanted to make a payment right away, she couldn't and the Marketplace reps say it will take some time for the information to transfer over to the insurance company.
Still, affordable, better coverage is the best birthday present she could ask for.
My parents' story isn't unique. Across the country, those who need help the most paying for their health insurance and health care costs are breathing a sigh of relief. Like the Sherburne family in Utah:
It took half-a-dozen tries over several days. But Phil Sherburne struck gold on Saturday — silver actually — with family health coverage purchased on the Affordable Care Act’s online exchange.Or Joy Kramer, 54, of Georgia, a cancer survivor who may be paying just $210 after being denied :
After plugging in particulars about his family of five, the Salt Lake City business owner was able to compare 38 plans and apply for tax credits to put toward his monthly premiums. He settled on a silver-level plan from Altius that retails for about $850 a month.
After tax credits, the Sherburnes will pay just $123 a month.
[S]he’s grateful for the Affordable Care Act, and she doesn’t have much patience with its many critics.Or Allan Pacela and his family:
“I think those people have never experienced what I’ve experienced,’’ she says. “They are shutting the door on the cancer survivors and the self-employed.”
I am a retired engineer on Medicare, and my wife had long been insured by Cigna, under a group plan from my engineers' society. Because of minor pre-existing conditions, she could not leave that plan, because no other plan would insure her.For more stories about how the Affordable Care Act is making health insurance more affordable, click here.
The Cigna premiums increased to $5,000 per quarter, or $20,000 per year, just for my wife. This year, Cigna canceled the entire plan, leaving her with no insurance.
So, we turned to Obamacare. She found it simple and easy to sign up through an agent in a 10-minute phone call. She obtained their best plan, providing much much better coverage than in the past, at a cost of $3,000 per quarter.
My wife would not have insurance coverage at all as of Jan. 1, if not for Obamacare. And, here's the kicker - we now are saving $8,000 per year, for a very much better plan.
FREEDOM TO SHOP AROUND
About a month or so ago, I received a notice that my health insurance company was raising my rates. The 12 percent increase was expected. After all, health premiums have been skyrocketing for years. That alarming rate was why President Obama and the Democrats pushed for health insurance reform in the first place.
Much has been made of the president's promise that "if you like your health insurance, you can keep it." Less has been made of a much more important fact: If you hate your health insurance, you can leave it.
Now, if an insurance company jacks up your rate, you have the freedom to shop around. I plan to and I'm sure I'll be able to find a plan with better value now that the exchange has been launched.
As for my parents? Well, in writing this, I asked my mother if she wanted to append a letter to President Obama.
"Just tell him thanks," she said. Then she smiled.
"It was a good birthday."