Thanksgiving is quickly approaching. It is the one time of the year, when most people take time to inventory those things for which they are most grateful and identify their hopes and dreams for the coming year. The lists are varied and often include family, friends, good health and a good job just to name a few. This year we hope you will take the time to participate in Project Gratitude. Project Gratitude encourages people who are looking forward to the New Year with an especially thankful heart, because they will be on the receiving end of Affordable Health Care, to share their stories around the Thanksgiving table.
My guess is you or someone you know has faced a difficult time due to a medical issue. You may even know someone, or perhaps you have been pushed to the financial brink due to gigantic medical bills. If someone you love or care about is faced with a catastrophic illness or accident you know you can’t put a price on life. It is our hope that the many and varied people throughout the United States whose hope has been renewed due to the ability to purchase affordable health care insurance will take a moment and share their story and encourage others to check out the health care exchange and protect their families from the difficulties that come from having no insurance, a junk plan, or needs that outweigh their ability to pay.
Since the roll-out of the federal health exchange, the focus seems to have been on “all” the problems with getting coverage. Misinformation and mistruths have been spread by pundits and the media for the sole purpose of having ACA/Obamacare fail for political purposes. Any way you look at it, it is sad. By keeping people worried, afraid and suspicious of ACA/Obamacare it appears that many have missed the benefits it has provided to many others, many of whom who could not get insurance because it was too expensive or because they had a pre-existing illness.
It is common knowledge that the recession had a serious impact on many, many families throughout the United States. People lost their jobs, their homes and in many cases their health insurance. While some of these people may have qualified for unemployment, following a job loss, anyone who has ever tried to get a COBRA policy in between jobs, knows they are often very expensive. The loss of a job, the inability to quickly find another job and the high cost of COBRA plans has resulted in numerous individuals and families going without health insurance.
It seems that in the last 30 years employees and/or individuals and families have had to pay a larger share of the cost of their health insurance. Due to financial pressures, many people have come to view health insurance as a luxury instead of a necessity. More and more people have dropped their insurance plans due to cost, as they feel they are unable to pay the increasing premiums and deductibles. The following table compares the cost of health insurance premiums over the past ten years in comparison to worker’s wages. Wages have increased less than 20% compared to health insurance premiums which have risen over 80%. No wonder people believe health insurance has become just too expensive. (http://t0.gstatic.com/images?q=tbn:ANd9GcSQrvziv3UOxK84MsCr5MRJC57xOonqWzUhJ3Fg2o2hFwEYA46u)
Since the ACA rolled out in early October thousands of people have applied for and obtained health insurance beginning in January 2014. Consider the case of David Heitler-Klevens. He and his family were paying a $625 premium for health care per month and had a family deductible of $6,000 per year. They were able to cut their costs for health insurance considerably by shopping on the health care exchange. Beginning in 2014, they will pay a premium of $67 per month and have a $1,000 deductible. Who wouldn’t be excited and thankful about that?
Not every person who accesses the exchange is eligible for tax incentives or subsidies. That doesn’t mean they don’t benefit from being able to shop on the exchange. Judy Tomlinson Hampson did not qualify for tax incentives or subsidies. However, she was able to purchase a plan with about the same premium, but her deductible and co-pays will be half of what she had been paying. In addition, all her doctors, clinics and hospitals are on the provider list so she will simply continue her care.
There is also an additional group of people who are thankful for Obamacare/ACA this year. Someone in their family has been diagnosed with a pre-existing condition and has been unable to buy affordable health insurance or has a plan in which the premiums and deductibles are so high that, while covered, it isn’t very helpful. Sometimes families have had to make a choice to insure some members of their family and not others.
Cheryll Athorp from Alaska was unable to obtain affordable health insurance due to a pre-existing illness. She is self-employed, but was diagnosed with breast cancer in 2003. While she successfully completed treatment, she only option prior to the federal exchange opening was to buy insurance that was sub-par due to a pre-existing condition. During 2013 this plan would have cost $1,700 a month in premiums and had a $20,000 deductible. She accessed the federal health exchange and purchased a silver plan for a premium of $134 per month. That means her savings are more than $1,500.00 per month on premiums alone.
Then there is Terri Mitchell from Iowa. She needs to have surgery on her eyes but was worried about the financial strain it would place on her. She shopped on the health care exchange and found an affordable plan. She is looking forward to having her surgery and is thrilled she will be able to maintain her eyesight. Her two sons, ages 24 and 26, hadn’t had insurance since they were 18. From January 1, 2014 they will have health insurance that they were able to purchase for the first time since becoming adults.
The final group of people who are purchasing health insurance plans on the state and federal exchanges are people with pre-existing conditions who in the past two years were able to purchase insurance through ACA. Most people believe that ACA will be effective January, 2014. While this is true, for the vast majority of people, when the law was enacted it directed the federal government to set up a Pre-existing Condition Insurance Plan. In many ways it was the “first” roll-out of ACA. Premium prices were determined based on age only.
This insurance plan saved my life. Three years ago I was in the hospital, swollen from Lymphedema, experiencing considerable difficulty breathing, malnourished, unable to walk and under insured. After admission, late that night, the staff put in a call to my son, telling him he should probably come to the hospital because they weren’t sure I would make it through the night. That hospitalization and subsequent Nursing Home stay almost drove me into bankruptcy and that didn’t even include all the help I needed that I just didn’t get because it was so unaffordable.
I live today because, due to ACA, I have received the medical care I needed. While I will never walk again, my quality of life has vastly improved and I have hope that I will live many more years. If I had had good insurance, would I have been able to walk again? Probably, I don’t know, but I am simply grateful for the opportunity to watch my son grow up and be around for many years to come.
Spike Dolomite Ward of California has a story similar to mine. She too benefited from the PCIP program. She was diagnosed with late stage breast cancer during a period she was uninsured. She was able to purchase Affordable Health Insurance through the PCIP program. She credits PCIP with saving her life as it allowed her to get the treatment she needed. Like me, she has also become an advocate of ACA, telling her story in an attempt to pay it forward. You can learn more about her on her website http://www.spikespeaks.net.
This year when you gather around the Thanksgiving table with friends, family, or acquaintances, consider the stories you read here or one of the hundreds you will find at https://www.facebook.com/acasignupsuccessstories. For every story here, there are thousands of other people who share a common hope and gratitude for Affordable Health Insurance. Our stories may be different, our needs varied, but each of us represents one of the reasons health care reform is needed. We hope you will join us and institute Project Gratitude at your Thanksgiving table this year. Tell your story about how your life will change due to affordable health insurance. After Thanksgiving, take a few minutes drop by our Facebook page and share your experiences. We look forward to hearing from you and wish you and your family a wonderful Thanksgiving.
By Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CPC-I, CENTC, CPCO, Lynne Smith, MSSW and Peter J Wills, Accountant and Business Software Support Consultant.
Barbara is an independent consultant in healthcare providing consulting for physicians. She is an industrial engineer from RPI with an MBA from NYU. She worked in the pharmaceutical industry for many years before moving into the healthcare industry where she had a company where she provided top quality coding, compliance and revenue cycle management services for physicians. She has since moved into full time consulting for physicians. Barbara is a nationally known expert known for her education, consulting and expert witness services.
Lynne has dedicated her career to helping others. She has experience as a social worker in a rural county, an administrator in a large hospital network and as a College Professor. She uses the skills she developed over the years as an advocate in a variety of areas including her most recent venture serving as a Healthcare Advocate. She is currently a recipient of the Pre-Existing Condition Insurance Plan, which she was able to purchase following ACA being enacted.
Together, Lynne and Barbara own the ACA Healthcare Advocates consulting firm and are available to individuals, families and businesses to help them meet the requirements of the Affordable Care Act in order to meet the specific needs of the client while optimizing the fiscal considerations.
Peter is an Accountant and Business Software Support Consultant. Prior to moving to America to marry he was an Accountant in public practice in Australia for most of his working life. For the last three years before moving here he worked as a Business Software Support Consultant for a business software developer in the housing, mining and engineering field. Peter is using his computer and business talents to assist Barbara and Lynne.
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