I am nervous, very nervous. For my family, there is a lot at stake potentially in the upcoming election. I have never felt this way about a presidential race. Of course, I have felt passionate about candidates since high school, but this is different.
My son was born with a congenital heart defect. There is no one to blame. It just happened. He did nothing to cause. I did nothing to cause it. It is most likely a genetic anomaly.
The stress a family goes through when a child has a serious health condition is indescribable, but it is only just the beginning. On top of worrying about your child’s very survival, there then becomes the question of how will you pay for treatment. Here is the very personal story of our families trials and tribulations with finding health care coverage.
When my son was born, I was on Medi-Cal. Income and asset requirements are different when you are pregnant, thankfully, or else we would not qualify. I own my home; I have money in the bank; I own some stocks. All of this would disqualify me under normal circumstances, despite my income, for Medi-Cal. Exceptions are made from pregnant women and children.
When my son was born, I was working under a grant as a school readiness teacher. Since it was grant funded, the school district would only grant me temporary status, thus no access to employer-based group plan health insurance that by law would have to cover a preexisting condition. Try buying health insurance privately when you are pregnant. It was impossible.
After my son was born, the Medi-Cal coverage lasted for two months. He was diagnosed at two weeks of age with Tetralogy of Fallot, and the social workers were great at getting him signed up for California Children’s Services (CCS). We automatically qualified since I was on Medi-Cal. Our CCS coverage would have to be renewed a year later, eight months after Medi-Cal ran out and I no longer qualified, as I was no longer pregnant.
A word about Medi-Cal: It is a very invasive and confusing process to apply. It is difficult if you do not have a phone, or you live in a remote area, as we do, to be in touch with your worker. By allowing very limited assets, they make it difficult for people to save and get ahead financially. The worker even told me I should switch my bank account, stocks, property, etc. to someone else’s name so I could qualify.
CCS was amazing! They took care of everything: the weekly doctor’s appoints to check blood oxygenation, the echocardigrams, the visit to the cardiologist every three months, and the million dollar surgery! They would have even helped with gas vouchers and housing for the surgery, which was six hours away in San Francisco, but we felt they had been generous enough and did not need the extra assistance.
Unfortunately, we did not qualify for CCS based on our income when it came time to renew. Income guidelines have not been changed since the 1960s. We also did not qualify for California’s SCHIP program Healthy Families, which would have given us automatic CCS approval.
I then began to search for health insurance through the individual market. I was, of course, denied, as my son’s heart condition was one of the preexisting conditions health insurance companies could completely flat out reject to provide coverage. A group plan would have insured him, but that was not an option from my temporary status and work and his father being self-employed.
The next step was California’s Major Risk Medical Insurance Program (MRMIP). In order to qualify, we had to have a rejection letter from a health insurance company (no problem) and be with out insurance for an entire year. During that year, my son needed two out patient procedures completely unrelated to his heart. We spent over $45,000 in health care for him. After that year was up, we were put on a waiting list for a few months, as the MRMIP program is for all pre-existing conditions in the state and has limited funding.
Under MRMIP, we had normal health insurance. The state negotiated the rate, which was reasonable ($260 a month). After being on the program for a couple of years, you were guaranteed coverage on the open market. Here’s where I probably made a mistake.
After a year on MRMIP, our income dropped, and we were able to qualify for Healthy Families. In order to save money, I switched programs…$30 a month versus $260. It also meant automatic enrollment in CCS. We finally had full coverage, but it only lasted a year.
Our income once again put us out of the Healthy Families program when it came time for renewal. We would have to wait another year without insurance to be abled to apply for MRMIP again. Fortunately, my job status changed from temporary to permanent, and I was offered insurance through my employer. Since I worked part time, the premiums were prorated and very expensive taking most of my paycheck each month. I didn’t care. We had insurance. Who needs money for living expenses?
Once again, everything changed when the Affordable Health Care for America Act became law. I was able to apply online and get insurance for my whole family, even my son, at 1/4 of the price I was paying through my school district! The coverage is not equal, so comparing is hard to do, but we have it, and it is affordable! The insurance company was more concerned about my arthritic hip than my son’s heart!
I am tired of Romney’s lies. His plans do not include my son. My son did not have coverage under HIPAA. He has had gaps in his coverage. He is a minor. My son is not alone.
I started writing this post a couple weeks ago before the debate. The lying continues. Paul Krugman writes,
How many Americans would be left out in the cold under Romney’s plan? One answer is 89 million. According to the nonpartisan Commonwealth Foundation, that’s the number of Americans who lack the “continuous coverage” that would make them eligible for health insurance under Romney’s empty promises. By the way, that’s more than a third of the U.S. population under 65 years old.
Another answer is 45 million, the estimated number of people who would have health insurance if Obama were re-elected, but would lose it if Romney were to win.
That estimate reflects two factors. First, Romney proposes repealing the Affordable Care Act, which means doing away with all the ways in which that law would help tens of millions of Americans who either have pre-existing conditions or can’t afford health insurance for other reasons. Second, Romney is proposing drastic cuts in Medicaid — basically to save money that he could use to cut taxes on the wealthy — which would deny essential health care to millions more Americans. (And, no, despite what he has said, you can’t get the care you need just by going to the emergency room.) Wait, it gets worse. The true number of victims from Romney’s health proposals would be much larger than either of these numbers, for a couple of reasons.
This is the first time a president has ever done anything that personally affected my life significantly. Of course, government decisions affect us one way or another, but this one is personal.
I am worried. Americans are believing the lies.
I can’t even convince my son’s grandparents.
Lynn Sullivan says
I too have a daughter with a pre-existing condition, Cystic Fibrosis, one of the most expensive diseases to have. I hear you loud and clear! I fear for her and others in her situation for the future. We cannot convince our daughter’s grandmother either. If our reason for being on this planet is not to take care of each other and live long, healthy lives then why are we here?
Linda W. says
I had an interesting visit to a doctor recently. A dermatologist / plastic surgeon – to remove a new and scary skin growth (melanoma runs in my family so I watch for anything strange.) My insurance deductible wouldn’t cover the visit so I decided to pay cash since the year is ending soon anyway and I’m not likely to meet the deductible at all. When I asked about paying cash, the doctor responded “Yes that’s fine and we give a 45% discount for cash payments.” After my jaw hit the floor I asked why and got quite an education about how insurance works from the doctor’s point-of-view.
I’m starting to think that perhaps we are moving in the wrong direction entirely and that what would -really- bring down the cost of healthcare dramatically would be to eliminate or ban insurance entirely. If only a small percentage of wealthy people could afford care, a whole lot of doctors would have nothing to do unless they lower rates. And with insurance out of the mix, the red-tape burden on the doctors would instantly be reduced.
I realize the prospect sounds scary but absolutely nothing else is actually bringing down costs of medical care – not even Obamacare – costs are up, not down.
I have a special needs son, and that’s why I support Romney. I hope that my children will live long lives, and a society driven farther and farther down into poverty, plus government debt driven to ridiculous levels, means that all our children will be worse off, especially the most vulnerable. Four years of Obama’s policies have harmed our children enough – we can’t afford what he’s likely to do once he knows he never has to face another election.
Paul Krugman is far from a reliable source on Romney’s policies. Yes, he was once a good economist, but he gave up being an economist in order to be a partisan hack. If you truly care about your child’s future, you’ll focus on reliable, trustworthy sources. Why not listen more closely to what Romney is actually saying, and less to partisan spin from one of the more vehement attack-dogs?
I’m curious Ann. What is Romney’s plan for affordable healthcare? He says his program will take care of pre existing conditions but yet he also says the healthcare should be left up to the states. We all know that both statements cannot be accurate so which is the position he is taking? Also, you stated that you have a special needs child. As a professional in that field I’m also curious how Romney, who says we need larger class size, can possibly help your child’s learning environment. I am willing to listen.
What a terrible shame that you use your child for advancing a political party. Not one word you said regarding Romney was true. Shame, shame on you.
Jennifer Lance says
Until you have been through open heart surgery with your baby, do not judge. We do to the cardiologist this week. We hope to buy another year of surgery free life. We are so thankful we have affordable insurance. I do not belong to any political party. I will vote for Obama because of my son. The terrible shame is the lies that Romney spills out and people believe. His own advisors have to back pedal after he speaks, just as they did after the debates regarding preexisting conditions. I am advocating for my son, not Obama.
The true shame here is that while you claim to be advocating for your son and not Obama you are advocating for Obama. Unfortunately, you provide no substance for the claims that Romney lies. I have been through open heart surgery and I am thankful that I can afford insurance.
Jennifer Lance says
Wow that is an adult way to engage in adult discourse. Apparently, you have a challenge expressing yourself in your own words. When you grow up I will be happy to continue this conversation.
Jennifer Lance says
I provided links backing my statements you accused of being false. Not sure what you are upset about.
Perhaps you would be better served if you read the Affordable Healthcare Act (Tax). I realize there is a lot to read. Then you can make an informed decision without the tinted slant of any political party.
While I am very sorry to read about your child’s condition I do not think that most folks truly understand the implications that Obamacare will bring. The government will decide what sort of treatments you are going to get so if you prefer more of an alternative route forget it – big pharma will be there making sure you are pumped of the newest and latest drug. The govt will have access to our bank accounts Pg 58 and 59. Doctors will paid the same and the govt will mandate what the fee will be (Pgs 241 and 253). There goes specialists and the quality of finding the best. Why would a doctor that would demand top pay for being at the top of field want to work as hard and be paid as someone as ith a lesser skill set? Pg 272 Cancer hospitals will ration care depending on a person’s age. Companies that do not offer this care will be taxed heavily – most likely bankrupting a lot of companies. Companies are not hiring now no one will want to bring more labor force and have to p the tax
This isa good video I think everyone should watch.
When Obama came into office and declared his new plan, my employer based coverage (over 1mil employees) was literally transformed before my eyes. My rate went from around $200 to $700 a month. That plan also dropped half of the coverage I had before. With no option, we then had to privatize my plan and went with a plan that covered hardly anything for 350/mo. On top of that, when we were pregnant a few years back we were told we could add them for next to nothing a month. Now, this pregnancy, we are told the baby’s plan alone (which cannot be added to my plan) will be $590/mo. The crazy part? Under Obama, my infant has to be insured for maternity labor and mental illness. It makes no sense. I’ve never heard of an infant giving birth and going to therapy for having a shit mom. “That b- gave me breastmilk again. arg.”
You know that simply because my husband and I make a combined income over 47k we are unable to get Kaiser’s $8 a month plan for our child. No its $590. I’m not rich and I appreciate there is help for those in need, but we must realize we are not only voting for ourselves but others. So because you feel entitled to a privilege, we must suffer so that we can barely make it ourselves.
Please people, take a much closer look at the facts. While “Obama-Care” seems to be a good humanitarian thing, it’s backed with treachery. The way politicians get themselves in is by offering what you think is the best thing for you and the nation,but in reality it just ushers in those things that you would never openly vote for. The way of slavery for all humans is in store for America and the rest of the world if we keep heading down this road. Obama may not even be smart enough to realize what he is doing,but he is making way for a “New Order”. One in which you and I will have no vote,No Say. Think About it!
Know the TRUTH about the Government Health Care Bill H.R.3200 – Key Points
If you have not seen this video, you need to watch it.
Come to Canada!
Jennifer Lance says
I have thought of it!
Wow! you are one rude person. May God give you peace in your heart, bless you and your loved ones so that you never have to go through the pain of having an ill child. Amen