In one illness I experienced the old system, the ACA and a high-risk pool. I had always had insurance and because of my employer — was uninsured when I lost my voice.
When you hear the “C” word your world changes.
Stage III — IV CANCER of the vocal cord. I felt like I was viewing the world in slow motion. My wife was trying to hide her tears as she spoke to doctor in her businesslike way, the fear in her voice scared me even more. Listening to the prognosis, the doctor mentioned a high cure rate and hope rose out of the numbness. The tumor was so big at that time that I was struggling to breathe, and was admitted to the ICU as we made plans to get to get what we hoped would be lifesaving chemo and radiation. Even though I didn’t have insurance, we did have a good amount of cash at our disposal. Tuns out under the old system that nobody was willing to take 3 times the amount of the treatment in CASH — upfront. The doctor explained that without treatment the cancer would overtake my body in an estimated 6 weeks.
Without treatment, they would keep me on a breathing machine until I died — and as a parting gift they would burden my wife with a bill of around 3 million dollars. Thank God she is a persistent woman and didn’t give up! She procured insurance through one of the first provisions of the Affordable Care Act. I met the enrollment criteria and we secured the insurance card that was needed to begin the treatments that would end up saving my life.
I just recently celebrated my 5-year cancer-free anniversary, and am considered medically cured of cancer. Any new occurrence would be considered a separate incident, yet I will always be labeled “pre-existing” as far as insurance companies are concerned. I started the Facebook page “Obamacare Saved My Lfe” just a few months after I received my cancer-free diagnosis. I’ve been honored to hear the stories of thousands of people that have also benefited from the Affordable Care Act. Their lives have changed forever and their compassion for others reaches into their whole being, including the loved ones of those whose lives were swallowed by the sadness of losing their battle for life. I too am forever grateful, and this experience has changed me profoundly and my life has taken twists and turns I could have never imagined. I am far less concerned with material things, and am more focused on family — even finding my long-lost brother after 52 years. The joy of life is clear in the present, instead of being just out of reach in the future.
This all happened in 2012, two years before the ACA exchanges began. I was placed in a high-risk pool during that lapse. In 2013 we started out with a $ 4000 maximum out of pocket costs, and every time Congress met they decreased the budget which increased my out of pocket expenses — as there is always something more important for them to spend money on. In the next 10 months their actions increased our out of pocket expenses threefold to $ 12,000. They also quit accepting new enrollees in the pool because all the budgeted money was used and now gone. My lesson to you is this — high-risk pools DO NOT WORK and leave people with “pre-existing” conditions extremely vulnerable.
It is also important to note that the insurance companies can label pretty much anything a “pre-existing” condition, and you, too, will be in a high-risk pool with high premiums and subpar coverage. This fear of segregation often leads patients to to lie to their doctor which unfortunately causes misdiagnosis and delayed treatment, which can ultimately mean the difference between life and death.
President Trump and other legislators have mentioned moving to a different state to get the health insurance you need. We love where we live — and have worked hard to build our businesses and become integral members of our community. Moving for medical care presents a future with a loss of freedom that I never thought I would experience in the United States of America.
Essential benefits and patient protections should be uniform and reliable in ALL 50 states.