The Not-So-Affordable Care Act and Me

This month we were late on making our monthly insurance payment. We’d just returned from vacation in Maine, I needed to buy all sorts of back-to-school supplies, and we needed birthday presents for two of our three kids whose birthdays are in the same week of August. Money was going to be tight until the end of the month. I realized that I was down to the last bottle of my test strips, and when I called the pharmacy to place a reorder of my 90-day supply, I was told that the cost would be $885.53. Normally the cost is $80. My heart stopped, and then I remembered that I hadn’t paid the insurance bill. I wouldn’t be able to order test strips until I paid the staggering insurance bill, which I couldn’t do until the end of the month, and it was the middle of the month. I cursed. I sighed deeply and then I drove to Walmart and bought enough (inexpensive) generic test strips to last until the end of the month. Thank God for Walmart. It wasn’t too far in the past that places like Walmart didn’t offer inexpensive, generic test strips.

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I remember when the Obamacare talk first began in 2009. It was the year my third son was born and I was excited because they were talking about eliminating pre-existing conditions as something that meant you could be denied coverage. (I’d lived in fear of the pre-existing condition label ever since I graduated college and was kicked off my parent’s insurance. Unlike most of my friends at that time who were pursuing their “passions,” my job search was limited to jobs with benefits.) By 2009 I was a stay-at-home mom (I hate that term, but for lack of a better term, that’s what I’ll use here), and while we had insurance through my husband’s job, it wasn’t great. My “high-risk” pregnancy and Cesarean section was costly, and with three kids under 10 years old, it seemed as if we were at the doctor’s office on a weekly basis. Not having insurance was not an option.

My husband changed jobs a few years ago and now he works for himself, which means we have to pay for insurance through Obamacare. I cringe every month when it’s time to pay our insurance bill. Our BlueChoice bill is bigger than our mortgage. (It’s not even a great plan, and our deductible is really high.) Experts project that premiums will rise by approximately 9% next year, which makes me hyperventilate. But I don’t have a choice. I need insurance.

Last week it was announced that Aetna, the nation’s third largest health insurance company, was going to pull out of Obamacare exchanges in 11 states. This followed the April 2016 announcement that UnitedHealth Group, the biggest insurer in the United States, was pulling out from most exchanges on the health-care marketplace. USA Today reported that “The insurer blamed heavy losses for the move. The company suggested that too many sick people are buying plans, not enough healthy people are paying premiums to cover the expenses, and the government isn’t making policy changes to fix it.” When I read that I was outraged, because they’re talking about me. According to insurance companies I am a “sick” person, a person who desperately needs insurance to buy the drugs that keep me alive, a person who is expensive to cover.

Insurance companies want more “healthy” people to sign up for coverage, but they are the people who need it the least. Many of them decide it’s more affordable to pay the fee than pay for insurance. (The annual fee for not having insurance in 2016 is $695 per adult and $347.50 per child.) As someone whose quality of life depends on good insurance, it’s disheartening to hear that companies are pulling out of Obamacare because they’re not making enough money. Having insurance is not about choice for most of us, and I’m not sure it should be a for-profit business. I don’t like to be negative, but if we’re labeling people like me with Type 1 diabetes as “sick” and expecting the “healthy” to balance the insurance seesaw, guess who’s going to rise to the top? Guess who’s going to sink to the bottom?

The government’s new Diabetes Prevention Program is taking people with prediabetes down the wrong road, says nurse David Spero. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more.

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