If the AHCA passes, something like this could happen to you.
I’ve been self-employed since 1990. When I left my last full-time job — which did include health care benefits — I bought my own health insurance coverage. I was 29 at the time, a non-smoker, and in good health. But health insurance was something I thought everyone needed to have, so I signed up with one program or another — I honestly can’t remember any details — and stayed insured for years.
Understand that I seldom needed insurance coverage. Again, I was in good health. If I caught a cold, I went to the doctor. If my insurance covered the visit and medicine, fine. If it didn’t, I paid and didn’t complain. When I had some problems with my knee and needed several tests, some physical therapy, and finally some arthroscopic surgery to repair a torn meniscus, I ponied up the $1,000 deductible before finally getting some benefits to cover most of the other costs. I’m not rich and I’m not poor but I was usually able to afford any kind of medical attention I needed.
Each year, my insurance rates went up and I paid the new premium. It wasn’t a big deal; I made more money every year and I saw the increased expense as part of my cost of living increase. Occasionally, I’d shop around for a new policy and get one that was a little less costly. That would creep up over the years and I’d change again.
In the early 2000s, my future wasband took a job in the Phoenix area with a company that offered very good health insurance plan. Around the same time, I got a sizable increase in my health insurance premium. He told me I could get on his insurance and it would be cheaper and better. Even though we weren’t married, I assumed he knew what he was talking about when he made the offer, so I dropped my insurance and got on his.
Sometime after we married, when I was still on his insurance, I started having digestive issues. I went to a gastroenterologist connected to Wickenburg Hospital — which I will never do again — and told her about my symptoms, including pain in my upper abdomen. She translated that as chest pains and decided that I needed to get an EKG. When that showed no problem, she sent me for a stress test. When that showed no problem, she sent me for another test. When that showed no problem, she finally gave up trying to diagnose me with heart problems. She was never able to resolve the digestive issues I had. Neither was another doctor I went to see. I wrote about this in a 2010 blog post titled “Getting Quality Health Care: Apparently Impossible.”
My wasband lost the job with the great insurance got another one with good insurance. I stuck with his new plan. Then he lost that job and was unemployed for a while. He got us on Cobra, which he paid for with our joint checking account. Except he didn’t pay on time. He missed a payment and they cancelled our coverage.
He got in touch with them right away and made the payment. It was only five days late. They reinstated him immediately. But they looked at my medical records, saw the heart tests, and refused to cover me because I had a “pre-existing condition.”
Except I didn’t have the condition they claimed I had. I had never had that condition. All tests had proved negative. My heart was fine.
It took six months of fighting with Blue Cross to get insurance coverage again. For the entire time, I was completely exposed to financial loss: if I was hit with a major health problem, the cost of medical attention could easily bankrupt me. Actually, I guess it could bankrupt us — I don’t think my idiot wasband realized how exposed he was, too.
I finally got coverage under my own name, separate from my wasband, by signing papers saying I’d never put in a claim for heart-related issues. I had no trouble with that because I had a healthy heart.
And, as you might imagine, I learned my lesson and kept my insurance separate from my wasband’s no matter how good his next employer’s plan was. I simply couldn’t trust him with something that important. (That probably helped confirm my financial independence from him in divorce court a few years later.)
I have been on one health insurance plan or another since that “pre-existing condition” scare all those years ago. The Affordable Care Act (ACA or ObamaCare) made it easy to find insurance that met my requirements. Again, I’m generally healthy and I make a decent living. I have insurance primarily to prevent bankruptcy in the event of a major illness. I have assets to protect, including my home, my business assets, and my retirement funds. I’ve worked too hard my whole life to put them at risk.
To keep my premiums as low as possible, I have a very high deductible: $5,000. I take advantage of a health savings account if I can. (My new plan does not allow additional savings but I can still use the balance from my old plan.) It’s nice to have annual check-ups and special tests like mammograms covered by insurance without having to worry about the deductible. Coverage under ACA helps people who can’t afford doctor’s visits at all to make at least make one visit a year which can, hopefully, find any problems before they become serious.
I’m not at all happy with the provisions of the Paul Ryan American Health Care Act (AHCA or TrumpCare) in part because it will allow insurers to deny coverage or greatly raise rates for people with pre-existing conditions.
Will it affect me? Will I be denied coverage? Or charged some outrageous rate for premiums? Just because I had a few heart tests ten years ago? Tests that proved I had a healthy heart?
And will some test or problem you’ve had in the past prevent you from getting coverage?
And what about well-care visits? Maternity coverage? Contraception? Mental health care? Any number of items on the list of required coverages from the ACA?
(Don’t worry boys, I’m sure you’ll still be able to get your little blue pills. Republicans wouldn’t dare threaten a man’s sex life.)
With only 17% approval rating from the people, Republicans could pass the bill later today anyway. They don’t care about the people who voted them in. They care about the lobbyists and rich donors who pay for their campaigns. The people most likely to benefit from this plan.
So I guess time will tell how it affects you.