On Sunday, I will be joining a few other willing souls in Latah County and go knocking door to door in search of signatures to get Medicaid Expansion in Idaho on the ballot this Fall. I could go into all the financial details of why this makes sense for our state: reclaiming federal tax dollars we have already paid into, the cost to the state and county tax coffers for individuals without insurance, and the value of preventative care. Or I could go into the issue of astronomical rise of health care (which is not health insurance) costs in this country: tort reform, “cover your butt medical practices”, and the pharmaceutical industry. But others have written about all of this, and with much better grasp of all of the details. I will, instead, tell you my own health insurance story.
I have never been without health insurance. I was covered by my parents as a child, and then by student insurance as a college student. When I graduated from Physical Therapy School I headed west with my license, a free place to stay for the winter, and $600 in my pocket. My graduation present from my mother was a 3 month health insurance policy. If I remember right, it cost $99. It wasn’t quite as exciting as the new cars that my friends were getting, but it was practical. Within a month of arriving in Tahoe, I had a full time job and health benefits. When I met Jim, he was a student, had student health insurance, and I was covered by a series of my employers. We got married, Peace Corps covered us for a while, and my employers covered us while he finished his teaching degree. He was hired by Moscow School District and we got pregnant the day after the insurance went into effect. I started private contracting (no benefits) for work, and Jim’s employer covered us while our family grew. The pre-tax deductions for insurance kept rising, but it was never more than we could absorb.
Fast forward 20 years to 2009, and Jim was diagnosed with glioblastoma, a very aggressive brain cancer. Due to the sick leave bank, he stayed on Moscow School District insurance up until the day of his death 14 months later. We hit both our $300 deductible and our $1000 out of pocket maximum in the first week, and then again in the 1st month after the beginning of the next calendar year. It was affordable, and with monthly MRI’s, his chemo rounds being $10,000 per infusion, and the final 4 weeks of hospice care costing $27,000, it was a godsend. If he had lived longer than those precious 14 months, we would have come close to hitting the 1 million dollar maximum life time cap. Yes, lifetime caps existed then.
Then Jim died. In addition to grieving, there is a lot of stuff to figure out after someone dies. I contacted social security to find out about widow benefits, I went in to talk with the school district about his pension and getting the family covered via COBRA. No widow benefits until I hit retirement age. Jim’s pension was $700/month. The cost of COBRA to cover myself and 2 kids….$1300/month and due to rise in January. I paid it to get us through December, but I knew I had to look elsewhere. There was one private insurance company offering health insurance in Idaho, and I couldn’t afford anything that looked like Jim’s old policy. I looked into other options. The community had been generous with financial support. I had some cash. I bought catastrophic insurance. I opened a health savings account (HSA) knowing I could, over the course of 3 years with community money, fund that to cover maximum out of pocket. It wasn’t good insurance. There were caps on everything but catastrophic care, and dental and vision were all out of pocket. But, it was insurance. If something really bad happened, I would not lose my house. It was affordable. Then the private insurance company decided NOT to offer an ACA plan, and the only policy offered was triple the premium.
By this time, I was back to my contract work, but I could not spend over half my income on health insurance. I made too much to qualify for Medicaid. I went in to see a navigator, and I put our family on the ACA. Similar catastrophic insurance, same HSA. But preventative care was covered, and there was no lifetime cap. I made enough money that the premiums were covered by the subsidy. I was able to afford dental insurance. I met Greg. We married in July of 2015, and the kids and I both jumped on his insurance. Because Greg and my combined income was much higher, we paid the federal government back for the Jan-June subsidy I received in 2015. That was a $3200 hit.
My son, age 23, is now a public school teacher in Denver. He has good health insurance, but lacks the time to make a dentist appointment. My daughter stayed on our insurance until age 26. She works for a small non-profit, and is their one and only paid employee. She was able to negotiate a small health care stipend. She makes enough money to qualify for the ACA subsidy. Her stipend covers what her subsidy doesn’t. She is on a catastrophic plan, no dental insurance, and I will help her fund her HSA until she hits her max out of pocket. She needs some major dental work due to a playground mishap in 2nd grade. I gave her the funds for her implant as a Christmas present. Not exciting, but practical.
I know I am lucky. Jim’s illness was covered until death even though he was unable to work. I had community money to help me bridge the hardest gaps. Private insurance was affordable during the time I needed it. My family was healthy during our most vulnerable times, and we had no other debt. As a physical therapist, I could have found work with benefits, but I had the choice to provide stability for my family by staying in the same house, the same community, and in the same job. This I could not have done without the safety net of the ACA. I have never been without health insurance.
I had someone tell me last weekend, “those folks who want Medicaid….they should just get a job!” Are there folks that abuse the system? Yes. But, I am here to tell you that there are many folks (78, 000 in the state of ID) who are working, sometimes more than one job, that will benefit from Medicaid expansion. They make too much money or have too many assets for standard income based Medicaid. They earn too little to qualify for subsidies to help pay for coverage through the ACA. I benefited from a safety net when my family needed it the most. I will do what I can to assure other families do not fall into the gap.
I will be gathering signatures this weekend to put Medicaid expansion on the ballot along side of my candidacy this Fall. Please give a few hours and come out and join us. If you are unable, hunt down a petition and sign it. Be kind to the folks going door to door. Many of them, as well as whom they represent, are just like me.