What Healthcare Reform Means to Me

I have been digesting the news about the new healthcare reform law for the last couple of days. Here are the most important takeaways for me:

My pre-existing condition is now covered.
In the past,I could not purchase private insurance on the open market because insurers would simply not cover me. Their explanation was that I had a pre-existing condition, Type 1 Diabetes. With the passage of the new bill, insurers are required to offer me the same coverage as someone without a pre-existing condition.

I don’t think I need to remind this audience that Type 1 Diabetes is an autoimmune disease and that we have no control over who or when it strikes. It is certainly not my fault that I developed this condition and there is nothing we can do to cure or prevent it. But there is something we can do to reduce the complications (and the costs associated with those complications): tight control. Unfortunately, without health insurance, most of us could not afford the test strips, insulin pump supplies, frequent A1C tests, annual kidney tests, podiatrist evaluations, dental cleanings, and annual retinopothy and glaucoma screenings that are required to keep our diabetes in check.

And don’t let the naysayers fool you. For many of us, there was simply no insurance coverage available, at any cost. Only 35 states offered a high risk pool, and mine was not one of them. In addition, most of us were not eligible for Medicaid because we had too many resources. I looked it up … my husband and I would have had to earn $18,900 a year or less to be eligible for Medicaid, and we could have a maximum of $6,000 in “Resources” — things like savings, 401ks, a house, and investments. Sure, we could have used the free clinic in our area … where people routinely waited for hours only to be turned away and where the medications we needed were not available. And those “free drugs” that the pharmaceutical companies offer? You must go through an arduous application process  every month — and the process is different with each pharmaceutical company that sells you a drug. You can be turned away, but if you aren’t turned away, the amount they offer is usually not always enough to your monthly needs.

I cannot be penalized with higher costs because of my pre-existing condition.
We all know someone who has developed some sort of condition while insured on the private market (borderline high blood pressure, sleep apnea, or borderline high cholesterol, for example) for which the insurance company decided not to drop them from the policy altogether, but instead decided to raise their rates until they could no longer afford the coverage. My biggest fear with this bill was that insurers would use this caveat as a workaround to prevent me from purchasing their plans. But the new  law requires the insurance companies to cover me for the same cost as my so-called “healthy” fellow insured.

I have more flexibility and choice in my day-to-day life.
Up until this point, I have been forced to stay employed full-time with a large organization that offered health insurance to its employees. These were the only types of companies that, by law, were required to offer me insurance, even with my pre-existing condition. If I were to lose my job, or choose to work as an independent contractor, I would lose my insurance coverage. Now I have options. I can buy insurance on the private market, and if I can’t afford it, I can receive a subsidy from the government to help me cover the premium.

Is the new law perfect?
Certainly not. We could go on and on about how we would have done things differently. And we might find that, after the law is implemented, some of the ideas we implemented turned out to be really bad ones. But is it a start? Without a doubt. And as someone who has been fighting with the insurance industry for fair treatment and adequate care for nearly thirty years, I’ll take it.

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2 Comments on “What Healthcare Reform Means to Me”

  1. Saffy Says:

    As someone watching the HCR from the outside a long way away in a land where everyone’s looked after by the state, I have always struggled to understand how the US system worked for the likes of T1s. I’ve read some really sad and scary stories about medical insurance et al and although I kind of get why so many people were opposed to this legislation, I’m so pleased it’s through. Like you say, it gives you options – including being able to make career choices as though you didn’t have T1. Surely that’s real freedom?

  2. Mahagony Says:

    Well said.

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