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Monday, January 6, 2014

Why I’m Breathing Easier in 2014

I know firsthand that the Affordable Care Act can help people.
By Jill Richardson
Click here for more of Barry Deutsch's history of GOP
opposition to government health plans

For the first time in years, I’ve got health insurance. Before now, my “insurance” was nothing more than exercise, a healthy diet, and medicinal herbs.

I’ve gotten insured through the Affordable Care Act without dealing with a buggy website because I live in California. Our state made its own website because our politicians are more concerned about their citizens’ health than making President Barack Obama look bad.

On Covered California, the state’s web-based health insurance exchange, I found a wide variety of plans and with subsidies some cost as little as $1 a year. I chose one that costs $23 a month after subsidies. Even without subsidies, the rates are pretty good.

Why didn’t I have insurance? Because I’m self-employed and I have a pre-existing condition. I’m young and otherwise healthy, but I get migraines. The insurance companies — before the Affordable Care Act took effect — decided I was too risky for them.

At this point, the sum total of my migraine-related medical costs is one prescription that I take daily. It used to cost about $150 a month, but a few years ago a generic drug came out and now it’s $56 a month.

So those are the costs the insurance companies were saving themselves by denying me coverage. Without insurance, I just didn’t go to the doctor unless I had no choice.

Once, on a business trip to Bolivia, a dog bit me. When I got home, I had to get rabies treatment, just in case. Price tag: $4,000. Even after the hospital and the drug company each cut me a break, it cost $2,000, all out of pocket. For someone who struggles to make ends meet each month, it was devastating.

My worst fear is getting bitten by a rattlesnake. That’s not an irrational fear either. I hike several times a week on trails where I see lots of snakes, and three friends have been bitten. One was covered by Medicare. The other two had no insurance, and they got stuck with bills for $150,000 they can’t pay.

If that had happened to me, I simply couldn’t pay. Maybe I’d go bankrupt — but the hospital still would not get its money because I don’t have it. And since the hospital has to make ends meet, they’d probably respond by increasing the prices for everyone else.

The crazy thing is that hospitals charge individuals higher rates than they charge insurance companies. Insurance companies have negotiated rates, so they might pay a mere $14,000 for the hip replacement that would cost $45,000 for an individual paying out of pocket.

For me, the Affordable Care Act is a godsend. I hated it at first because I resent that I am forced to give my money to the same greedy insurance companies that did not see fit to give me affordable coverage for all these years. I’d prefer a “Medicare for all” approach. But if I can’t have that, I’ll take this.

My lack of health insurance hasn’t only been risky for me. Right now, whooping cough is going around where I live. I know people who have it. If you’re vaccinated, you can still get mildly ill. But it’s highly contagious and can be serious for infants and the elderly. If you live near me, you want me to go to the doctor if I get a cough, just in case. Otherwise, you’d want me to stay away from your baby.

It’s true that the Affordable Care Act isn’t equally good for everyone. If you get insurance from your employer, it might not impact you at all. Americans with low incomes get better rates than those with more money. But I’m sick of hearing fear-mongering and horror stories about it because I know firsthand that it can help people.

OtherWords columnist Jill Richardson is the author of Recipe for America: Why Our Food System Is Broken and What We Can Do to Fix It.