My thinking became second nature.
Every time I would walk down the stairs, I would think about what would happened if I were to accidentally fall. Without health insurance, I had to worry about the financial risk if I became injured. Would I be able to pay the bills? My mortgage? Could one slip cause me to lose my house?
I went 10 years without health care. Now that I’m in my late 50s, the Affordable Care Act has been a real godsend, finally making health care costs reasonable for me. For the three years since I first signed up for Obamacare, it’s been a relief knowing I’d be okay if something terrible happened to my health.
Every year I’ve been on Obamacare, premiums have gone up. And next year, my state of Connecticut is predicted to experience a 24 percent hike — the biggest increase yet. Fortunately, I receive subsidies, which have softened the effects of the increases in the past. I haven’t been notified yet about what’s going to happen to my plan, but I’m bracing for an increase.
I could be stuck with a really difficult choice: Either switch health plans or pay a lot more for the coverage I currently have. I may have to make unwelcome changes to my work life, picking up more hours at my part-time job. And if the increase is too high, I’ll have to switch plans — a hassle and a headache.
But either scenario would be better than where I was before: uninsured with no other options. Even though premiums are rising, Obamacare is still going to be more affordable than if I were on my own. Just having coverage is the real struggle for me.
I don’t have a typical 9-to-5
I wasn’t always on my own to pay for health care. I started working part time when I was still in high school. My career path led me to a regular 9-to-5 job at, ironically enough, a health insurance company. Then in my 30s, I realized I couldn’t continue working for a corporation. I needed to find work that was more meaningful. Eventually, along with some other like-minded people, I ended up opening up an animal shelter. Twenty-five years later, I’m the director and sole employee, still doing what I love — caring for and placing pets without homes and advocating for animal welfare.
Of course, the animal shelter is a labor of love. And while it does provide some income, it doesn’t pay all my bills. I also work part time as a bookkeeper and have worked at various nonprofits over the years. Combined, I’ve been able to carve out a living for myself. But individual health care was never something I could afford on my own. Because I have high blood pressure, premium costs were always out of reach for me. Insurance companies deemed me an expensive risk, and I was forced to opt out.
When I was younger, it didn’t bother me at all not being covered. The only thing I was really worried about was a car accident, and some of that would be covered by my car insurance. But as I got older, year over years, the stress of a potential illness or accident became progressively worse. I started to worry about having a heart attack or stroke, both of which run in my family. The risk of cancer also rises as you age.
When I had a relatively minor health issue that landed me in the emergency room three years ago, I ended up with a $7,000 bill. Luckily, I was able to pay off some and the hospital and physicians forgave most due to my low income. But it felt like a warning for future incidents where I wouldn’t be so lucky. Not having health care became a constant cloud of anxiety weighing over me. I began to wonder if I should give up my passion, the work that fulfills me the most, to go back into a regular company job simply for the affordable health coverage.
It’s not surprising that premiums have gone up
When Obamacare became available for 2014, I immediately signed up, feeling a burden lifting off of me for the first time in years. The first time I walked into a doctor’s office and only had to pay a $25 fee instead of my usual $125 a visit, it felt great.
Hearing news that premiums have risen isn’t a shock. It’s very common for premiums to go up each year for health insurance. Anyone who has paid for an individual health care plan is intimately aware of this. A 10 percent premium hike year over year, like last year’s ACA marketplace rise for my particular plan, is totally normal and reasonable.
Even people who are used to being on an employer-based plan see their premium share regularly increasing. While they are insulated from the full increase because their company contributes a portion of the cost, the days of companies paying 100 percent for employees’ medical insurance are long over. Still, while they grumble about higher rates, they aren’t getting hit with the full amount. And what most don’t realize is that whatever their company contributes to their insurance costs is money they’re not receiving as salary.
The average rise in premiums by 22 percent nationwide is definitely more than I anticipated, but I’m also aware that subsidies, which I receive, will also increase to help make up for the additional cost. It all depends on what the final cost is, but I’m going to try really hard to stay on my current plan and avoid downgrading. The bureaucratic hassle of switching up my coverage and having to go through both the marketplace and the insurance companies to make the change, a wearied and circular route of phone calls I have taken multiple times before, is something I really want to avoid. Obamacare is still going to be more affordable than if I were on my own. There really aren’t any better options.
I don’t blame politicians … or the insurance companies
There’s plenty of blame to go around about the price hike. In my eyes, our country’s health care system is fundamentally broken. We are heading in the right direction now toward universal coverage, but it will take some time and painful periods of change for us to get there. Periods of uncertainty or temporary cost hikes are all just part of the deal.
As someone who has worked at a health insurance company, it’s tough for me to put the onus on insurance companies. I know what goes into rate determination every year, and the biggest factor is medical claims — how many procedures and costs have accrued due to people’s illnesses over that past year. Perhaps uninsured people are rushing to get health problems fixed that they’ve put off. Or perhaps there just aren’t enough young and healthy people to offset the costs. Whatever the cause, insurance companies are doing what they have to do as bills pile up at their doorstep.
Nor can I blame the politicians. Many Democrats, especially, are doing their best to solve a serious problem with an obstructionist Republican-majority Congress who wants to vote to repeal and take away the only thing that is saving me — and millions of others — from catastrophic health care costs. I’m a big supporter of single-payer, and I really hope that our government continues down its current route and eventually winds up with a much more people-oriented health care policy.
It’s frustrating to see face after political face expounding on how horrible Obamacare is. They aren’t the ones who depend on it!
If I had to point fingers, it would be at the pharmaceutical companies and hospital administrators. They set prices on drugs, medical equipment, and services with their shareholders and paychecks in mind, not the needs of a sick person. I don’t trust the pharmaceutical industry, with their million-dollar lobbyist efforts in Washington, to feel incentivized to lower costs.
I remember before I had Obamacare, a doctor recommended a colonoscopy, a standard preventative procedure for older adults. I asked him how much the procedure would cost, trying to factor it into my budget. The doctor shrugged his shoulders, saying that he didn’t know.
That to me says everything about the problem with this system. Doctors don’t know how much their prescriptions or procedures cost, walled off from the reality of prices through a network of administrators and insurers who handle the claims. They prescribe the most expensive procedure. Or a consumer, guided by TV advertising, asks for the latest drug and the bill winds up being paid by insurance. Costs just continue to balloon out of control, and ultimately, we end up paying for it while medical device or drug companies profit. A 2014 report from Forbes showed the world’s top 10 pharmaceutical companies have on average a 19 percent profit margin — higher than the average in the banking, auto, gas, and media industries.
We need to do something to help keep prices down and make health care affordable for everyone in our country. There are going to be some bumps in the road, but that’s how necessary change happens. For me, Obamacare is not just something to be tolerated and replaced with “something better” — or more likely, nothing at all. It’s my lifeline.
As told to Karen Turner.
L. Vanessa Gruden is executive director of the Ferret Association of Connecticut, a nonprofit humane organization based in Hartford, Connecticut. She has written extensively for Fancy Publications on the topic of domestic ferrets. Her business career in finance and bookkeeping spans both the corporate sector and, for the past 20 years, various nonprofit organizations such as CT Association of Nonprofits, the CT Housing Coalition, and Northeast Citizen Action.