Wednesday, March 26, 2014

Obamacare...

…a tale too many can count as their own.  *a really long tale, but please read all the way through*


We had spectacular insurance. For a while. 

And thank goodness---we racked up over $350,000 in medical bills with our little miracles! Had we not had insurance we would have had two options:

1) Declare medical bankruptcy. Really? at age 25? How could we have that over our heads just starting out?? (studies estimate that more than 2 million people in the US declare bankruptcy every year due to medical bills, making it the No. 1 reason for bankruptcy)

2) Spend the rest of our lives paying off medical bills. There goes the American dream. No house in the future for a family of five.

So when I say I understand the need for a healthcare reform, I really, really, really understand. 

BUT I'm really, really, really glad that we decided to have another baby before the healthcare reform kicked in. 

Because one baby turned into two. Two babies with a serious life threatening condition. 

And everyone told me "Oh how lucky you are, two babies for the price of one!"

WRONG.

Every doctors appointment I was charged double. Every ultrasound was charged double. And for delivery we had double the staff on hand, which meant double the bills. Then there was also double the NICU stay. 









So why should I be happy that I had them before the healthcare reform??

Because the healthcare reform has failed us miserably time and time again.

  1. In October we were informed that we would lose our coverage as of January.
  2. In a panic to provide coverage for my then 13 month old son and my two premie daughters I started looking up insurance agencies and trying to get quotes.
  3. EVERY insurance agency we contacted gathered basic information---our income and family size ---then EVERY insurance agency we contacted refused to quote us because our income for our family size was below the poverty line. They proceeded to direct us to our local Medicaid office.
  4. November 2013 we apply for medicaid, knowing that the process for getting insurance can be long and lined with red tape. We, under absolutely no circumstance, wanted a lapse in coverage for our babies. I was going to do everything possible to stop that from happening.
  5. December 2013 we are denied Medicaid with no explanation. I immediately started a new application, while at the same time applying for a "fair hearing" to have the denial overturned.
  6. January 2014 we receive our 2nd notice of denial *note that our family of 5 with medically needy children was bringing in no more than $845 a month (my husband attends school full time)
  7. January 2014 I clock over 6 hours on the phone with the local medicaid office, yielding no change and no explanation as to why my family has been denied coverage. 
  8. January 2014 both girls have rattling coughs and fevers. With no insurance we were told by several doctors offices that they would not see us unless we paid up front. What choice did we have? We paid over $100 per child to be seen for not more than 10 minutes by a doctor who told us to come in if things get worse in 2 days or if we are still worried.
  9. January 2014 we are told by Medicaid offices that they will backpay unpaid medical bills amassed in the application period. I explain that doctors want all fees up front if I don't have insurance and proceed to ask for advice or information on clinics that do not have that policy. I am told by Medicaid officers that I am out of luck.
  10. Late January 2014 February 2014 I receive a call from the fair hearing committee of medicaid. The committee member had obviously not read my file prior to calling. He was dumbfounded as I explained the process that I had gone through, had no explanation as to why we were denied, (not once, but twice!) and promised to get back to me.  Thankfully he did get back to me and had instantly fixed whatever issue there was and sent us Medicaid cards for our children. We were told that we did not qualify for coverage as a family and that Medicaid would contact the "Marketplace" and tell them that we were allowed to shop for insurance. 
  11. February 2014 The "Marketplace" is still referring us to Medicaid.
  12. Mid-February 2014 I get a job as a night manager at Culver's. I turn in every verification/notice of payment and insurance offered (Culver's doesn't offer employee healthcare).
  13. March 2014 I am given notice that my children will no longer receive coverage. *Note that we are still well below the income guidelines for a family of five
  14. March 2014 The "Marketplace" is still referring us to Medicaid
  15. March 2014 Medicaid employees can offer me no explanation as to why my children no longer have coverage nor as to why we have not been given the green light at the Marketplace
  16. March 2014 I have a bout of kidney stones that necessitates a visit to the ER. I am informed that although Medicaid would backpay while I am in the application process, Obamacare/Marketplace does not. 
It has now been almost half a year since we began our journey with the Obamacare and we now not only DO NOT HAVE INSURANCE but we have ER medical bills to pay. 

I did not write this in order to garner sympathy, nor did I write it to incite a political debate. I wrote it because I feel that our story should be heard. There are many more stories of real American families that are very similar to ours and the flaws in the system need to be fixed. 

13 comments:

  1. So, I don't know you - I'm your cousin Danny Challis's wife. I posted this to my fb wall, and one of my friends who doesn't know you said to pass this along to you. I have no idea what it is, or if it will help, or if you've already seen it - but I said I would pass it along. We are praying for you guys, and I promise never to ever say to a parent of twins, "two for the price of one!" http://www.patientadvocate.org/NURD/index2.php?application=underinsured

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    1. Hi Kate! Thank you so much for the info---I had not seen that before and I'll be spending this week looking into the details. We should definitely remedy the fact that we don't know each other ;)

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  2. I'm glad you wrote this Debbie. I'm in nursing school now and I've been wondering how this Obama care has really been effecting families. Your story is not the only one I've heard... it breaks my heart, but also infuriates me about the ethics in the business of health care. I'm grateful for this new and humbling perspective your story has given me. I really do believe that it's in the individual lives that we can each make a big difference in this world. I'll only be one nurse but I hope to be able to do that. Your story motivates me to do all that I can to get involved and make a difference. Your sweet family will be in my prayers.

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    1. Lisa, thank you for the response! After spending 10 weeks in the hospital, and visiting the girls everyday during their 2 week NICU stay, some of my most favorite people are nurses. They certainly made a huge impact in my sanity and they literally saved my babies. Your compassion will absolutely move you to make a difference---not just in the lives of individuals, but in families and communities and subsequently the world. Thank you for your prayers

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  3. I can't even imagine how frustrating this situation is for you!! There is definitely a HUGE need for healthcare reform, but Obamacare is not it! I will share this!

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  4. Oh my goodness, you poor thing. What a nightmare. I know you didn't write it for sympathy, but you have mine all the same. It is so unfortunate what Obamacare is doing and will continue to do to our healthcare options. Good luck it all. We are also without insurance for the time being and it's a scary place to be. I just have to share with you the the comfort and peace that has come from having essential oils on hand, as i have been able to care for my family at home without having to incur any medical bills as of yet. They truly are empowering and work. Let me know if you want more information. I know they could help your family.

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    1. Kristen, thank you for the input. I've heard from many that essential oils have changed their lives. I'll let you know when we are in a position to explore that

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  5. I am a caseworker in another state and I am saddened by how Obamacare has wreaked havoc on Medicaid, and states. I just cannot believe the amount of pain and suffering this has caused and why there has been so little media attention to it. There is talk about the exchanges but little talk about how many states are unable to properly process applications since the new year or about the known state/federal denial loop problem between state medicaid determinations and healthcare.com automated medicaid suggestions. I don't have an answer nothing works now and my state is massing huge overtime costs and still getting more behind.

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    1. freedomreign, it saddens me to hear how widespread these problems are! I hope that as a caseworker you are able to find peace in this stressful time! I'm sure that its difficult to want to help people in your position and be met with roadblocks and people who might blame you for the issue. Keep your head up and thank you for your comments!

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  6. Our state is also paying hours and hours of overtime to Family and Children Services workers because of all of this mess. Instead of getting more help for everyone, there is less and many people I know have lost their insurance they have had for years due to ObamaCare. I pray for you, your family and everyone who has gotten entangled in this web of misery called ObamaCare.

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    1. Thank you Charlotte, every prayer helps!

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  7. The state you’re in makes a difference. If you are in a state that has not accepted the medicare expansion this could explain part of the problem. Obamacare is working better in some states than others. Healthcare in general in the USA is a mess. I don’t think Obamacare was the best answer, but for some people it has helped. But there is a BIG difference from state to state. Not sure why that is. I’m sorry about your situation. It should never happen in a country like ours. I think the REAL problem and “evil” about our system is the fact that people’s healthcare is TRADED LIKE A COMMODITY ON THE STOCK MARKET!!!! Does anyone else think there is something inherently wrong with this?

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