Health Insurance & RA: Dangerously Uncovered

I recently read an article online from The New York Times,"When Having Insurance Still Leaves You Dangerously Uncovered," by Aaron E. Carroll, that highlights the growing problem in U.S. healthcare regarding rising out-of-pocket costs for patients who already pay for insurance. The headline caught my attention because for years, until very recently, I've been forced to pay large sums of money each year due to the high out-of-pocket costs of my insurance plan. I say "until very recently" because in August of this year I was accepted for Medical Assistance (MA), which is Minnesota's Medicaid program for people with low income. Hooray! While it's embarrassing and stressful trying to live your life with a low income (obviously low enough to qualify for Medicaid), being accepted for this program has lifted a huge weight from my shoulders.

Why didn't I look into Medical Assistance much sooner? Actually, I did. About 10-12 years ago I tried to apply for both Minnesota Care and MA and I couldn't qualify for either program due to "earning too much" and MN Care's strange requirement that demanded the patient be without any insurance for three months. That was such a joke at the time, because back then I made even less than I do now. I also couldn't risk not being covered for months while having a chronic illness. Overwhelmed with work and life and trying to manage my health and RA, I didn't have the energy to keep checking into the programs, making the seemingly millions of phone calls, and swimming in confusing paperwork--it was too daunting.

Now, a decade later, it wasn't a renewed hope about these programs after the implementation of the Affordable Care Act, aka "Obamacare," that led me to being accepted for Medical Assistance. Instead, I discovered that I now qualified for MA as part of the application process for a financial assistance program through my healthcare system, Fairview Health Services. Fairview requires all applicants applying for their program to first apply for Medical Assistance through the state of Minnesota, which I dutifully did. And voilà! I was accepted! This was surprisingly great news, and I almost cried with joy when I found out that all of my outstanding medical bills that were currently in collections would be paid. I'm still in shock, really.

But hold on, my Medical Assistance news gets even better. About a month ago, I found out that MA will pay for my ever-increasing monthly premium payments that I have with my private insurance policy. Double hooray! After several phone calls back and forth with MA employees and my insurance company I finally figured out how to get these expensive premiums reimbursed and I faxed in my first set of paperwork a couple of days ago. What's kind of a pain, although I shouldn't complain, is that I have to send in proof of payment each month and then get reimbursed later. I wish there was a way that MA could just pay my insurance company directly, but apparently there isn't. But again, I don't want to complain. I'm overjoyed at this recent development!

I know this article so far probably sounds mostly like some celebratory party about my MA acceptance, and it is to an extent, however, I also know to not celebrate too much. Thousands of dollars of accumulated medical debt still scream out to me in flashing red numbers every time I log into my bank account online and see my credit card balances. It's not very long ago, and for many years, that I was one of those unfortunate sick people that Carroll writes about in his New York Times article--someone who has insurance but also has horrendous additional costs on top of paying for expensive monthly premiums.

For over a decade I've had my own private health insurance policy in the form of co-insurance, which was the only option I had after exhausting the COBRA benefits from my father's insurance through his employer. COBRA and then my co-insurance plan were both very expensive. For most of those years, however, this was the only health insurance I could get due to the discrimination that was allowed against people with pre-existing conditions. It wasn't until the Affordable Care Act was passed that I finally had more freedom regarding financial access to my healthcare.

The reason I'm not running around in the street screaming my head off with happiness right now (other than alarming the neighbors) is that my sudden good fortune of receiving assistance from MA could very well be taken away, depending on what the Trump Administration decides to do about repealing or changing the Affordable Care Act. These are uncertain, anxiety-filled times for people with chronic illnesses and other health problems who are worried about their access to care being jeopardized in the near future. It will be interesting to see what unfolds regarding healthcare and I will be watching and listening intently. I only hope that these political changes won't lead to more patients being "dangerously uncovered" and unprotected in our healthcare system.

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