Thursday, January 6, 2011

Health Insurance: a Love Story

My wife and I are responsible adult human beings—and have been for a long time.

So, when we got married in June 1978, one of the first things we did was take out a health insurance policy with one of America’s leading insurers. We paid the monthly premiums on that policy and thus kept it in effect until I entered seminary in August 1979 when we were able to take advantage of the very sweet deal being offered to seminary students back then by the Annuity Board (now GuideStone), a policy on which we paid the monthly premiums and thus kept in effect until I became pastor of my first post-seminary church in 1986, at which time the Annuity Board very kindly let us switch right over to a regular (as in non-seminary student) policy. Since then we have had health insurance, without interruption, through, in one fashion or another, our employers.

When Joshua was born in 1984 he was covered by our insurance and continued to be covered until he reached an age where he could not be any longer at which time we took out an individual policy on him with one of America’s leading insurers which was and continues to be no problem because he has had zero, zilch, nada health issues for his entire charmed life.

When Sara was born in 1987 she was covered by our insurance as well and remained covered until she finished college. She has worked consistently since graduating but has not had health insurance coverage available to her at work.

So, when she finished school we attempted to secure individual health insurance coverage for her from some of America’s leading insurers but were unsuccessful because she had made an unpardonable error during her 20th year of life—she got sick.

It was a blood clot—a massive clot that seemed to come out of nowhere and that settled in her left leg; it extended from her ankle to her abdomen. It was a very dangerous and scary condition that put her in the hospital for a week with half of that time being spent in ICU. After much treatment and much prayer the clot was eliminated; we were and are very grateful to the medical personnel and to the good Lord for her recovery.

Testing revealed that Sara has two genetic conditions about which we previously did not know, one that predisposes her to clot excessively and one that predisposes her not to break up clots. When the insurance companies say that she has a pre-existing condition, I’m tempted to give them a response that I remember from my high school days: “Duh.”

Since we were unable to secure an individual health insurance policy for Sara, we kept her covered under the provisions of COBRA (Consolidated Omnibus Budget Reconciliation Act) for which privilege we paid one of America’s leading insurers—the one that had covered Sara for years under our group policy—the very reasonable amount of around $535 per month for eighteen months. Meanwhile, we did some research into what other options might be available; in the course of that research we were told by “experts” and “specialists” that (a) under no circumstances should we allow there to be a break in her coverage exceeding sixty days and (b) under no circumstances should we, unless she got a job that provided insurance, not finish out the entire eighteen months of available coverage under COBRA.

We are responsible adult human beings. We did what we were supposed to do.

Under the provisions of the Affordable Care Act (the appropriate shorthand name for the health care reform law to which mature grown intelligent people really should stop referring as “ObamaCare”) adopted by Congress and signed by the President in 2010, our daughter, whom, because of our efforts to be responsible adult human beings who try to do the right thing, with much effort and at much expense, we managed to keep covered not just every month of her life but every second of her life from the moment she was conceived until the last second of December 1, 2010, when her COBRA coverage expired, can go on our group health insurance policy until she turns 26 a couple of years from now.

So perhaps you can understand—although sadly some of you will not—why I am not filled with warm fuzzy feelings when some of our leaders so glibly boast about their upcoming effort to repeal that Act.

Oh, there is one more chapter to this love story. Sara’s COBRA eligibility expired at midnight on December 1, 2010. She could not go on our group policy until January 1, 2011. We contacted the leading insurer that had covered her under our group policy from 2004 until 2008 and to whom we had paid the very reasonable amount of just shy of $10,000 to keep her covered for the last eighteen months under COBRA to ask, very reasonably, I thought, if they might not be willing to provide her with an individual health insurance policy for just that one little month between the time that her COBRA coverage expired and the day that she could go on our insurance.

“No,” they very politely said, “we cannot.”

“But,” they very politely said, “we’ll check with our underwriters to see if they have any suggestions.”

We thanked them for that.

They called back and said, “No, they do not.”

Our daughter, you see, has a pre-existing condition for which she takes Coumadin every day and because of which she has a blood test once a month and which she has managed beautifully for almost four years now and with which she has had zero, zilch, nada problems since that frightening week in the hospital in the summer of 2007.

Please allow me to recap.

Our daughter had unbroken health insurance coverage from the day she was conceived somewhere around July 1, 1986 until her COBRA coverage expired on December 1, 2010.

Our daughter has a pre-existing condition—one with which she was born but that did not manifest itself until she had had unbroken health insurance coverage for over twenty years—for which she will have to take medication for the rest of her life but which is fairly easily and inexpensively managed.

Our daughter, for the month between the day her COBRA eligibility expired and the day that she was able, under the provisions of the Affordable Care Act, to go on our group policy, was uninsured and was unable to secure health insurance coverage.

One of America’s leading insurers, the one that had covered our daughter for years under our group policy and under COBRA, was unwilling to let us purchase—and we would have gladly given them another $535 of our hard-earned money for the privilege—an individual policy for her for one measly little month (actually one day short of one measly little month, but who’s counting?)—and so you can probably imagine how much confidence I have that the health insurance industry ever would have done the right thing by people with pre-existing conditions had they not been required by law to do so.

My wife and I are responsible adult human beings. We have tried to do the right thing in terms of insuring the health of our daughter. We are not rich and we are not poor; we are solidly in the middle of the middle class. And for the month of December 2010 we ran the risk that our daughter, who had been insured for every second of her life until then, would, if she became sick—and, given the magnificent way in which she manages her pre-existing condition, had she gotten sick it most likely would have been because of something having nothing to do with said condition—or gotten injured, have had to go into the hospital without insurance.

She’s covered again now, thanks to the Affordable Health Act of 2010, but it all got me to thinking.

And mainly it got me to thinking about people who live every second of every day with the anxiety and uncertainty with which my family had to live for only thirty days.

It got me to thinking about those parents who cannot afford adequate health care or health insurance for their children. It got me to thinking about those people, who, unless the government makes it so, will never be able to get health insurance coverage because they committed the unpardonable sin of getting sick, even if they got sick like Sara did when she was covered and after she had been covered for a very long time. It got me to thinking about how blessed my family has been and how I want other families to be similarly blessed.

It got me to thinking about what’s in—or lacking from—the hearts of people who don’t think things like that—that people like that—are worth thinking about.

I am not a health care policy expert. I am under no illusion that the Affordable Health Act of 2010 as presently configured is perfect or that it should not be adjusted and improved.

But I do know this: our wonderful child, our beautiful daughter, is benefitting from it.

So you’ll just have to forgive me for being grateful.

And you’ll just have to forgive me for not joining the throngs who cheer every time some Congressperson—all of whom, by the way, have the privilege of purchasing health insurance for themselves and their families regardless of their pre-existing conditions—utters the word “repeal.”

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