Out on the Exchange

Even though open enrollment in the new health care plans is over, if you have had a certain qualifying event, if you are Native, or if you are applying for Medicaid you can still find coverage.

Many of the people that I see are uninsured still. There are many reasons that people are uninsured under the ACA, and the most common reason I see uninsured folks is because they are undocumented. We have some Title X funds to help people who cannot get coverage, but it is not enough and we only get Title X at certain health centers.

I wrote a while ago about midwifing under the ACA, and while I was not entirely clear about the fact that many of the things I was disparaging about our health system were in place before Obamacare went into effect, I will be very clear now.

After recently getting married I decided to look over my new family’s options for health care. I am still covered under my mom’s insurance (one of the few good things that softened the blow of the ACA), but I cannot cover my husband under this insurance.

My employer (my UNION employer) offers coverage that is absolutely abysmal. I thought to myself, where is my Cadillac plan that union members are supposed to have access to? Instead my options were either:

1) A low(er) deductible plan that would cost me nearly $1,500 a month to cover us both, still had a deductible, and was essentially an 80/20 plan.

2) A high deductible plan with a complicated health savings account that would still cost nearly $700 a month to cover us both. The deductible? 10,000 annually for a family. This is essentially catastrophic coverage.

After talking with my co-workers I found that many of them are on plans through their spouses, their children are covered by DSHS, or, irony of ironies, one of the women employed by my clinics to help sign people up on the exchange is uninsured herself because all of her options are too expensive.

After too many nights of lying awake envisioning bike accidents, I went out to the exchange to see what our options are.

Spoiler Alert: they’re horrible.

The care is neither affordable or comprehensive. None of the plans that I could find cover vision or dental, and as a person with both eyes and teeth, I was enraged.

What about prescriptions? Out of pocket maximums versus deductibles? As someone who interacts with health insurance plans and the health care industry every day I thought that finding the right plan would be easier. But boy was I wrong. I was offered essentially the same plan over and over, slightly different price, slightly different deductibles but the same promise of poor coverage and high out of pocket costs.

It is a horrible thing to be uninsured, but this coverage simply feels like a security blanket: it feels and looks good on the surface, but can do nothing to keep the real monsters at bay.

Most of my patients understand this acutely, and cannot afford the colposcopies, biopsies, abortions, and antibiotics that they need because even if they are insured the only plans that are a reasonable rate (by reasonable I’m still talking $4-500/month) still have unreachable deductibles that start over again every year.

So, dear readers, it is time to take a stand. I deserve real, affordable health coverage. My patients deserve real, affordable health coverage, and you do too. It is time to write out and speak out with our stories. It is time to say, enough! This for profit health care system is making us all sick, and is a far cry from leading us toward single payer health care.

Tell your stories to your friends, your co-workers, strangers on the bus, as I have started doing and you will find that everyone is angry that the wool was pulled over our eyes.

Get up, get organized, stand up, fight back.

For more on the fight for single payer health care, look into groups like Physicians for a National Health Plan and find great coverage on what the ACA was really designed to do at Socialist Worker

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