“A startling number of those of us with health insurance find that we have to choose between paying for daily needs and paying our medical bills. Such expenses leave people even more impoverished and often in debt, which is tantamount to remaining unhealthy.”
This is just one piece of the article that stood out to me. Much of it did. I can relate on a personal levelto the burden of the cost of health care. I’m a single mom with two children, and an independent contractor who pays self-employment tax and I purchase health insurance through Covered California.
When I got divorced, I was tasked to find health insurance for myself – but in my location, I can’t purchase health care directly from a health insurance provider, I have to go through Covered California’s Insurance Marketplace. They offer a variety of plans from many insurance companies. But none of them are affordable for someone who already struggles financially, and none of them make health care accessible. In fact, the cost of maintaining my very basic lifestyle with my income – providing a home, car, food, and clothing for myself and my children – makes it nearly impossible to afford the health care plans offered through the marketplace. Not only that, with a monthly out of pocket cost of $400 just for the insurance, I can’t afford to actually go to the doctor, which creates an additional out of pocket expense, since the insurance plan doesn’t cover most of the service. While I sit and worry about my health, it almost makes more sense for me to drop my insurance and pay cash patient prices when I need to see a doctor. And I’m not the only one who feels this way – an L.A. Times article from 2018 about insurance rate and premium increases says:
Amanda Malachesky, a nutrition coach in the Northern California town of Petrolia, said the elimination of the penalty for being uninsured makes dropping coverage more palatable. Her family of four pays almost $400 a month for a highly subsidized Anthem Blue Cross plan that has a $5,000 deductible.
“I’ve wanted to opt out of the insurance model forever just because they provide so little value for the exorbitant amount of money that we pay,” said Malachesky, who recently paid several hundred dollars out-of-pocket for a mammogram. “I’m probably going to disenroll … and not give any more money to these big bad insurance companies.”
The same article also states that “health insurance prices keep growing faster than wages and general inflation as a result of rising medical costs overall, squeezing many middle-class families who are struggling to pay their household bills. The 8.7% increase in California — 9% in most parts of Southern California — ends two consecutive years of double-digit rate increases for the state marketplace. In 2018, premiums rose an average of 12.5% statewide.”
High Cost for Limited Access to Providers
When I chose my plan, I selected the option that covers the two major medical providers in my Orange County, California area – Hoag and Memorial Care, because the excellent providers I was going to with my previous employer sponsored health insurance through my ex-husbands job did not accept Covered California health plans. However, when I searched for an Urgent Care location, it gave me the address of a small office on a side of town I don’t frequent that is not sponsored by any of the medical facilities I chose, despite the fact that I called to confirm that the plan covers all Hoag and Memorial Care facilities and not just one particular office. Also, when I did go to the Hoag Urgent Care near me, after confirming that my plan covers all Hoag facilities, I received a bill showing that the Urgent Care visit was in fact, out of network. An $80 copay, plus a $140 bill, plus $400 per month to have insurance. That’s a lot of money out of pocket in one month just for a visit to Urgent Care. I can’t imagine what my bill would look like if I were diagnosed with something serious or if I was injured.
To add to the frustration, if I improve my financial situation, the cost of my health insurance will increase. If my income exceeds $20,000 per year, I’ll lose my discount and I will be required to pay the full $500 per month. It’s an uncomfortable weight to carry, knowing I can’t afford to go to the doctor because I can’t afford to pay more than the monthly cost just to carry insurance, and the only alternative is to not carry any insurance and risk incurring major life-altering medical expenses should I find myself with a major illness or injury.
At this stage of the game, it seems like hard working Americans should have better alternatives for health care. We should not have to choose between death and debt.
Read Rich Meyer’s Medical Insecurity to learn more about his plan to reduce the cost of health care.
Guest post by Heidi B.