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Posted at 09:55 AM ET, 06/12/2012

Waiting for ‘Obamacare’

UnitedHealthcare’s announcement that it will continue certain provisions of the Affordable Health Care Act regardless of the U.S. Supreme Court’s upcoming decision hardly turns the insurance giant into Santa Claus.


A sign giving direction to The University of Miami Hospital's Emergency Department. As we wait to hear from the United States Supreme Court on the constitutionality of the Affordable Care Act, some experts say that if the act is overturned, Americans now insured will no longer be eligible and will be kicked back into a system where the emergency department is their first visit when sick. (Joe Raedle - Getty Images)
Insurers Humana and Aetna announced they, too, would join in keeping preventive services like immunizations available without co-payments, allowing coverage for adult children up to age 26 and simplifying the appeals process for denied claims. All of these are part of the Affordable Health Care Act’s Patient’s Bill of Rights, which took effect on Sept. 23, 2010.

What a great marketing move. See, insurance companies aren’t so bad, after all.

It’s smart business, too. Prevention can lower costs down the road, and young adults are generally the cheapest group to insure.

Allowing adults under age 26 to stay on or join their parents’ policies has meant that an estimated 6.6 million adults have health insurance who otherwise wouldn’t, according to a survey from 2010 to 2011 by the Commonwealth Fund.

Not so lucky, though, are children with preexisting conditions. As of September 2010, kids with preexisting conditions like asthma cannot be denied benefits, per the Patient’s Bill of Rights, but none of the insurance companies said they’d continue that mandate if the U.S. Supreme Court struck down the Affordable Health Care Act.

Cost, of course, was cited as a major concern.

But what about the heart and soul of the legislation? To provide accessible — and affordable — health insurance to all Americans in
A physician in Manassas, Va. (Karen Bleier - AFP/Getty Images)
2014?

Let’s not lose sight of that goal.

Nearly 50 million Americans no longer have health insurance, according to the last census. That’s almost 17 percent of the population. It’s an increase of 13 million over the last decade.

Blame the recession. Blame unemployment rates of 8 percent or higher. Jobs and health insurance have been married in this country for years, although that relationship’s on the rocks as fewer employers offer health insurance.

Too many numbers? Then let’s talk about just one middle-class family. Mine.

When my husband was laid off from his computer programmer job in October 2010, we continued our health insurance coverage through COBRA or the Consolidated Omnibus Budget Reconciliation Act.

At a time when you’re trying to cut expenses rather than add them, you’re facing a new bill. It cost us around five times what we’d been paying for employer-subsidized insurance. In fact, it was just a couple of dollars less than our monthly mortgage.

We thought we were looking at a short-term solution with COBRA. One of us would surely find a job with benefits. Or we’d get insurance through a private company.

Neither happened. On April 30 of this year, our COBRA coverage ran out after 18 months.

For the first time in my life, I faced the very real possibility that my family would not have health insurance.

Have you ever shopped for health insurance? It’s probably not such a scary experience — if you’ve never had any medical condition worse than a hangnail. Otherwise, prepare yourself for an inquisition.

One company’s underwriter spent nearly two hours on the phone with me as she asked about every single prescription every member of my family had filled in the last five years.

She started the interrogation with this question, “Why are you taking hydrocodone and oxycodone both and how often and how much do you take?”

I was stunned, until I remembered they’d been prescribed for post-op pain after minor surgery in March.

“Why both of them?”

Well, hydrocodone made me itch, so the doctor prescribed oxycodone, which I took for three days before switching to over-the-counter ibuprofen.

After all of this, I was turned down for conditions so minor they’ve never required a hospitalization, or even an emergency room visit.

But what’s a very big deal is that I can’t get health insurance.

And every time I re-apply, I must answer this question: Have you ever been turned down for health insurance?

In the meantime, I have one of those temporary Band-Aid policies for people in transition between jobs. It doesn’t cover prescriptions or  preexisting conditions; in fact, I suspect it covers less than a French bikini, though I do have a laminated card that says I have insurance.

I’m looking at options. One of my neighbors took a job as a paraprofessional for a local school in order to get health insurance for her family after her husband started his own business. She admits that most of her paycheck is eaten up by health insurance premiums, but they have great coverage.

And I wait for the decision of the Supreme Court justices, hoping against hope that they don’t throw out the bill.

As I write this, I’m battling Day 8 of a summer cold. “Go to the doctor,” one friend told me.

If only it were that simple. Instead, I’m waiting for Obamacare.

Diana Reese is a writer in Kansas City. Follow her on Twitter at @DianaReese.

By  |  09:55 AM ET, 06/12/2012

Tags:  health insurance, obamacare, Affordable Health Care Act, Patient's Bill of Rights, UnitedHealthcare, Humana, Aetna, COBRA, preexisting conditions

 
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