I spoke on the phone this week with a woman who had a series of serious cancers. She was doing well but facing more treatment and a slew of medical bills from the care she had already received. She had lost insurance coverage several years ago and couldnt afford a policy because of pre-existing health conditions.
Over my 15 years as a health advocate, Ive spoken with more people like her than I care to remember. Ive talked to them in community meetings from Hendersonville to Wilmington. Theyve called me, written me letters and sent me every form of electronic communication possible. These conversations have always been one of the toughest parts of my job.
Its one thing to confront a governor or state legislator and highlight failures of leadership on health care. At least with the politicians you can point out a solution and ask for some action.
Its quite another to speak quietly with a fellow North Carolinian whose individual health and familys financial security are on the line simply because of a serious illness. Im always amazed at the ability of people facing hospital bills larger than the cost of most houses coupled with formidable health challenges to remain positive and focused. That respect doesnt mean its any easier to hear their stories, however. There are fewer things that are more emotionally draining and exhausting.
With this latest conversation, however, something was different. For the first time in 15 years, I could offer a firm answer about a health plan that would fit the callers budget, an end to the endless medical bills and, finally, some economic security.
The federal Affordable Care Act starts enrolling people in health plans with Jan. 1 start dates beginning Oct. 1. In just a few weeks, the person I was talking to despite a history of cancer will be able to sign up for a health plan that fits her budget. Health plans will be prohibited from charging people more because of pre-existing health conditions, and a variety of plans and deductibles will be available. For people with incomes under about $88,000 for a family of four, tax credits will reduce the premiums paid to insurers to make these health plans work. In fact, people can sign up for preliminary information right now at healthcare.gov/.
As I related the facts about the Affordable Care Act on the phone, I didnt think much about it because Ive been doing health policy and advocacy so long sometimes I even (regrettably) dream about health cost charts and lists of talking points. After the call though, reality hit me. When someone asks, I can now offer real solutions to the enormous mess our countrys health care system is for people with no insurance or with expensive and ineffective coverage.
Sure, Gov. Pat McCrory and N.C. legislators managed this year to deny 500,000 of the very lowest-income North Carolinians coverage under the Affordable Care Act by refusing the billions of federal dollars available to expand our Medicaid program. But despite our political leaders best efforts, they couldnt prevent the rest of the Affordable Care Acts new online marketplace and consumer protections from beginning in our state.
For more than a million North Carolinians, federal health reform will mean a selection of better health plans that fit their budget. And for health advocates whove shared my experience of trying to answer the toughest of health insurance questions, the sweet relief of finally having a real answer is at hand as well.
Adam Searing is project director at the
Health Access Coalition at the
N.C. Justice Center in Raleigh.