Impact of Health Insurance Reform on Americans

Posted on by Karina

As House Democrats introduced health insurance reform legislation to improve the Senate-passed bill, Speaker Pelosi, Leader Hoyer, Whip Clyburn, and Caucus Chairman Larson held a press conference this afternoon in the Capitol with Americans who represent the struggles many have with our current health care system and how they will benefit from much-needed health insurance reform:

Ed Morris

Ed Morris

My name is Dr. Ed Morris. My wife and I own a small business, Franklin Health and Fitness Center, in the little town of Franklin in western North Carolina. As you probably know, more than half of small businesses no longer provide health insurance at all to their employees. Well, why is that? Well, our premiums for our business over the last 10 years tripled. This is a huge cost for our business every year to pay these health insurance premiums. Well, why are our premiums so high? Well, we as a small business are in such a pool that we cannot spread these costs around. One of our employees had cardiac bypass surgery about eight years ago. Well, the next year when the insurance company got these legitimate medical bills, our premiums went out the roof the next year. So to keep offering the coverage to our employees, we had to do two things. First of all, we had to raise our deductibles from $250 to $3,000 for an individual. And secondly, we used to pay 100 percent of the premiums for our employees but in order to continue to have coverage, we now require the employees to pay up to 40 percent of their own premiums. And many of them simply can't afford that.

Well, what will this bill do to help us? First of all, we will be in a big pool so our cost will be much lower. And secondly, it will prohibit insurance companies from raising our premiums if an employee gets ill and actually has to use the insurance. And third, and probably most importantly for me as a small business owner, beginning this year, I will receive tax credits of up to 35 percent to help cover the cost of these premiums. This will help me continue to provide health insurance for my employees and possibly to hire some new employees to grow my business.

Our congressional district has one of the highest rates of uninsured of anywhere in the country–23 percent are uninsured in our district. We have over 700 bankruptcies every year just in our congressional district. Every year, hundreds of my friends and neighbors suffer because of lack of adequate health insurance and these hundred of medically related bankruptcies, and this huge burden that us small businesses have, businesses just like mine in our little mountains of North Carolina.

So I am here as a small business owner to urge my Congressman, Congressman Heath Shuler, and really all the Members of Congress, both Democrats and Republicans, to do the right thing to help us small business owners, to do the right thing for our employees, to do the right thing for our local economies, and to do the right thing to reduce our national deficit. So I am urging Congress to say yes to this health care bill this week.

Kim Moldofsky

Kim Moldofsky

Hi. I am Kim Moldofsky from Morton Grove, Illinois. Agliophobia is a fear of pain; iatrophobia is a fear of doctors, but I have yet to find a word that defines my biggest fear–a fear of pre-existing conditions. My fear of pre-existing conditions began years ago when I was diagnosed with Sjogren’s Syndrome, an auto-immune disease that causes dry eye and dry mouth. My illness seemed more of nuisance than a health crisis, so I was shocked when after my husband's employer went bankrupt and we lost our medical coverage, I was repeatedly told that I was uninsurable due to this condition. That was back in 2001, when I was 33 years old.

Eventually, my husband found a job with benefits. After a period of time, my faulty immune system was covered in full, which was helpful because by then I had developed rheumatoid arthritis. Still, once it was diagnosed, and I found the right combination of medicines to combat my symptoms, life continued at a normal pace. We were happy to have medical insurance, but we didn't have a great policy. We had a $5,000 deductible for our family, and with two young children under foot, we often met that deductible. At one point, I realized our high cost, high deductible actually penalized us for using the plan. For example, using the mail-order pharmacy aligned with our plan, it cost me over $2,000 a year for certain medication, a certain arthritis drug. On my doctor's recommendation, I checked the prices at the local Costco. It turned out that the same drug cost me less than $300 without my insurance at Costco.

In the fall of 2008, my husband lost his job and eventually his benefits. This time, I felt fortunate to find a private insurance, a private insurer saving me the expense of the state plan. However, like many policies, it does not provide coverage on the issues that matter most to my family, even my 9-year-old son has a pre-existing condition that is not covered. And of course, my arthritis, well they accepted me into a plan, into the plan with a special deductible for arthritis-related treatment. Knowing that this typically only involves a couple thousand dollars of treatment a year, we felt okay with that. However, it wasn't until after we had signed on the dotted line, the only dotted line that was available to cover my entire family, that we learned this deductible which I assumed was $5,000 or $10,000 was actually a $65,000 deductible–a $65,000 deductible for the most pressing medical condition in my family.

It is not creaking bones that keep me awake at night–it's the fear of developing a condition related to my arthritis that could send us tumbling into bankruptcy. Although I have some coverage, I have a fear of unexpected news, odd test results, a new diagnosis. I have a fear of a new pre-existing condition, a phobia without a name. Although we pay several hundred dollars a month for access to quality care, I am afraid to use it. I often ignore minor aches and pains. I have held off on some scheduled blood tests and exam, and I worry that my attempt to save a few dollars now could cost me dearly in the future if minor problems spiral into larger ones, but ironically, as long as people with pre-existing conditions can be denied coverage, spending money on doctor visits and tests to solve problems early on could actually cost more dearly in the future.

Stella Johnson

Stella Johnson

My name is Stella Johnson, and I am a retired school teacher for Washington, D.C. I am also a member of the Alliance for Retired Americans. Like many seniors, I must take prescriptions every day to manage my high blood pressure and high cholesterol. But unfortunately, along with over 3 million other seniors, I am in what is known as the Medicare “donut hole.”

For several months of the year, I have to pay full price for my prescriptions, even though I am still paying my Medicare premiums. In other words, I pay the money but get nothing in return. For an example, in 2008, I received a letter from my insurance company stating that I would not receive any money for my medicine during the month of December. No you know how that is, that is supposed to be a very joyful month. However, I found myself, during that time, quite desperate for I would not receive any money until the new year for my insurance began. I had to use my utility bill money in order to buy my medicine. And then, in order to catch up these bills, I had to even go to borrow money from my food money. I became quite desperate, and I didn't know what to do. Because in times like this, it is very hard for me to make ends meet. I have to chose between taking the medicines I need and paying my monthly bills. Because my prescription costs so much, I fall behind on some of these bills. When I get hit with late penalties, things even get worse.

The health care bill will help seniors like me, who struggle every day to afford the prescriptions they must have. Retirees all across the country desperately need this bill to pass right away.

Carolyn Comeau

Carolyn Comeau

Thank you. I'm Carolyn Comeau. I live in Ashville, North Carolina. I was diagnosed with breast cancer three years ago at age 45. I got the diagnosis call as my husband was on an important job interview for a position that would allow us to have good, high-quality benefits. Thank heaven he got those benefits in that job. However, seven months later, he was laid off. He works in the construction industry, which was hard hit in our state — and laid off in the middle of my treatment. We had no choice but to get — then get benefits through COBRA and that was $1,058 a month for 18 months. We looked to the individual market for private-insurance, we did not qualify for Medicaid, and had a disastrous meeting with a representative from a company who quoted us $2,000-plus a month for me only. You feel, in a sense, tainted. Being a woman should not be a pre-existing condition.

It's hard to describe the stress of going through a catastrophic illness and the side-effects of the treatment that you receive and worrying about the insurance mess at the same time and how you are going to make it through as a family. The light on the horizon that we thought we had was the North Carolina high-risk pool. I currently pay into that $400 a month. I have a $5,000 deductible. However, my oncologist's office does — is not a member, is not affiliated with that program. And the latest update is that I just got word that there is an exclusionary policy with the high-risk pool for the genetic testing that my doctors want me to have, which would possibly impact my treatment and my future course as well as the futures of my children.

And the final highlight is that recently my husband and I did our taxes. And as we sat down and saw everything in black and white, we saw that very nearly half our income went to health-related costs. And that is just for me. My children are on the North Carolina CHIP program and my husband is uninsured.

So, the bottom line is — the reality: if you're healthy, you get insurance. If you get sick, there's no option — you then have a pre-existing condition, there is no place to turn. Insurance should help everyone, including those who need it. There's no real option in a private market for people with pre-existing conditions. So I urge and urge strongly that Congress make the humane choice for our country and pass this health care reform bill. Plain and simple: It's a broken system and it continues to leave a trail of families whose finances have been decimated by the system.

As Speaker Pelosi concluded her remarks, “for the health and well-being of American people, for the fiscal soundness of America's budget, for seniors, for our young people, for women, for small businesses, for competitiveness — we will make history and we will progress by passing this legislation.”

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