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Why I Fear Losing Insurance as Someone With Pre-existing Conditions

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I am 53. I have multiple pre-existing conditions. I am disabled. I depend on my health insurance, my medical team, my medication and medical devices/tools to manage my life. Without them, I would not function, would be severely mentally ill, could not hear, and my pituitary adenoma (brain tumor) would not be managed. Healthcare is very important to me, as it is to many other people. I currently pay $345 per month for my healthcare premium and it is one of my biggest budget expenses. In addition, I have office co-pays, lab co-pays, and prescription co-pays to maintain my health which cost close to $200 per month. If I am sick or have an injury, my health expenses rise.

My husband’s insurance premiums are paid through his work. That is a blessing. But he has had nine surgeries in the past 11 years. This past year he had an issue with his thyroid, which lead to afib and congestive heart failure. The hospital bills, doctor bills, prescriptions, and ongoing care are very expensive. But we have “good insurance” right now and we are grateful that we can manage our health issues.

Unfortunately this may not be the case for us much longer. In a case argued early June, Texas vs. the federal Department of Health and Human Services, the Trump Administration refused to defend the remaining provisions of the Affordable Care Act (ACA). Thus many other provisions, several of which pertain to my age group, could be thrown out. These include premium limits for ages 50-64, minimum benefit requirements, and a requirement that bans insurance companies rejecting people with pre-existing conditions.

I cried and cried as I realized what this decision means to me personally. I have multiple pre-existing conditions, so “good” companies with limits on health care premiums for my age group no longer have to maintain those limits. They can increase limits based on age. So younger, healthier people may pay much less for conventional ACA health insurance than those like me in an older, riskier group. How much more? There is no cap on the limit. In addition another problem rears its ugly head. Pre-existing conditions may be denied. The older you get, the more likely you are to have a pre-existing condition. I reviewed a list of pre-existing conditions including but not limited to bipolar disorder, cancer, diabetes, MS, pregnancy and sleep apnea.

What is left for people like me ages 50-64, with multiple pre-existing conditions and living on a fixed income? President Trump extols the wonders of association health plans (AHPs). He claims these low cost health plans will accept anyone, even those with pre-existing conditions. It sounds wonderful, doesn’t it? What is not explained about AHPs is that they do not have to provide minimum medical benefits or cover pre-existing conditions. What does that translate to in plain English? AHPS can choose not to cover medications, hospitalizations, mental health care or pregnancy. They can exclude whatever they choose because there are no minimum requirements for healthcare. Add to that the exclusion of pre-existing conditions because no minimum benefits are required, and many will choose not to purchase an AHP plan. Essentially many people in the 50-64 age group and many people with pre-existing conditions will be without medical care. There will be no viable options for them.

I will potentially be one of these people without a health care plan, attempting to meet my healthcare needs out of pocket, not getting care, or using creative methods like participating in studies or being a guinea pig for an intern — if I can find such possibilities.

I am uncertain what my future holds after this year. I currently have insurance, but that may change in 2019. My tears flowed as I wrote this, not just for me but for friends, students and all the people it may affect. I looked at my medicine box and wondered if next year I would be blessed to have the medications that keep me healthy and stable. My husband assures me of two things: we will find a way through this, and we will vote to make this better in the coming election. All I can do is raise awareness and shed tears.

Originally published: July 1, 2018
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