By Lauree Benton
Editor Note: This 2013 article is a reminder of what is at stake in the efforts to repeal the ACA (Obamacare). The current GOP plan (AHCA) would let employers deny coverage for maternity and other care. Pregnancy would become a preexisting condition–again.
I didn’t know pregnancy was a preexisting condition until I was 8.5 months pregnant.
“You are uninsurable,” says the sales representative from Blue Cross of California. “Pregnancy is considered a preexisting condition.”
“You mean the preexisting condition that allows humanity to survive?” I snapped. I was furious.
To the sales rep’s credit, he thought it was ridiculous too.
(Full disclosure: I had insurance. I’m still on my father’s plan at age 24, thanks to the Affordable Care Act. But I wanted insurance for my son when he was born, and I figured why not just get a family plan for both of us?)
I went on a rant about the sexist nature of the policy. About how much medical care is required when a woman is pregnant. What if an uninsured woman unexpectedly becomes pregnant? What if she makes too much money to qualify for MediCal, but not enough to pay for the next year of doctor’s visits, blood tests, ultrasounds, and hospital stays out of pocket? What if she doesn’t know about AIM before 30 weeks, and misses the cut off? What if, god forbid, there are complications? I knew I would be okay. I have insurance. But what about the women who were in a more precarious position than myself?
I went on and on. I could still go on and on. I won’t. It’s sexist as hell. Let’s leave it at that.
Anyway, the sales rep also told me that I could not insure my child until after he was born. (As a member of the SDFP editorial board said: “So a fetus can get a lawyer, but not an insurance policy?”)
He suggested I apply as soon as my son is born. It’ll solve both problems. He will be a person with a birth certificate and social security number, and I will no longer be pregnant.
A few weeks later when he was born, I did not fill out the forms immediately. I was on some heavy drugs. I just grew a human and had it pulled out of my body. Give me a damn minute.
Fast-forward two weeks and I’m on the phone with Blue Cross yet again. The online form wouldn’t work because I didn’t have his social security number yet. Meanwhile, my newborn son is uninsured and I am hoping beyond hope that nothing happens.
It took three hours to apply over the phone. THREE. HOURS. With a newborn in the house. They asked me my entire medical history. And I couldn’t remember many of the answers. Lesson here: Keep medical records from the time you are old enough to stash paper in a shoebox. You may need it.
Have you ever been diagnosed with kjahdsfgkjdhfgajdhfgeitis?
I don’t know what that is. So probably not.
Have you ever gone to the doctor? If so, when? Month, day, year. What was the doctor’s name? Location? Phone number? And what was the prognosis?
Seriously? Let me and Google start working backward…
The worst part was the insane questions they asked about my son.
Has he ever been diagnosed with an eating disorder?
No. He’s two weeks old.
Has he ever lived for a long period of time in a foreign country?
He’s not lived for a long period of time at all.
I mean. What?
Fast-forward 27 days. I get a letter in the mail. My sons insurance was approved! It will kick in four days later.
I got denied. Because how dare I take painkillers after having a baby. They were also unhappy that I did not have a completely medically unnecessary test done. I could reapply in 30 days.
Nope. Screw it. I have insurance. My boy has insurance. Forget this.
The kicker: His policy was $760 per month. Just for him. A baby. And the deductible? $2,000.
His circumcision? Out of pocket. That one time we went to the emergency room at 2 a.m. on a Tuesday because we were new parents and I panicked? Out of pocket. The emergency room doctor who is inexplicably billed separately from the visit itself? Out of pocket.
Which means we paid the bulk of his medical cost out of pocket. Plus $760 per month for vaccines.
Then his plan was canceled. (I want to be clear here. This is not one of those “Obamacare killed my insurance plan” things. This was a matter of personal finance.)
I cried when I got the cancelation notice. I couldn’t even manage to keep my son insured. How am I supposed to succeed at anything as a mother?
My son has been uninsured for four months now. And it causes a lot of stress and worry. We pay for his doctor’s visits out of pocket, and go to the community health center for $20 vaccines.
Right now it’s not so bad. But what if he gets sick? Or there’s an accident? Am I really going to spend the money that could go toward his college fund on the basic necessity of healthcare? Because in this country, it is not a right, it is a privilege.
I didn’t think the Affordable Care Act would help us. We don’t qualify for subsidies, so what would the exchange matter?
But when we looked at it, it took my boyfriend and I all of 20 minutes to navigate the Covered California site and come up with three plans that will serve our needs better than before. They are all $200 to $300 cheaper per month than the plan we had, there is no deductible on two of them, and I can’t be denied coverage for having a uterus.
We haven’t signed up yet. But it has nothing to do with the website or our generations “short attention span” as Brian Bilbray accused us of on KUSI. It’s because we know we have time to weigh the options. And for the first time, we have affordable options to weigh. We want to make the best choice.
And it’s not like the insurance industry is easy to navigate. There are still questions. Which plans allow us to keep our pediatrician? What is the cost/benefit ratio of the no deductible, higher premium plan verses the high deductible, lower premium plans? PPO or HMO? What the heck is an EPO?
We have time. We will figure it out. We will enroll. We will save money.
Most importantly of all, my baby boy will be insured again come January 1, and I will breath a sigh of relief. Thanks to the Affordable Care Act.
This article was originally published on May 5 2013
By Lauree Benton is a San Diego resident and proud mom.