Affordable Care Act, Obamacare — December 3, 2014 at 12:42 pm

Without insurance since 1996, couple gets coverage and care thanks to the ACA

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Before Obamacare, they couldn’t afford health insurance — which meant a chronic illness went undiagnosed for years.

Dolly and Chip Harris had a dream: They wanted to start their own restaurant. In 1996, they left their jobs, which meant losing the health insurance Chip got through work. They worked hard to make their new business a success, but luck wasn’t on their side.

After their restaurant closed, the South Haven, Mich., couple found other jobs — Chip cleaning houses and Dolly working as a waitress. They also play in a Pat Benatar tribute band, but still didn’t make enough to be able to afford health insurance.

So Chip never sought treatment for a chronic cough that lingered for six or seven years. “I just knew something was wrong,” Dolly says. “But we weren’t able to do anything about it because we didn’t have insurance.”

That all changed thanks to the Affordable Care Act (ACA), also known as Obamacare. Dolly and Chip found a Silver plan with a $350 annual deductible and a $1,000 out-of-pocket maximum. They pay just $10 per visit to see the doctor. The monthly premium is $900 a month, but because of their low income the couple received tax credits that pay for their premium. Their only expense is co-pays and low out-of-pocket costs.

Even more important, Chip was finally able to see a doctor about his cough, which was diagnosed as COPD. This progressive lung disease, which causes coughing and makes it hard to breathe, can’t be cured but it can be managed with lifestyle changes and medication. Chip now uses two inhalers and sees a specialist every six months. Without insurance, the inhalers would cost $300 a month — a steep price, especially since the 58-year-old Chip had to quit his job because exposure to dust and chemicals while cleaning houses aggravated his COPD. But with insurance, Chip is able to get the care he needs to manage his condition.

They’re taking full advantage of their insurance benefits, Dolly says.

I got my annual physical, mammogram and cholesterol test, we both got flu shots and Chip got a pneumonia shot, which is important for managing his COPD. All thanks to Obamacare.

Under the ACA, these preventive services are all covered with no co-pay for anyone with insurance. Dolly was also able to afford a cortisone injection for arthritis in her wrist, which is painful when she’s waiting tables.

Now, she’s making it a mission to educate others about the availability of affordable insurance.

The friends we play with in the band didn’t have health insurance, either, and they found out they qualified for Medicaid [under the Healthy Michigan Plan]. Because they have healthcare, my friend found out she has diabetes and glaucoma. She was glad to find out what was wrong so she could take care of herself. Another friend wound up in the ER with chest pain, and although he didn’t have a heart attack it was enough to make him realize he should sign up for Obamacare, too.

Dolly is concerned about the Supreme Court case that has the potential to eliminate tax credits for Americans in states that did not create a state-based exchange.

“We have our health insurance,” she says. “I hope they don’t take it away.”

Open enrollment for 2015 continues until February 15, 2015, and you can start your new plan January 1 if you sign up by December 15, 2014. Tax credits are available for those who need financial assistance, or you may be eligible for Medicaid expansion under the ACA, called the Healthy Michigan Plan. Learn about all your options today at Healthcare.gov.

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