Affordable Care Act, healthcare, Obamacare — January 29, 2015 at 6:54 pm

Young woman with a heart condition can finally get the care she needs thanks to the ACA


A hospital denied her treatment after a stroke because she didn’t have insurance, but Obamacare changed all that.

When Jae Stewart was 14 years old, she collapsed in the gym while playing basketball. The doctors said she had a heart murmur and sent her on her way, but little did Jae know this was the beginning of a lifetime of heart trouble.

Jae had her first heart attack at age 21 and another after a serious car accident a few years later. She had her first stroke before she was 30.

She has congestive heart failure, but the doctors aren’t sure why or when it started. Jae is still being evaluated to find the cause of her heart disease so it can be treated most effectively — a process that only began in earnest once she signed up for insurance under the Affordable Care Act (ACA), also known as Obamacare.

Before that, Jae’s life was filled with uncertainty, because she didn’t have insurance she could count on.

Jae didn’t have insurance at all for many years. She’s an occupational therapist, but in 2012, when she had her stroke, her employer didn’t provide health insurance.

She was sent to one of the best heart hospitals in Texas, where everyone thought she’d get great care. But that’s not what happened, Jae explains.

I needed good insurance to get good healthcare. The cardiologist told me they were going to do open-heart surgery. When they found out I didn’t have insurance, the billing department tried to set me up with Medicaid — but because I was working, I didn’t qualify. They told me then it was at the discretion of the surgeon, because he’d be the one billing me.

About 15 minutes later a guy walks in and tells me I’m being discharged. I couldn’t even walk, because every time I got up my blood pressure would bottom out or go through the ceiling. I didn’t even have a ride home.

I couldn’t believe they were going to discharge me after I had a stroke. The guy told me if I felt I needed to be there I had to go back through the ER to get admitted again.

What Jae faced is what happened to countless people before the ACA. She didn’t get the treatment she needed — but she did get a bill for $48,000, for just two days in the hospital.

After that, she struggled to find any health insurance. Her friends urged her to tell her story to anyone who would listen, so she made a video about it.

For a while, she got some help after Texas introduced an insurance plan for people with pre-existing conditions. But that didn’t last long. Jae got a new job, which made her ineligible — even though she had missed the open enrollment period at work. So she was uninsured again.

I had doctors telling me I needed to file for disability – but I like my job. I like to help others. I didn’t want to sit at home — and I have student loans to pay.

Plus, Jae needs expensive medication to keep her heart issues under control. Just one of the drugs she takes would cost $3,000 a month if she had to pay for it out of pocket.

So Jae is enormously grateful for Obamacare. She’s been covered since early 2014. Her premium this year is $402 per month because she doesn’t qualify for a tax subsidy, but her other costs are low. Her annual deductible is $1,000 and her out-of-pocket maximum is $3,250. She pays $25 to see her doctor and $50 for specialists. Best of all, her prescription medications have zero co-pay.

Not only does this make Jae’s healthcare costs more manageable, it means she can afford to see her doctors regularly so they can figure out exactly what’s going on with her heart.

Jae doesn’t understand why people are so opposed to the ACA. One woman she knows was quoted a price of just $150 per month for insurance and thought it was too expensive.

“I wonder what she spends every month on eating out,” Jae says. “It’s about reassessing your priorities in life. And who do people think is going to pay their bills for going to the ER because they don’t have health insurance? The hospitals pay for that — and we all pay more because of it.”

For Jae, the priority is being as healthy as possible with a heart condition. She considers herself lucky to have Obamacare, and she knows the facts.

There are people saying their doctors won’t take Obamacare and that’s crap. I’ve never had a doctor refuse me now that I have insurance.

I don’t know where people get some of their ideas, like thinking they’re giving their money to Obama. It says on my card, ‘Blue Cross Blue Shield.’ It doesn’t say Obama. I pay my money to the insurance company.

I hope people will realize how important it is to have insurance. You never know when you might have a car accident or get sick. I was really on a roller coaster before but everything’s good now.

If you haven’t signed up for coverage yet, what are you waiting for? 2015 open enrollment ends February 15th. Visit today to find the right plan for you.