Kathe is one of millions of examples of how the Affordable Care Act delivers better access to healthcare at a lower cost.
November 1 marks the beginning of the health insurance open enrollment period — and another chance for Americans to get affordable coverage that gives them access to the essential healthcare services they need.
Just ask Kathe Koja of Berkeley, Michigan. As a self-employed writer married to an artist, Kathe and her husband always had trouble buying health insurance before the Affordable Care Act (ACA). Although they’re both healthy, the 55-year-old Kathe once had pre-cancerous cells on her ovaries that marked her forever as someone with a “pre-existing condition” — even though they were removed to keep her cancer-free.
But over the years, Kathe and her husband were often forced to go without insurance. They cancelled their last insurance plan in 2012 because it was far too expensive and covered almost nothing. There wasn’t even coverage for prescriptions or preventive care.
“It got to the point that you’d have to get hit by a bus, maybe two buses, to justify the monthly cost,” Kathe says. “We could go to the doctor but we couldn’t afford any medication. It was a joke.”
When coverage became available through the ACA, aka Obamacare, Kathe and her husband learned they could get covered for less than $200 per month, with the help of tax subsidies — financial assistance that’s available to about 85 percent of Americans under the ACA.
“When I saw how much money I would save, I cried,” Koja says. They renewed their plan for 2015 and hope to keep the same plan for 2016, although they’ll shop around to get the best coverage for their health needs and budget.
Kate and her husband understand the value in having access to affordable healthcare.
I had to go to the ER before we signed up for insurance, and I kept telling the doctors, ‘Don’t do that test! I can’t afford this.’ Going without coverage was a gamble in case something went wrong. But the plan we have now rewards us for preventive care visits like pap smears and mammograms, because we don’t pay extra for those. Preventive care saves money and lives in the long run.
Just last month, Kathe took a tumble and really whacked her elbow. She wasn’t sure if she should visit the ER or urgent care, but then she remembered her insurance plan includes free 24-hour phone access to a registered nurse.
In one phone call, she was given self-care instructions and was reassured that it was nothing serious. “In less than 15 minutes, I found out I didn’t need to worry about it,” Kathe says. “It’s a very cost-effective benefit that kept me out of the urgent care clinic or the ER.”
What’s more, because Kathe was successfully treated for a condition that could have led to cancer but didn’t, she knows how important preventive care is, not only for herself and her family, but for society as a whole.
Insurance means access to care that can keep you healthy so you’re a contributing member of society. If I get sick, I can’t work and I can’t pay my taxes.
Even if all you care about is money, the ACA is the most cost-effective way to make sure people stay insured, stay healthy and stay part of the productive pool of society. We’re not freeloaders — it’s called the Affordable Care Act, not the Free Care Act. It just makes it more affordable for us to be insured.
Open enrollment runs from November 1, 2015 through January 31, 2016. You must enroll or renew your current plan by December 15 to get coverage that begins January 1, 2016.
Erin Knott, Michigan state director of Enroll America — a non-profit organization devoted to helping people sign up for health insurance — had this to say about the start of open enrollment.
Michiganders will once again have the opportunity to enroll in quality, affordable health coverage. In our work across the Great Lakes State, we have seen firsthand that the Health Insurance Marketplace is giving thousands of Michiganders the financial security and peace of mind that comes with knowing you’re protected. That’s why we’re working across the state the educate consumers about their options and help them get the resources they need to make the best decision for their family.
Get Covered America, which is a program of Enroll America, offers in-person enrollment assistance that’s free and unbiased. It’s all about getting you the best plan for your needs and budget. Click HERE to find someone in your community and schedule an appointment.
You can also sign up on your own at Healthcare.gov, where it’s easier than ever to compare plans to find the right one for your needs. I also put together some resources to help you make an educated purchase decisions. Remember: You may qualify for financial assistance to help make insurance more affordable.
If you got covered in the last two years — or you buy insurance during this year’s open enrollment period — I’d love to hear your story. Contact me HERE if you’re interested in being profiled in an upcoming post. Special thanks to Families USA for bringing Kathe’s story to my attention.
[Images courtesy of Kathe Koja.]