Sunday, December 8, 2013

I Did It: My Obamacare Story

I signed up yesterday for Obamacare. And I couldn't have been happier, both with the results and with my experience navigating the ACA website.

Couldn't have been happier with the results: as I've shared here repeatedly, I've been without any health insurance at all for a number of years now. Due to an unfortunate decision Steve and I made over half a decade ago, when we trusted a promise made to us by someone who represented herself as a friend and turned out to be eminently untrustworthy (as in eminently sociopathic), we now carry a second mortgage on a house we bought on the strength of that broken promise.

And we simply can't afford to pay our two house notes and our other living expenses and buy health insurance for me. Nor can we afford to sell the second house, whose value plummeted in the year we bought it, so that we'd lose a big amount of money we pulled out of our savings for retirement to buy the house, if we sold it at a loss now.

Steve's workplace does not provide coverage of same-sex spouses. Though for some unfathomable reason, The Advocate chose to list Little Rock as one of the nation's gayest cities in 2012, in its recent Municipal Equality Index, the Human Rights Campaign gives Little Rock a score of 21 out of 100, which is well below the national median of 57, and places Little Rock on a par with cities like Columbus, Georgia, and Grand Prairie, Texas, and just above Shreveport, Louisiana, Rapid City, South Dakota, or Bismarck, North Dakota.

On a par, that is, with places hardly known for their vibrant gay communities or the gay-friendly attitudes of their citizens . . . . The Municipal Equality Index looks at things like laws protecting and affording rights to LGBT folks (non-existent in Little Rock), laws recognizing gay unions (ditto), etc.

And so, as I say, Steve's workplace doesn't provide spousal benefits to same-sex couples, though it does have a policy stating that it does not discriminate on the basis of sexual orientation. And we've scrambled for some years now to try to figure out how to obtain healthcare coverage for me. We've made do by assuring that I stay as healthy as possible as a diabetic moving up in years, that I require as few doctor's visits as possible, and by paying out of pocket for those visits and for medication.

Needless to say, living this way produces no small amount of worry for both of us. There's a certain ignominy in being 63 years old and unable to buy health insurance. One feels thrown away. One feels like a downright failure.

That feeling was underscored recently when a distant cousin of mine posted something on his Facebook page asking family members and friends to write statements about thankfulness as Thanksgiving approached. I penned a short note saying I was thankful this year that millions of Americans who have been living without healthcare coverage now find themselves covered.

Almost immediately, a friend of my cousin living in Tennessee hopped on my statement. The gist of her response was that I must be an immoral deadbeat like all the other deadbeats now expecting her and other hardworking, righteous citizens to pay for their healthcare coverage. Get a job, already!

And now I'm covered, or so the ACA website told me yesterday--or I will be covered, when I've received word from the state agency overseeing some aspects of the implementation of the ACA in Arkansas. My overarching feeling after I punched all the buttons on the form at the ACA website: relief. Relief that I succeeded in making my way through the website. Relief that I'm being assured I will be covered, mixed with a bit of anxiety until I receive final word notifying me that all is in order and I now have healthcare coverage.

To all my fellow citizens who share the view of that Tennessee woman who doesn't know me from Adam, and isn't even connected to me by Facebook, but chose to jump on my comment about how thankful I am that millions of Americans without healthcare coverage can now obtain coverage:

1. I suppose I could, as you kindly encouraged me to do, get a job. Maybe McDonald's or its ilk is hiring the elderly right now, though I have the impression that many fast-food places don't provide benefits to their employees. With a Ph.D. in Catholic theology, my job choices are otherwise rather limited, especially in a small city in the evangelical heartland where Catholic theologians aren't in high demand. As someone approaching retirement age, I don't find a lot of places clamoring to hire me, either.

2. You accused me of wanting something for free. You misunderstand how the ACA works. I have long paid taxes and contributed to federal programs out of my income when I've been employed. Like all the other deadbeats you castigated in your response to my note of thanks, I have long paid into various social programs supporting those on the margins, and I've contributed to through my labor and taxes to the common good, just as you've done.

3. You appear to think that you are or should be disconnected from all your fellow citizens in need. Do you honestly imagine that you create a healthy society--for yourself and for your own family--when you allow many fellow citizens to fall through the cracks and go without healthcare coverage, because they can't afford to buy it? Do you think there are no social costs for such negligence, and that you don't end up paying a high price in the end, when those you've refused to help cover medically resort to emergency rooms--which receive your tax dollars--to patch them up as they're in direst medical need?

4. The gospel passages you seem to imagine you're quoting don't seem to be in my version of the bible. The version I read condemns self-righteousness. It doesn't glorify that attitude. It also condemns callousness towards those in need, taunting those who are at the bottom of society, representing oneself as a moral exemplar while imagining others who are going through hard times have earned their travail because they're immoral.

5. We're all in this together, as a society. When one falls, we all fall. When one rises, we rise with the one who is rising. Because I lived for six years in Canada as a graduate student, and was covered by the Canadian healthcare system at no cost at all during those six years even though I was not even a Canadian citizen, I have seen an alternative to the American system with its assumption that the provision of medical care should depend on ability to pay. 

I have long been ashamed that my nation, which claims to lead the civilized world, has a healthcare system on a par with those of some of the most underdeveloped sectors of the globe. I am a little less ashamed now that the Affordable Care Act has been implemented. It's far from perfect, and to their discredit, some of the most "Christian" and bible-quoting states in the nation have actually chosen to refuse billions of dollars offered by the federal government to provide healthcare coverage to their desperately poor citizens.

But we've made a start. And for that, I'm thankful.

The graphic is a a photo by Emmanuel Dumand of AFP-Getty and is from this New Yorker story by Atul Gawande.

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