Because Being Sick Shouldn’t Keep You From Being Covered…

The Health Insurance Marketplaces give you options
Oct. 3, 2013

For years, millions of Americans have been denied the security and peace of mind of having health insurance. This has included people with pre-existing conditions—from something as commonplace as acne or headaches to things as rare as toxoplasmosis.

Thanks to the health law, all of that is changing. Starting October 1st uninsured Americans, including those with pre-existing conditions, will be able to shop for more accessible and affordable coverage at Healthcare.gov.

This means that people like Jill from North Carolina can now shop for coverage. She shared her amazing story with us:

"This can’t be happening, I’m still young.

That was my final thought before losing consciousness. I was only 30, suffering my first terrifying bout of tachycardia (racing heart). The episode lasted several minutes, precisely how long I can’t say because I passed out in the parking lot beside my car. Fortunately, someone found me and called for help. I awoke in the ambulance with my heart still racing, 230 beats per minute according to the EKG. I was shivering and dizzy but mostly I was shocked that my heart had failed me.

I needed insurance to fix my heart, but because of my heart, I couldn't get coverageI was diagnosed with the arrhythmia AVNRT (atrioventricular nodal reentrant tachycardia). In laymen’s terms, my otherwise healthy heart was prone to an electrical short-circuiting. The options were (1) live with the condition, which would almost undoubtedly worsen over time, (2) treat with daily medication to—hopefully—prevent episodes, but suffer the debilitating side effects that include extreme fatigue, or (3) undergo a simple surgical procedure and fix my heart once and for all. My cardiologist recommended a simple surgical procedure, which boasts a nearly 99% success rate, to fix my heart once and for all. It seemed a no brainer. But without a decent health coverage plan, I couldn’t afford the surgery.

At the time, I was self-employed as a freelance writer and tutor to high school students. Individual premiums were pricey, so I’d invested in major medical coverage, which seemed a reasonable option given that I was young and healthy. The plan only covered about $400 of my $4,000 trip to the emergency room, and nothing of the follow up appointments with a cardiologist, nor the expensive diagnostic tests. I was suddenly several thousand dollars in debt, and unable to pay out of pocket for the procedure that would fix my heart.

None of this was supposed to happen. I didn’t drink or smoke. I ate right and exercised daily. Only a couple of months earlier, I’d run a 3:04 marathon. I was, by all definitions, healthy and active. There was nothing to indicate that my heart was anything but strong. I’d never experienced any serious health problems and certainly never expected, at age thirty, to encounter trouble with my heart.

I also didn’t realize the long-term impact of lackluster medical coverage on my health, life, and finances. Once I was diagnosed with AVNRT, no insurance company would touch me. I needed insurance to fix my heart, but because of my heart, I couldn’t get coverage. It didn’t matter that, in every other respect, my health was good. I had a pre-existing condition, which meant I was essentially uninsurable.

Over the next four years, as my cardiologist predicted, my condition worsened. The episodes of tachycardia became more frequent and frightening, from once every few months to almost daily. I lived in constant fear of the next episode, and suffered debilitating exhaustion afterwards. My work suffered. I was forced to stop running. Only a couple of years earlier, I was aiming to qualify for the Olympic Trials marathon then all of a sudden, I couldn’t walk around the block without my heart exploding in my chest. I barely left my house, and when I did, kept my cell phone within arm’s reach, in case I needed to call 911. It was no way to live, but without affordable insurance, I had no other options.

Then in 2011, I found out that I was eligible for insurance through the Affordable Care Act. Fortunately, I’ve had no health problems since surgery. But I know that the unexpected can happen.

The Affordable Care Act enables me to be better prepared. I look forward to learning about the available health market options beginning October 1st, and the security of knowing I’m covered, even with a pre-existing condition. But living without health insurance is like playing Russian roulette with both your health and finances. I don’t want to take that risk if I can avoid it, and thanks to the Affordable Care Act, I don’t have to."  

The new Health Insurance Marketplace will make it simpler for individuals like Jill to make a side-by-side comparison of coverage options. Most people will enroll online. But for some it will be easier to enroll by phone at 1-800-318-2596, in person (Find Local Help) or by mail.