Another brave person is telling her story about living in the gap in Idaho. This letter is unedited. Candace deserves a great deal of credit for putting her story in the public eye. She also deserves affordable access to health insurance, something she and 78,000 Idahoans don’t have.
Before the Affordable Care Act I had a catastrophic health insurance plan. I couldn’t see a doctor but I knew if something horrible happened at least I could be taken to the hospital. With the passage of ACA my plan was cancelled because it didn’t meet the minimum standards of coverage but I couldn’t afford the cost of a qualifying plan.
I applied for the federal insurance marketplace and was told that my income was such that I would qualify for Medicaid if I lived in a state that had chosen to expand its Medicaid program. I was also told that I couldn’t purchase insurance through the marketplace or receive subsidies for insurance because technically I could buy insurance through my husband’s employer.
My husband is a full-time teacher and I am building my business as a massage therapist while also staying home with our two small boys. Essentially we are a family of four living on less than $3000 per month and my husband and I still have student loan debt. But we are very fortunate to have a kind and generous landlord who allowed us to build an office in which I can work in the basement of the house we rent. Not every mother has such an opportunity.
The monthly cost for me to be added to my husband’s insurance policy, for which he is already required to pay $100/month, would be an additional $600. With our income the ability for us to pay $700/month for health insurance is obviously a ridiculous proposition amounting to extortion.
Through a number of phone calls and a postal letter to a federal appeals office in Kentucky I was able to miraculously appeal my case and for the glorious year of 2014 I had complete health insurance.
Late in 2014 Idaho opened its own insurance marketplace and my case was transferred from the federal to the state level. At this time I was once again denied eligibility for participation in the insurance marketplace and the subsidies that made buying insurance possible. I again spent many frustrating phone calls trying to appeal my case. I retraced my path back to the appeals office in Kentucky and came to discover that basically someone in that office read my letter, used common sense, and resubmitted my application with the change that I was not eligible for my husband’s insurance.
The appeals office in Idaho however was unwilling to take such action. I was told there is no federal code by which they are able to judge my appeal leaving them no choice but to deny me. I asked if there was someone with whom I could speak that could fix this glitch in the code. I was told my only option was to contact my state representatives for help.
I laughed and cried at the same time because certainly I was being told a very bad joke. Men who are working to eliminate a program have no interest in trying to fix it.
So now I stand worse off than before the ACA, without any insurance at all.
From my perspective this issue is not just about the expansion of Medicaid. It is also about a glitch in a well- intended program that no one seems able to fix. It’s about how perverted are our values when we reward the educators of our future citizens with poverty. And it’s about state representatives and legislators that act in service of their own pride and power instead of the best interests and well-being of all their constituents.