‘What If’ Coverage: Because Your Health Matters

In 2004, I got sick. Very sick. Thought-I-was-dying sick.

I won’t bore you with the medical details of the eight-week ordeal, but there were eternal stays in the hospital, nine (yes…nine!) spinal taps, ridiculous weight loss, unexplained and horrific headaches, and, ultimately, a surgery.

So, at 25 years old, I wrote letters to my loved ones and prepared myself for death.

Only I didn’t die. I lived to photobomb another day.

But that doesn’t change the fact that I thought I was gonna. For real. And there’s no real medical explanation for what happened.

And because there was no “real medical explanation” for what happened, somewhere, somehow I got labeled with a condition I don’t really have. Because there’s no medical diagnosis for what I have, I got Labeled.

You see, insurance providers need labels so that they can “approve” your treatment and, ultimately, pay for it. But what insurance providers do with that label can haunt you for the rest of your insured (and uninsured) life.

Fast forward to 2006. I was better. I had moved to San Antonio (“City On The Rise” to all you locals), and was pursuing a masters degree at UTSA. After a career in radio and television, which offered health insurance, I found myself waiting tables while I went to school. (Shoutout to my MoCaf friends!) Getting smarter, apparently, means a lack of health insurance.

When you have a history of long hospital stays and unexplained headaches, you tend to err on the side of needing health insurance. Insurance has always been explained to me as a good “What If” policy. It’s why my house is insured. It’s why my car is covered. What if something happens.

So, after a near death experience, “What If” it happened again?

I was still paying off hospital bills from 2004, which I had accrued WITH health insurance. I knew that if some unexplained ridiculousness happened again, I wouldn’t be able to afford NOT to have health insurance, so I started looking into individual medical plans.

I filled out all the appropriate, lengthy forms for individual health insurance. In 2006, post-surgery and multiple hospital stays, I was a non-smoking, non-drinking, for-all-intents-and-purposes-healthy 27-year-old, and yet, I couldn’t get approved for health insurance. Why? ‘Cause of that stupid label that followed me all the way to San Antonio. And I never had it to begin with.

I spent two and a half years without insurance. I spent two and a half years saving for needed prescriptions. I spent two and a half years discovering ways to get around headaches, faking my way through “not so great days.” I kept my fingers crossed on mornings when I woke up with headaches so bad my eyes crossed that I wouldn’t end up in a hospital room. Because I knew if I ended up in the hospital, I wouldn’t have been able to pay for it.

I was anxious. A lot.

Now, let me get something out of the way: I voted for Barack Obama. Twice.

Apparently, knowing one’s political affiliation is important when talking about healthcare these days. And so…I willingly announce my voting record because where I’m about to go, however political this issue has become, is not a political statement.

The Affordable Care Act would have saved me.

The Affordable Care Act – otherwise known as Obamacare because we’ve made this a matter of politics – is the most comprehensive health care program in the United States since 1965. It is designed to expand health insurance coverage, so that more people have access to health care. To read the full law, click here.

How giving more people access to health care became a political debate is beyond me, but it has.

Let me be clear: in 2006, when I was being denied health insurance because of a “pre-existing condition” that I didn’t actually ever have, I was not thinking about politics, I was thinking about my health.

With the Affordable Care Act (ACA), my pre-existing condition (however real or not) doesn’t matter. Seriously. An insurance company now can’t turn me (or you) down or charge me (or you) more because of a “condition.” And you know what else? Once you have insurance, the plan can’t refuse to cover treatment for your pre-existing condition.

Look, I am not an expert on ACA, but I have done a lot of research recently as part of SA2020’s work on EnrollSA, Get Bexar Covered.

EnrollSA is a coalition of healthcare professionals – a collaborative effort that includes hospitals, Bexar County, the City of San Antonio, nonprofits, and grassroots organizations. The goal of this coalition is to empower individuals to take advantage of the Affordable Care Act in an effort to increase health care coverage in Bexar County.

So, why the heck is SA2020 involved in this? We’re certainly not “healthcare professionals.”

Here’s the deal: there are more than 212,000 uninsured persons in Bexar County, almost 12 percent of the population. Increasing access to health care is a goal set by the community as part of the SA2020 visioning process. In 2011, only 78.3 percent of individuals in Bexar County had health insurance. Our goal is to have 86 percent of the total population insured by 2020.

Getting people enrolled in ACA directly links to increasing access to health care.

The elephant in the room (or donkey…see what I did there?) is the politics of it all.

So…let’s just talk health insurance.

• Fifty-two percent of women report delaying needed medical care because of cost.
• Seventy-seven percent of uninsured women, ages 19-64, are more likely to skip care because of costs.
• When explaining their decision to go to the emergency room, 40 percent of uninsured adults say they don’t have other affordable options, while 41 percent of uninsured adults say they don’t have a regular doctor.
• Latinos are uninsured at a higher rate than any other ethnic group in the United States.

There’s really nothing about any of those stats that screams politics. They all point to healthcare.

I am now insured – thanks, job – but feel the after-effects of not having preventive, regular check-ups for two years.

The weirdness that started in 2004 affects me in 2014.

I don’t know for fact that regular check-ups would have helped my brain, but I don’t know for a fact that they wouldn’t have helped, either.

But I couldn’t get check-ups because I didn’t have the option for health insurance, because I couldn’t afford it. And I couldn’t afford check-ups. I was a college student, waiting tables for crying out loud. I could very rarely afford gas for my car.

I understand that there are many issues surrounding the healthcare marketplace – additional expense, ill-managed technology, horrific public relations. But put aside the politics of it all and take a moment to really think about your health.

This is a complicated issue that has been made even more complex by talking heads, pundits, and bureaucrats who are spending more time arguing than helping explain it to the American people. I mean, seriously, have you looked at an insurance plan? It’s difficult.

That’s where EnrollSA can help. You have until March 31 to enroll for this year. After that, if you are not covered, you will pay a penalty. Attend a local enrollment event – they are happening all over the city – to get more information so you can be better informed. Just want to start enrollment? Do it.

Stop listening to the politics and start thinking about what it might feel like to know that if you’re not feeling well, you can simply make an appointment with your doctor.

“What if” you get sick? “What if” you end up in the hospital? “What if” you had health insurance? “What if” San Antonio met the community’s SA2020 goal of getting 86 percent of the population insured?

Molly grew up in Corpus Christi. Her focus in nonprofit capacity building grew to include her own consulting business, Nonprofit Fancy Pants. In March 2013, she joined SA2020 as the Chief of Engagement. Find her on Twitter @themollycox.

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