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Disabled Family Sees 300 Percent Increase In Health Insurance Costs Under Obamacare
Capitol Confidential ^ | 1/15/2014 | Anne Schieber

Posted on 01/17/2014 6:38:19 AM PST by MichCapCon

BAY CITY — The Affordable Care Act was supposed to help families with pre-existing conditions, not hurt them. But that has not been the case for the Davert family.

Their health insurance bill has gone up 300 percent and the family is looking at taking out loans and returning to work while on disability to pay the increased costs. The Davert's experience with Obamacare is not just frustrating, it could be dangerous given the medical issues and special needs of the family.

"We have such a unique family and we've overcome many obstacles," said Ken Davert, who has cerebral palsy. "Now it's a shame that one of the obstacles we have to overcome is our own government to pay for health insurance."

Ken's wife, Melissa, and the couple's twin children have brittle bone disease and a high susceptibility to lung infections.

"Up until now, our out-of-pocket maximum has been $2,500 combined for both children, which is a lot of money but certainly doable," Melissa said. "Now we're looking at a bill of $10,200 because we can't find a plan with less than a $5,100 deductible for each of our two children."

The Daverts have always had access to affordable health insurance. Because of their disabilities, Melissa and Ken receive insurance through Medicare. Their children, Austin and Michaela, received coverage through a private Blue Cross plan and a state program that pays for uncovered care related to the bone disease. This fall, like millions of others, the family learned that the private plan was canceled.

Immediately, they sought replacement on the federal government's health care exchange. It has been an odyssey months in the making.

They had no luck on the website. When they finally got through by phone, they spent an hour answering application questions. They then were told they would have a response one day before the deadline to sign up. Melissa was worried that would give them too little time to review their options.

That became the least of their worries.

When they heard nothing, they called on the day they were to get a response, waited 30 minutes and were disconnected, she said. They called back, waited another 30 minutes, only to be told their application was lost. They spent another hour applying again.

When they still didn't hear anything, they called again. By this time, it was right before the policies for the children were set to expire, a result of the federal health care law.

Life without insurance for children with significant disabilities was difficult to even contemplate, Melissa said. Just a few months earlier, one of the children required surgery for broken legs.

This time, the family was told that the children were ineligible to apply for insurance on the exchange. The representative could not explain why and said the family could file an appeal, which would take 90 days.

The family found policies on the private market, but no companies offered anything less expensive than a plan with a $5,100 deductible for each child. While the state plan for the children will pay the premiums and uncovered expenses related to the bone disease, it would not pay for routine care, which, for the family could be anything but routine. Several years ago, one of the children required a tonsillectomy and was in intensive care.

The family's sole income is from Social Security disability payments and they are considering loans to meet the deductible. Though limited, Ken has been able to pick up some hours to help cover the cost.

"I can only work part time with my condition," Ken said. "But I can get a couple of hours. About 20 hours a week is about all I can work. But it will certainly help in the long run."

The family is trying again to buy insurance on the exchange with an appeal. Even if they are successful, they don't think they will qualify for federal subsidies. To qualify for Medicaid in Michigan, families must be within 183 percent of the federal poverty level, less than $47,100 for a family of four. And while the “platinum” plan on the exchange offers lower deductibles, it does not cover their doctors in Ann Arbor.

"Our policy has been slaughtered by this law to where we have nothing," Melissa said. "I think they tried to make a quick fix to a very complicated problem."

Jack McHugh, senior legislative analyst with the Mackinac Center for Public Policy, said there is an achievable solution Congress could reach his year.

"The first step, and it's not that hard to do, is to eliminate many of the insurance mandates that are baked into the current Obamacare policies," McHugh said. "That doesn't necessarily mean repealing the duty of insurers to accept customers with pre-existing conditions (assuming that other changes are also made).

"It's complicated," he said, but not insolubly so.

McHugh said the current mix of insurance plans are full of "cross-subsidization," through premiums and deductibles. Policyholders must now buy gold-plated plans that must pay for everything required by the law, whether the policy holder wants the coverage or not. Forcing this on the industry triggered a massive disruption of the health insurance market, which was far greater than most politicians understood when they passed the bill, he said.

"Maybe convert those gold-plated plans to a catastrophic plan for most people, which would be more affordable," McHugh said. "Insurance companies could then increase their pool of policyholders, which improves their ability to cover claims without charging exorbitant premiums and deductibles. The law could provide a basic health care entitlement for a lot less money and with a lot less turbulence, chaos and disruption to people’s lives."

McHugh said he thinks if Congress acts this year, prices could go down within 18 months. He believes most Americans support a policy that prevents people from going into financial ruin from illness.

"We can do much better than this law," he said.


TOPICS: Health/Medicine
KEYWORDS: abolishobamacare; disabledchild; disabledfamily; obamacare; obamacareanecdotes; obamacaredeductibles

1 posted on 01/17/2014 6:38:19 AM PST by MichCapCon
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To: MichCapCon

Thank Obummer and the Rats in Congress.


2 posted on 01/17/2014 6:42:16 AM PST by Blood of Tyrants (The War on Drugs has been used as an excuse to steal your rights. Support an end to the WOD now.)
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To: MichCapCon

They should get their pre-existing health insurance back.


3 posted on 01/17/2014 6:43:57 AM PST by Slyfox (We want our pre-existing HEALTH INSURANCE back!)
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To: MichCapCon

If they think that’s bad,
just wait until the IRS gets ahold of them for speaking out about it.


4 posted on 01/17/2014 6:45:47 AM PST by MrB (The difference between a Humanist and a Satanist - the latter admits whom he's working for)
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To: MichCapCon
Good thing Obama’s watching out for them.
5 posted on 01/17/2014 6:49:25 AM PST by Navy Patriot (Join the Democrats, it's not Fascism when WE do it, and the Constitution and law mean what WE say.)
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To: MichCapCon

I surprised there is not more public outcry over this generally and I assume young people said to heck with it and are paying the penalty because they have been quiet as well.


6 posted on 01/17/2014 6:52:17 AM PST by DonaldC (A nation cannot stand in the absence of religious principle.)
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To: MichCapCon
Obamacare will be the equivalent of Mao's Great Leap Forward
7 posted on 01/17/2014 6:54:32 AM PST by oldbrowser (Obamacare will be the equivalent of Mao's Great Leap Forward)
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To: MichCapCon
You have to break a few eggs to make an omelet.
8 posted on 01/17/2014 6:57:18 AM PST by Awgie (truth is always stranger than fiction)
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To: DonaldC

I don’t think they know about the fines.


9 posted on 01/17/2014 7:04:58 AM PST by autumnraine
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To: MichCapCon
The Affordable Care Act was supposed to help families with pre-existing conditions, not hurt them.

Sez who?

10 posted on 01/17/2014 7:06:03 AM PST by Texas Eagle (If it wasn't for double-standards, Liberals would have no standards at all -- Texas Eagle)
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To: MichCapCon

Hope they speak out about how it feels to “embrace the suck”


11 posted on 01/17/2014 7:06:58 AM PST by bigbob (The best way to get a bad law repealed is to enforce it strictly. Abraham Lincoln)
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To: MrB
"If they think that’s bad, just wait until the IRS gets ahold of them for speaking out about it."

Yes, opposition to the Devine One's offering is not tolerated by the Regime or his lemming like followers. Obamacare is working perfectly. It is destroying US businesses, making health care much more expensive and worse, and increasing dependency on the government. This is our own version of the forced march into the countryside in Cambodia. Many will die, many others will lead lesser lives while proclaiming the wisdom of Dear Leader - or else.

12 posted on 01/17/2014 7:10:08 AM PST by Truth29
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To: DonaldC

The invincibles all think that the fine is $95. It’s actually a percentage of their incomes which, even at minimum wage, is greater than $95 per year. And that’s just this year.


13 posted on 01/17/2014 7:30:37 AM PST by Mercat
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To: FReepers

Click The Pic To Donate

Support FR, Donate Monthly If You Can

14 posted on 01/17/2014 7:34:55 AM PST by DJ MacWoW (The Fed Gov is not one ring to rule them all)
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To: DJ MacWoW
Obamacare

ZEROCARE.

15 posted on 01/17/2014 7:54:21 AM PST by UCANSEE2 (I forgot what my tagline was supposed to say)
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To: MichCapCon

I read about this family before and here is my question: if their only income is disability why aren’t they eligible for medicaid?


16 posted on 01/17/2014 7:54:45 AM PST by jocon307
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To: jocon307

Four people collecting disability puts the household income over the maximum income for Medicaid.


17 posted on 01/17/2014 8:29:05 AM PST by MichCapCon
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To: MichCapCon

They along with many in this situation will not be disabled for much longer


18 posted on 01/17/2014 8:31:02 AM PST by pennboricua
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To: MichCapCon
RE :”The Daverts have always had access to affordable health insurance. Because of their disabilities, Melissa and Ken receive insurance through Medicare”

Did the author really mean Medicaid?

I don't think that medicare pays for people under 65, does it?.

19 posted on 01/17/2014 8:42:30 AM PST by sickoflibs (Obama : 'If you like your Doctor you can keep him, PERIOD! Don't believe the GOPs warnings')
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To: MichCapCon

Thanks for filling me in, I have to say that really surprises me.


20 posted on 01/17/2014 9:25:06 AM PST by jocon307
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To: MichCapCon

Sounds like some creative financing is in order for this family. They have no problem taking handouts for disability but do have a problem paying for their zerocare. Stop receiving one or two disability checks and they will cross the threshold to get the subsidies. They will come out ahead.


21 posted on 01/17/2014 9:46:36 AM PST by Organic Panic
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To: MichCapCon

ComradeCare is another failed Obama idea expected.


22 posted on 01/17/2014 9:52:27 AM PST by Vaduz
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To: MichCapCon

Wonder when the 30 million people who were without insurance, and why we needed to pass Obamacare, are going to sign up?


23 posted on 01/17/2014 10:03:43 AM PST by N. Theknow (Kennedys-Can't drive, can't ski, can't fly, can't skipper a boat-But they know what's best for you.)
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To: MichCapCon
Don't worry, immigration is next.

Anybody who thinks DC is capable of doing anything other than destroying the average American citizens life by a thousand cuts has rocks in their head.

There needs to be a huge public works program building insane asylums to be stocked with politicians who advocate for in state tuition for illegal aliens, amnesty, nationalization of the health insurnce industry, gun control, homosexual marriage,seizure of property by eminent domain to raise tax revenue, and othe similiar insane positions.

Rounds these SOB's up and lock them away where they can do no further harm.

24 posted on 01/17/2014 2:56:03 PM PST by Rome2000 (THE WASHINGTONIANS AND UNIVERSAL SUFFRAGE ARE THE ENEMY -ROTATE THE CAPITAL AMONGST THE STATES)
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