By Maureen Forman
I have been a medical social worker for 30 years. We’re the folks that get called in to figure out how someone in the hospital is going to get follow up care after they are admitted in a crisis with no insurance. Yes, you may be able to get lung cancer or congestive heart failure diagnosed in an emergency room, but that doesn’t mean that an oncologist or cardiologist will see you after the crisis pass. Why? Because you have no insurance!
You can get referred to the county clinics in Riverside and apply for county insurance but all of that takes time. You can apply for special funds from philanthropies devoted to helping cancer patients, but that takes time too. You can apply for special Medical.. But guess what .. That takes a lot of time . And what about medications? Oh that’s right, you don’t have insurance, so you can pay for your meds out of pocket at a higher rate than insurance would ever pay, and that is if you can afford it after setting up payments on the hospital bill which is also far higher than an insurance plan would ever agree to.
The reason this is so critical to know is that a lot of people in this valley risk losing their insurance if the Affordable Care Act is repealed. In fact, according to the just released HARC survey the number of uninsured in our valley went from 33.6% in 2013 act down to 13.9 % in 2016. That’s almost a 20% drop!
Thanks to Affordable Care, people now have access to outpatient physicians, follow up, prescription benefits with negotiated prices for meds … in short everything that prevents them from ending up in the emergency room. The Affordable Care Act also addresses the infamous donut whole gap in coverage that seniors face for their prescription coverage. Thanks to ACA that donut hole is set to go down each year until 2020. And if, God forbid , you should lose your insurance by losing a job, you cannot be denied insurance for a pre-existing condition, nor can your young adult children who, thanks to ACA stay on your insurance until age 26, be denied new coverage when they age off your insurance at 26 for a pre-existing condition like.
These are just a few of the many critical, stabilizing components of the ACA that get bypassed in the rhetoric about premiums and deductibles. Without them we risk going back decades in medical coverage and again having thousands of people coming into the emergency room only when they are in so much pain they can’t stay home any longer. I urge you to write to Congressman and your Senator with your own stories of how having insurance made a difference in your life. This will affect all of us!