#CoverageMatters: Stories of Coverage

Continued access to affordable healthcare is critical to the vitality of our community, state and country. We are asking policy makers to consider the potential impact repealing the Affordable Care Act (ACA) without a replacement option could mean for the more than 80,000 Mecklenburg County residents who have selected plans for 2017, as well as thousands more North Carolinians.

Restricting or eliminating current programs would place more stress on the public resources that are already in high demand in Mecklenburg County and across North Carolina.

The ACA is still the law and people who still need coverage should sign up for insurance by the 12/15 deadline to have coverage starting Jan. 1, 2017. At the same time, we empower people to share their stories of coverage that demonstrate the inherent value of of affordable health insurance.

Lana Rubright

lana-rubright-4Click to hear Lana Rubright share her story of coverage and how being able to afford health insurance through the ACA ultimately saved her life.

Consuella Harge

Harge shares in her own words why access to affordable healthcare is crucial to the vitality of our community:

consuella-harge-9-web

I was diagnosed with Lupus in March 2013 after being hospitalized with a high fever up to 105 degrees. I had shortness of breath. I had joint pain in my wrists and fingers, and I had swelling in my feet and hands.

But my journey didn’t start there. Lupus took well over a year to diagnose. I was referred to many different doctors like allergist, dermatologist because my primary care doctor at the time couldn’t figure out why I was having all these symptoms and where they were coming from. This was very discouraging. My medical bills were piling up. These Doctors would give me all different types of drugs and nothing would get rid of the hives I had, or the swelling of my whole body which would include a swollen face, lips fingers, arms, and eyes.

After being diagnosed, I would have flare ups. Being hospitalized with pneumonia was a constant in my life.  I tried to work, but fatigue and high fevers would force me to take family medical leave of absence from work.

I became pregnant in early 2014 and was considered a high-risk patient. On March 30, 2014 I was laid off from my job and had no insurance. I went to social services and applied for Medicaid. Since Medicaid didn’t approve me until June, no OB/GYN would see me for prenatal care. Many of these places didn’t take Medicaid either.  Medicaid did eventually retro activate my benefits back to January, however that took a lot of time and calls to Medicaid.

I probably went about a month without prenatal care.

Being laid off caused a lot of stress. I ended up with a cold that lasted over a month  as I looked for a job to support my family. After a month, I got a new job. Once my cold was gone, I continued to have shortness of breath, which went on throughout my whole pregnancy.  I could not breathe walking to and from my car, walking from parking lot to work, walking to and from bathroom at my job. It was horrible, I couldn’t even walk and hold a conversation with someone because I would have to stop and breathe.

I had a successful delivery on September 6, 2014, giving birth to my baby girl, Grace.

The day after my successful delivery, it was noted that I had decompensated. I was told that I was coughing up blood and my oxygen levels were desaturating. A bronchoscopy was performed and my right lung collapsed. A tube had to be inserting so my right lung could function properly. The bronchoscopy results showed that my lungs were saturated with fluid, and I had to be put into an induced coma to drain the fluid from my lungs. I was in a coma until September 26, and I was hospitalized until November 10.

Waking up from an induced coma was very scary because I had no recollection as to what had happened to me. I was later diagnosed with ARDS, Acute Respiratory Distress Syndrome, which requires me to be on oxygen 24/7.

Since I could not talk or walk, hold my head or arms up. I had to go through occupational therapy and physical therapy. I would practice lifting my head up every day. I would practice sitting up and sitting in a chair which would help my lungs function better. My lungs and heart had to learn how to work together again so breathing was very hard to do, especially while being on a ventilator.

Today, I am still recovering. I still require supplemental oxygen with rest and activity. I get fatigued at times, but I try to do my best when I have the energy to do so.

My dependence on oxygen may be lifelong. I can feel the intensity in my lungs while trying to play in catch with my son, teaching him how to dribble and kicking around a soccer ball. Doing these things causes me to increase my oxygen liters to 4 or 5L and I’m still short of breath.

I literally need supplemental oxygen to breathe.

In November 2016, a social services senior representative called me and stated that I no longer qualify for Medicaid or Medicaid disabled coverage due to payments I receive from Social Security disability. I made countless phone calls to social services, county workers, health care providers and anyone who I thought could help me get insurance. No one could help me get insurance even though I am currently supplemental oxygen and I have a life threatening illness.

On November 14, I got a call from Madison at Legal Services of Southern Piedmont. She helped me get qualified for insurance for December 1, 2016 that same day. Legal Services of Southern Piedmont also helped me get healthcare for 2017. What a relief! I am truly thankful for their heartfelt work and professionalism.

If I didn’t have health insurance what would happen?

  • I would have to choose between my responsibilities of taking care of my children and my household expenses with my fixed income or use my fixed income to pay for healthcare expenses.
  • My children would worry about if I’m going to live or die. Not having the medicine I need to survive, my life would literally be at risk causing me serious anxiety. My Lupus could flare up causing my immune system to fail.  I could be hospitalized and unable to care for my 10-year-old son and 2-year-old daughter.
  • The repeal of the Affordable Care Act could mean that I would now be responsible for hospitalization costs that were once covered by insurance. My last hospital stay cost almost $500,000.
  • I would be responsible for an estimated cost of $1,252 a month for my prescriptions assuming I had a Drugs.com prescription card. The cost would be far more without that card.
  • I wouldn’t be to afford the doctors I need and want. I love my doctors. I have a good relationship with them. These doctors know my history and what I’ve been through. They truly understand me and my illness.
  • I would have to come up with an action plan to find health care providers and or insurance that’s affordable and that would accept me with my preexisting conditions. Multiple phones call and internet searches would have to be made. This process would be very tedious and discouraging with no insurance and no one to turn to.

Why is Affordable healthcare important?

You are not exempt from becoming ill and losing everything you have worked for due to an illness.

A life threatening illness will change your life. Having coverage gives you a peace of mind.

People like me, who have life threatening illnesses, can get affordable healthcare coverage through Obamacare.

Thank you so much, Consuella Harge

Tim Messenger

lssp-medicaid-gap-tim-messenger-2LSSP health insurance navigators helped Tim Messenger sign up for health coverage during an enrollment event at Bethesda Health Center.

When we first met Tim last spring, he was struggling in the Medicaid gap like 300,000 other N.C. residents. He had no income, and he couldn’t qualify for health care through Medicaid because he had no children or qualifying disabilities.

Because he spent years without access to preventative care that could have managed his Type II Diabetes, Tim’s eyesight has deteriorated enough for him to demonstrate that he has a disability, and he qualified for Social Security disability benefits this fall.

Qualifying for disability benefits makes Tim ineligible to qualify for Medicaid now, but thanks to the Affordable Care Act (ACA), he was able to use his Social Security income to apply for health insurance through the Health Insurance Marketplace and receive a subsidy. Before the ACA, people like Tim found themselves in a different gap — living month-to-month on a tiny Social Security check with few other options for support.

Tim enrolled in a plan with a premium that costs $30.42 a month and includes coverage for his ophthalmologist to perform a necessary surgery on his eyes. He also signed up for a dental plan.

Your support of the work LSSP does makes these tangible impacts on people’s lives possible.

During a time when the future of our country’s healthcare system is uncertain, people like Tim, who have already spent years struggling to access health care, are more vulnerable now than ever. Access to coverage matters.

LSSP is committed to helping people like Tim and will continue to advocate for policies that enable them to receive the care they need. Read about Tim’s experience in the Medicaid Gap

Janet Louangrath

oe4-janet-louangrath-igotcovered-2Janet Louangrath, 21, is a student pursuing her associates degree in psychology at Central Piedmont Community College in Charlotte. Growing up, Louangrath never had health insurance, and her family didn’t prioritize regular visits to the doctor. When she developed sudden health problems at 19, Louangrath realized how important health coverage can be.

“I realized I needed insurance to get the care I need,” she says.

This year was the first year Louangrath enrolled in coverage through the Affordable Care Act. With the help of a health insurance navigator from Legal Services of Southern Piedmont at a campus enrollment event, she selected a coverage plan that fits both her healthcare needs and her budget at $15 a month.

Knowing what she does now, Louangrath stresses the importance for young people to have coverage even if they are healthy.

“Don’t delay,” she says. “You don’t know when you might need health insurance.

So it’s best to have it. You don’t want to go to the hospital and get stuck with this huge bill, when you can easily pay lower prices like me and have it covered.”

Darlene Hawes

Darlene Hawes has had health problems her entire life. As a child growing up in west Charlotte, she hated watching the neighborhood kids playing outside from her front door, unable to join in because she had been born with a hole in her aortic valve – a heart condition that prevented her from exerting herself. She longed for the freedom to live without having to worry about her health.

“I always told myself, ‘When I get to an age when I can take care of me, I’m going to take care of me,” she says.

And that’s what she did. As soon as she could get a job, Hawes has worked and supported herself. But life also got in the way. Between her uncertain health and helping to support her parents, she ended up dropping out of high school.

“School was in and out,” Hawes says. “I went to the 11th grade, but I kept dealing with illness. I just put my education aside every time something came up.”

As she prepares to turn 56 in January, Hawes has been through a lot. A vertical scar on her chest tells of an open-heart surgery she had in 2003 after doctors told her that her heart valve was hanging on by a string. Her husband passed away in 2012, leaving her bereaved and without the health coverage she had needed from his insurance plan.

She spent two years trying to get by without seeing a doctor. The stress of piecing together the care she needed was overwhelming. To cope, she filled journals writing about that emotional time.

“I didn’t go to the doctor because I didn’t have insurance,” Hawes says. “By the grace of God, I’m here.”

Hawes didn’t realize there were affordable coverage options available to her until she sought help from Legal Services of Southern Piedmont for a tax matter regarding her husband’s estate. She was happy to learn that LSSP also offered free in-person assistance to help her enroll for 2016 health coverage through the Health Insurance Marketplace under the Affordable Care Act.

In November, she re-enrolled in her second year of ACA coverage with a $0 per month premium. As someone who has had serious health problems her entire life, Hawes realizes the value of health insurance and the comfort it provides.

She can access the care that she would otherwise not be able to afford thanks to the ACA. Hawes uses her insurance for checkups and to cover blood-thinning medication that she needs to prevent the risk of stroke and blood clots with her condition. She has enjoyed developing a relationship her doctor by going to appointments more regularly.

“I wouldn’t be able to live my everyday life knowing I have this condition,” Hawes says. “Without this help, I wouldn’t be here. I feel more comfortable about living now. I had given up on health insurance before.”

Access to health coverage has allowed Hawes to seek that independence she longed for as a child. She still dreams of earning her G.E.D. She loves writing poetry and singing as ways of celebrating her faith.

She realizes her story is one of grace, and she hopes that by sharing it, others will see the value of access to health care.

“Every day, I take life,” Hawes says. “I’m thankful and grateful for it. God gave me another chance, and I decided I needed to take it. Today is about giving back. I want to make God proud of me.”

 Hawes recently shared her story with Michael Tomsic of WFAE.

Sara Kelly Jones

oe4-sara-kelly-jones-2Sara Kelly Jones has always understood the importance of having health insurance. During her adult life working in the music industry of Atlanta and Athens Georgia, her mother made sure that she always had coverage, which she had always paid for out-of-pocket.

“I have never been without work since I was 13 years old, I had always had enough money,” she says. “Until I needed to take care of my mother.”

Fourteen years ago, Jones left her career and moved to Charlotte to become a primary caregiver for her mother who needed constant care.

Per her mother’s wishes, she continued to pay for insurance despite her premiums increasing by $100 a year. By the time her premiums had reached more than $800 a month, Jones worried about going bankrupt. She had a mortgage, living expenses and was caring for her mother every day, while working as a waitress.

“It was beyond anything I could possibly afford,” she says. ” I’d have to make the call between my mom and an extra shift. It was horrifying.”

Jones learned about the free, in-person assistance Legal Services of Southern Piedmont’s health insurance navigator program provides after her mother read about it in the newspaper. In 2015, she met with a navigator and enrolled in a health plan with a monthly premium less than $30 a month.

“The amount of stress the ACA relieves me of—I can’t begin to tell you,” she says. “I didn’t know how I was going to do both.”

Having health insurance gave Jones peace of mind. She was covered in case of a health emergency, and she didn’t have to choose between making enough money to cover her expenses and caring for her mother.

She was also covered when she did have a sudden health emergency –having a grapefruit sized tumor removed from one of her ovaries.

“I didn’t worry that every single penny would go to that,” she says.

Jones’ mother passed away in August, and as she has spent the last few months settling her mother’s estate and grieving her loss, Jones made sure to re-enroll in health insurance for 2017.

In November, Jones enrolled in another plan through the Health Insurance Marketplace with the help of a LSSP navigator. Though her premium was higher than the previous year because she became a smoker, it’s far below what she was paying before enrolling through the ACA.

“It was literally a life-changer. It enabled me to feel a lot better about my situation.”

Jones, a self-proclaimed news junkie, has been following the headlines since the 2016 election and worries about her ability to afford health insurance amid the uncertainty surrounding the ACA’s future. She knows that without affordable coverage options, she would go back to paying more than $800 a month for insurance. She worries about being thrust back in that situation and if she could even get coverage if insurers’ policy of denying coverage based on pre-existing conditions was reinstated with the repeal of ACA. She realizes she’s not alone.

“I desperately need it,” she says. “I work two jobs six days a week. I have awesome bosses, but in the service industry; nobody gives you health insurance. You can never count on that. There are millions of us, and we’re all in the same boat.”

Jones shares her story of coverage because she believes all people should have access to affordable healthcare options. And in doing so, Jones knows she is honoring her mother, who believed everyone should have insurance too.

Jones recently shared her concerns about coverage with Michael Tomsic of WFAE

Marvin Bailey

marvin-bailey-igotcoveredMarvin Bailey is 50 years old and spent most of his life without health insurance until the Affordable Care Act allowed him to seek out more affordable options. Bailey says though he’s been blessed with good health for most of his life, his health insurance gives him peace of mind with the promise that if his health were to take an unexpected turn, he’s covered.