Let me be clear… This is not a political post. I have no idea how much of this is due to “Obamacare,” although I know at least some of it is in part.
When I was still working for Warner Bros. we had great, I mean GREAT health insurance. When we decided I would come home to be better able to be available for Joseph’s issues and my mom’s issues, we took the health insurance in mind… But it was fine because we had Poe’s. And then he was laid off three months later.
Poe was out of work for two years. For as long as we could, we paid for Cobra. But thousands of dollars later (while on unemployment), we went through all of our savings. After we exhausted Cobra benefits, Poe needed serious, emergency dental surgery. There went all my retirement savings from 18 years of age. Two decades of savings.
But my kids both have medical issues. Forget about Joseph’s doctors and therapists – his meds alone are over $2k per month. Logan needs EKG’s and Echo’s annually, and eventually will need open-heart surgery. And so… I found a program called Heathy Families. In California, it was an alternative to Medi-Cal. I felt better about using it, because I paid premiums, according to our income, rather than being totally “on the dole.”
Eventually I started my own business, but it’s not a corporation, it’s just me as an independent contractor. Poe eventually found a job in security instead of his chosen field of CADD design. As a contractor, I don’t get employer insurance. Poe is offered insurance… The premiums for which are about 80% of his take home pay. So – we cannot afford it. Even after the updates due to Obamacare – now it’s about 85% of his take home pay. We still can’t afford it.
Eventually, Medi-Cal absorbed Healthy Families, and we were officially “on the dole” due to our income level and my children’s need for insurance. Don’t like it, but I have to take care of my kids’ medical needs. Poe and I haven’t been insured in years.
So here’s a bit about my private parts – so if it’s too graphic for you, I’ve put it below the fold:
I have spoken about this before… I have a birth defect called Uterine Didelphys. I won’t get into all of it, except to basically say I have two uteruses (Uteri) and two cervices. Yeah… Enough is not known I don’t know how to pluralize it. The part that’s important about it, is that one of the effects of this defect is the propensity to have cysts and fibroids, and beyond my reproductive parts, it also moves to the kidneys. The kidneys are impacted because they form at about the same time in the womb. Anyway… Beyond my usual symptoms from the defect, about a year ago I started bleeding during sex. I don’t mean like spotting because I wasn’t “ready.” I mean deep, heaviest day of period bleeding. Run down legs, pool beneath me, my husband thought he was killing me bleeding. It started infrequently… but got to the point where it was every time we had sex. Because of my non-insurance status, I went to Planned Parenthood to see if my income would qualify me to be seen. It did. I was seen. Of my two cervices, both of them are screwed. One of them is over grown with tissue, and that tissue is extremely vascular. Meaning, anything that brushes up against it breaks blood vessels, and bleeds. On the other, it’s covered by a cyst. Both require surgery. Planned Parenthood won’t do the surgery. Because I cannot afford a “regular” doctor, and am not insured, I get to “live with it. There’s nothing we can do.” I also had my dual pap smears while I was there. The results came back positive for abnormal cells. But the new course of action is to see me “in three years.” So yeah. The test to see if I have pre-cancerous cells, means I get to wait three years to potentially let it grow before they’ll see me again. In other words… I’d really love to see a “real” doctor.
Anyway… Back to my original story. The kids were now in Medi-Cal, because the Healthy Families program went away. That meant that we now had to travel an hour to get to the new pediatrician, because no one closer accepted Medi-Cal. Then that doctor changed, and it’s still an hour. Now we are assigned to a pediatrician in Chinatown. That doctor caters to Chinese patients, in Chinatown, and English is not her first language. Our first well-child visit with them took 8 HOURS. I’ve been in and out of ERs faster than that. Our second visit took 5 hours.
Around the end of October, beginning of November, the kids renewal on Medi-Cal was due. That’s where we have to justify with all these forms that we’re as poor as we say we are. This time, however, it was the roll-out and deadline for Obamacare. I went through the process of attempting to sign us up. It said that we were potentially qualified for Medi-Cal, and that we were to contact our county. OK, well, the kids’ renewal forms has a spot on it to add more family members, and on the forms I added Poe and I. Sent the forms in. That was in the beginning of November. In the beginning of January, I got a decision notice. One child, Joseph, was getting Medi-Cal. Okay… that’s one person from the forms. I waited a week and then called the number I was given on the form. That number went straight to a voicemail that I was to call another number. I called that number, and the service representative was very patient as I explained what happened. He then explained the new process in California, with the Obamacare act in place. No longer can I direct call my social worker. Now, I have to call the customer service line as the first line of defense (him) and if they can help, they will. He was able to pull up out account. Joseph was approved, yes. Logan was approved under another plan (??). When I asked why they were different, “Well, it’s based on different incomes, and household changes.” “They live with the same parents, in the same household, with the same income profile. They’re brothers, living with their married parents.” “Oh. Then I don’t understand what’s going on.” “And what about my husband and I?” And there started a cycle. You see, they have no record of my husband and I. My husband and I who were on the same form.
I was told that our case was too complicated for him, the representative, to properly handle, and so we were being forwarded to our social worker. That worker had 1 week to contact us back. If we didn’t hear from them by a certain date, I was to call back. I didn’t, and I called back a week later, and went through the whole rigamarole again – because I had to convince the new representative SHE couldn’t help us. This time, the social worker was to call in 3 days. Didn’t happen. I call back again. This time, it was a next day call. If I didn’t hear from them, I was to call back and they’d get a supervisor involved. On the day I was going to call, the social worker finally called me.
I explain the situation several times, over several phone calls. Bottom line? They don’t have a record of my husband and I (who were on the same form as the kids). The kids are covered, although I have no paperwork at all to support Logan’s coverage, and they can’t find his paperwork to reissue it. And they’re not “allowed” to look into my husband and I at the moment, because they haven’t received the paperwork yet “from the state” (the paperwork was sent, per instructions, to Sacramento, our State capitol). They couldn’t just look up the forms I filled out. There’s just too many to go through! How are they supposed to do that? This is a new process! She has too many people! (Really? I’m supposed to care? I did everything “right” and it’s now been literally months). However… I could make the process faster if I sent her, the local social worker, all the backup forms required for Jay and I, because then she’d be allowed to specifically look for our case. She sent me the forms. I started working on the backup they required, which took me a week and included:
- Copies of both drivers’ licenses
- Copies of both SSN cards
- Copies of both birth certificates (and our name change certificates from our younger years, and marriage certificate)
- Income paystubs, and my income/expense report from my business, our taxes, and my Schedule C
- Rent receipts
- Utility receipts
- Checking and savings account statements (all pages, please)
Essentially, I sent them basically everything that someone needs to take over and control our lives, or pretend to be us. I was very uncomfortable with it. But with Obamacare, you see, if I don’t go through the process, we remain uninsured, and will have to take a tax penalty next year. Damned if you do, damned if you don’t.
I sent it certified return receipt. I get a voicemail. “While I got your paperwork, we are not allowed to look into Medi-Cal cases until we receive the paperwork from the state. We don’t know when that will be. Goodbye.” So, she lied to me. I think she had me do all the extra work (I’d already done on the original forms) as a delaying tactic.
At this point… I don’t know what to do. I don’t know who to turn to. This is a fucked up system. Before… we simply couldn’t afford it. I could accept that. We’re poor. I don’t expect anything handed to me, and that was the reality. Now… I feel like our lack of insurance could be criminalized, and I’ve done everything “right.” I can’t think of a solution. The only silver lining is that somehow the kids are magically covered “in the system.” The whole thing sucks, and the whole thing screams bullshit to me. And now… Everything that legally says we’re us is sitting in some social worker’s office.