Brooks man caught in healthcare limbo
I am a resident of Fayette County and own a small business located near Brooks, Ga. My company, Prima Music, operates a website that sells educational books to music teachers throughout the world. I employ eight to 12 employees.
Until September of last year, I have maintained a group health plan for my employees (most recently with Humana).
Contrary to the promise of President Obama, our healthcare premiums have not gone down. In fact, they have been rising 10 percent to 25 percent annually for the past three years.
When our Humana renewal was to take place in September, the cost for my family had risen to almost $25,000 a year. This was for a very high deductible policy. Our out-of-pocket costs would have easily been over $30,000 in 2013.
At that time, I was forced to make a very difficult decision and drop our group plan. I simply could no longer afford to pay over 50 percent of my annual income in health insurance premiums.
Determined to make sure that my family had a major medical plan in place, I began an extensive application process to purchase an individual policy.
I completed lengthy applications with Blue Cross / Blue Shield, Coventry, Assurant, and through my State Farm agent. Every application was denied.
I have Type II diabetes. It is extremely well managed and my blood results are always very good. However, just being diagnosed with diabetes is the kiss of death when applying for individual health insurance.
My wife has marginal high blood pressure. This is managed with medicine. However, a diagnosis of high blood pressure also causes immediate rejection for some, or all, individual health insurers in Georgia.
In the course of researching options, I was told about the Pre-Existing Insurance Plan (PCIP) that was a part of the Affordable Care Act.
I contacted the PCIP (www.pcip.org) and was told that I could apply, if (1) I had been denied insurance within the last year (which both my wife and I had), and (2) we had no insurance coverage for six months.
It seemed like this was our best option to have a major medical policy, but the thought of going with no insurance for six months was alarming. The risk for catastrophic loss was very large.
Ultimately, we had little choice. My wife and I started counting the days from Sept. 1, 2012 to March 1, 2013, praying every day that we would not need medical care.
Months ago, my wife’s medication ran out. Our family doctor would not refill the prescription without expensive lab work. I have been rationing my diabetes medicine in order to make it until March 1.
Last week, I spoke to the PCIP customer service department to make sure that we knew the exact process to follow on March 1. I was told that I could not apply before the six months without insurance was complete, or they would reject the application. Only a few weeks to go. I thought we were going to make it.
On Monday of this week, I visited the PCIP website and saw this: “Beginning Feb. 16, 2013, the federally-run Pre-Existing Condition Insurance Plan (PCIP) is suspending acceptance of new enrollment applications until further notice.”
I called PCIP and was told that the program had been suspended because they had run out of money. I was told that I would need to wait until Jan. 1, 2014 before I could apply (over 10 more months with no insurance).
So, here I am. No insurance for my wife and children. A dwindling supply of medicine to treat our existing medical problems. No insurance company will write a individual policy because of well-managed conditions that are listed on their “no way” list.
Not only is my entire estate at risk of a catastrophic loss, my company is also at risk. If forced to close my business, all of my employees would lose their jobs.
This is perfect example of what government-run healthcare will be for all citizens of the United States in the coming years.
Our healthcare system is severely broken in this country and socialized medicine is not the answer for fixing it.
I am begging you, as my representative, to bring this situation to the forefront, before it is too late for us all.