Most of us already know that the US healthcare system is a disaster. Disaster really isn’t a strong enough word. I don’t have the active vocabulary to find a better one, though. So, I’ll stick with disaster. Being unemployed, I’m getting a very personal sample of how bad it is.
Last year, I was working on a one-year contract. I knew I was going to lose my insurance when the contract ended. It’s totally messed up that insurance is tied to employment at all. That’s just the tip of the iceberg, though. Before my insurance ended, I called my state’s Obamacare exchange.
I gave the person on the phone all of my information. I told him who my providers are, what medications I take, etc., etc. I was told that even though I was going to be unemployed, I had made too much so far this year to qualify for a free or a discounted plan. So, I asked what was the cheapest plan that has my providers and medications covered. He found one for only $300 a month, so I took it.
Turns out, he lied to me. (I suppose that maybe he was just confused and bad at his job, but it felt like he lied to me.) My therapist was not covered, and she’s the provider I see most frequently. And it wasn’t that my medications were covered. I had a prescription discount plan. All it did was take 10% off the cost of a prescription. I had one of my meds refilled and the pharmacy wanted $4000 for it. That’s not a typo, $4000. That was with the discount. Needless to say, I didn’t get the refill. The plan was a complete waste of $300 a month.
I was pretty excited when open enrollment started. I’d finally be rid of that awful insurance plan and hopefully get something decent. I called the exchange. I had been officially unemployed for almost four months and was running out of money fast. I was collecting unemployment. That was my only income. (Unemployment deserves a whole rant of its own, but I’ll save that for another day.) My expected income for 2025 was only about $3000. Surely, I’d qualify for a Medicaid plan. I got on the phone with an agent (after a roughly 45-minute wait) and gave her all of my information again. I was told that I did not qualify for a Medicaid plan. I didn’t even qualify for tax credits to help me pay for a plan. And the cheapest plan that I could get with even close to adequate coverage would be over $700 a month.
I asked how that was possible. I’m unemployed for goodness’ sake. Well, she explained that my unemployment income is $443 a week. That comes out to $1772 a month. To qualify for Medicaid, I have to make less than $1600 a month as a single person. I have a kid, but I can only claim him as a dependent every other year for tax purposes. It’s complicated, but I don’t get to claim him in 2025. I protested that I was only going to make $1772 for the first month of 2025, then my unemployment benefits would run out. She said that didn’t matter because they compute future earnings based on current earnings. Then, I asked about the tax credits, and it turns out that I make too little money to qualify for those. I won’t be paying enough in taxes for there to be any money to credit.
At this point I had been on the phone for almost three hours, so I hung up deciding to call back the next day and get it figured out. The next day, the woman I got agreed that the information I had gotten was messed up. How could unemployment disqualify a person from a discounted plan? She did my whole application again, only this time entered my income annually instead of weekly. And she found that I did indeed qualify for a Medicaid plan. This was a huge relief. Free insurance that covers my providers and my meds.
Well, today I got a letter in the mail saying that they were wrong and I, in fact, did not qualify for the plan she had told me about on the phone, and I was back to choosing a new plan for $700 or more. So, I called back. It was only about a 20-minute wait today. Then, the woman I got ran my whole application again and agreed with the letter and the first person I talked to. I didn’t qualify for Medicaid or tax credits. The cheapest plan was $700 a month. I was incensed. After arguing for a while, she suggested that I call back when my unemployment benefits run out and try again. Of course, by that time I will be substitute teaching and my income will be slightly higher than my unemployment. I still won’t qualify.
Even with unemployment and substitute teaching combined, I can’t afford $700 a month. Not even close. I now have the dilemma of buying something I can’t come close to affording or risk getting sick or injured and being in serious debt for the rest of my life. I honestly don’t know what I’m going to do.
When Obamacare was signed into law, I wasn’t particularly excited about it, but I thought it was at least a step in the right direction. Now, I’m not sure it’s even that. If collecting unemployment disqualifies you from discounted plans, the system is completely broken. There are relatively simple and cost-effective ways of fixing the problem, but none of them are going to happen any time soon. I can hope to land a job in the next two weeks, but my luck doesn’t tend to run that way. I’ll probably wind up with a $700 a month insurance plan and fall further and further behind. Ugh.
