Having coverage isn’t the same as having access
Thirteen years ago, I was a waitress making barely enough money to get by when I got pregnant unexpectedly. At the time, I was 22 years old and hadn’t had health insurance for years; this was long before the Affordable Care Act made it so that kids could stay on their parents’ health insurance plans until the age of 26. One of the first things I did when I learned I was pregnant was to get a referral to Connecticut’s state insurance plan, Husky, for low-income residents.
Ever since then, for the last 13 years that I’ve been poor and stayed poor, I’ve been on free state health insurance — and my health has suffered for it. There is one great benefit to being on this state insurance plan: It’s completely free. Because I fall into the lowest income bracket, I don’t have any co-pays for doctor visits or medications, and I have never once seen a bill for any of my or my daughter’s health care.
Unfortunately, that’s where the good part ends.
There Are Not Enough Doctors to Go Around
One of the hardest things about being on state insurance is finding a doctor who takes it. I have yet to find a private physician’s office who takes my insurance, so I’ve had to rely on community health centers or hospital-affiliated offices that have much-too-high patient-to-doctor ratios.
If I am actually sick and need to see my doctor? Forget it.
I envy my mother, who’s had the same physician for most of her adult life — a doctor who knows the ins and outs of her body and health as well as she does, and who seems to genuinely care about her.
For me, doctor’s appointments last 15 minutes if I’m lucky. I always come prepared with a list of questions and concerns to try to get the most out of my abrupt visits. And what if I’m actually sick and need to see my doctor? Forget it. It takes weeks to get a scheduled appointment whether you’re sick or not.
I have no choice but to go to an emergency room for things as simple as bronchitis or a sinus infection because even the walk-in clinics in my area don’t take my insurance. I know people catch a lot of flak for going to the ER for non-emergencies, but I am starting to think that the people who are critical of us are not the ones who depend on free health insurance in order to have any health care at all.
Without Specialists, People Suffer
I’ve been concerned for a while about some suspicious moles on my skin, so about six months ago, I asked my primary care doctor about them. She referred me to a specialist. I am still waiting to get an appointment to see a dermatologist who takes my insurance.
I also have arthritis in both of my knees — confirmed by my doctor, who ordered X-rays and then referred me to an orthopedist. That was three months ago. My doctor said it could take up to nine months before I get an appointment with the only orthopedist who takes my insurance and whose office is about 40 miles from where I live.
While I’m waiting for this care, I am suffering. I am in daily pain that can’t be helped because my primary care doctor won’t prescribe anything for it because she’s not a specialist.
Despite my complaints, nothing is worse than the fear of losing my health insurance.
So, I make weekly phone calls to my primary care physician’s office. I try to make sure I’m still somewhere in line to see who I need to see, without ever really believing I’ll hear from someone who can actually help me.
The Fear of Losing Free Health Care Is Overwhelming
For those of us who can’t afford health insurance, free state insurance is a blessing even despite my complaints — but nothing is worse than the fear of losing it.
I’ve lost my health insurance three times.
Every year, a large envelope comes in the mail. You have to report your income, confirm your address, answer a slew of questions about your family and living situation, and basically make your case that you still qualify for free health insurance.
Three times in 13 years, my envelope has been “lost in the mail.”
Three times in 13 years, I have shown up for important appointments and been turned away from the doctor’s office because my insurance lapsed and I didn’t know until it was too late. And getting back on state insurance once you’ve been kicked off is a nightmare — you have to go to one of the few offices in the whole state that deals with insurance and plead, sometimes literally, to get back on it.
You know what else?
Free Health Insurance Can Be Humiliating
Imagine spending hours of your life every month calling doctors to try to find a specialist and being told, again and again, that they don’t take your insurance.
To me, they might as well be saying, “Sorry, we won’t help the poor.” Because it really is as simple as that.
Not enough doctors are willing to take state insurance, and not enough doctors are willing to help the poor. Being poor enough to qualify for the kind of free insurance I have is degrading enough, but being told time and again that you can’t get help because you’re too poor to be able to afford insurance doctors are actually willing to take can eat away at your self-esteem and self-worth.
It’s certainly done that to me.
Handing my gray State of Connecticut insurance card to someone feels like being slashed Zorro-style with a big “P” for “poor person.” The judgment I feel — especially when I’m in an emergency room for a sinus infection, and I know I shouldn’t be there but I don’t have any other options — is heart-wrenching.
Where Do We Go From Here?
Unfortunately, in this political climate, I don’t see health care and health insurance getting any better or easier for the poor. I’m running out of hope that my needs will be met without a constant battle.
Health care coverage for the poor needs to be extensively widened, and health care costs in general must come down so more people with lower incomes can afford better care. Getting help when you’re sick or hurting shouldn’t be such a hard and humiliating experience for the poor.
Are you on free or reduced cost state insurance? What has your experience been? Let me know in the responses.
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