Whose job is it to help the poor? This question is likely to be one of the central themes of this November’s presidential election; your answer to likely indicates how you’ll be voting. If you think it’s the job of the government to help the poor, you’re probably leaning in favor of President Obama. On the other hand, if you believe the responsibility for helping the poor falls on the shoulders of individuals and other institutions – like the church, for example – you’re probably leaning towards Mitt Romney.
One of the key issues involving this question is the Affordable Care Act, also called “Obamacare.” If you haven’t heard about the Affordable Care Act – and the Supreme Court’s ruling regarding it – then you’re probably living under a rock. I know a lot of people, including my own father, are very much against Obamacare and the Supreme Court’s decision to uphold its constitutionality. His reasoning is simple: he thinks it is bad for business and, as a consumate businessman, that’s his top priority.
But there’s dissention in my parents’ house: my mother is what my father would call a “bleeding heart,” and believes that it is the responsibility of the American people to help those less fortunate. To her, the Affordable Care Act is an extention of that belief. She thinks requiring all Americans to carry health insurance – and participating in that system even if you don’t think you need insurance – is our way of buoying up the system so those less fortunate can join in.
If you’d asked me for my political opinion on this a few years ago, I likely would have sided with my father. In many ways, I follow his lead when it comes to fiscal conservativism. But all that changed when my cousin’s son was born in 2008.
Welcome, Baby K
My cousin and I were overjoyed to learn we were expecting children the same month. Our mothers had been in each other’s weddings, and we had done the same, so it only seemed right that we would welcome babies into the family within days of each other.
All that changed in late April 2008. My cousin, just 18 weeks pregnant, started experiencing signs of preterm labor. Her doctor admitted her to the hospital, ultimately putting her on bedrest and a heavy dose of magnesium sulfide to stop the contractions. But the OB’s best efforts didn’t work. My cousin was diagnosed with full placental abruption a month later, and welcomed her son into the world on May 31, 2008, nearly four months before her due date. Baby K was born at just shy of 24 weeks gestation. He weighed one pound, four ounces.
The doctors didn’t expect him to even survive the delivery, but he beat the odds. They didn’t expect him to survive the first 24 hours outside the womb, but he beat the odds again. Over and over, the neonatologists made predictions regarding his survival, and again and again Baby K proved them wrong. He might have been small, he might have been underdeveloped, but he was a fighter. He underwent eye surgeries, abdominal surgeries, and heart surgeries, and came out stronger and stronger. He was our family’s truest miracle.
But he was an expensive miracle.
The Lifetime Cap
As Baby K’s first few weeks in the NICU turned into months, his parents watched with first shock and then concern as the bills started to pile in. By the time Baby K was three months old – still several weeks shy of his original due date – his medical bills topped the $1 million mark. By the time he finally went home from the hospital at five and a half months old, his bills were closing in on $2 million. By the time he reached his first birthday, they’d passed $2.5 million.
My cousin and her husband weren’t worried about paying the bills; they had health insurance through their employer, and only paid the $2,000 out of pocket maximum, not the $2.5 million. The bigger problem was how close they were coming to the plan’s lifetime insurance cap of $3 million. At a year old, Baby K still required physical therapy, oxygen, and twice weekly at-home visits from a nurse. His parents knew they were likely looking at a many more years of intensive health care, including at least one more major eye surgery in the not-too-distant future. The odds that their son’s medical bills would top their plan’s lifetime cap wasn’t a matter of if, but when.
That moment happened just after Baby K’s second birthday. He started showing symptoms of epilepsy, and between the diagnostic tests and expensive medication to control the seizures, he topped the lifetime limit on his family’s insurance plan. His parents got the word in July 2010 that their son’s medical care would no longer be covered by their provider.
The Ruling
As you know by know, the Supreme Court narrowly upheld the constitutionality of the Affordable Care Act. As a result of that, insurance companies can no longer impose lifetime caps on medical care, meaning the $3 million number my cousin and her husband had been obsessing about for the past four years is now a moot point. The eradication of lifetime limits actually began in September 2010, but had the Court overturned the law, it could have been put back into place (although Republicans had vowed it wouldn’t let that happen, but let’s be honest – politicians don’t always stick to their word, regardless of what side of the aisle they’re on). My cousin and her husband were able to reenroll their son in their insurance plan on July 1, 2011, and thanks to the high court’s ruling, he’ll be able to stay there until he’s 26 years old.
Why It Matters
I’m not telling you that you have to support the Affordable Care Act. I just want you to understand that this isn’t just about people who selectively chose not to buy insurance, or those who can’t afford it. There are millions of kids (not to mention adults) who are locked out from buying insurance simply because previous medical episodes maxed out their old plans.
Before my cousin’s son, I never would have thought twice about supporting Obamacare. I would have derided it. Now, though, I’m able to see it from a different perspective.
I know the Affordable Care Act isn’t perfect – then again, what piece of American legislation ever is? But change is necessary, and Obamacare – even with all its imperfections – is the only step forward any President or Congress, Republican or Democrat, has been able to produce. It’s a start.
Reader, taking politics out of the equation, what would you like to see happen with health care reform in this country moving forward? (Don’t say “Repeal it” – that’s a political opinion; HOW would you revise it? Improve upon it?)
