Thursday, December 5, 2013
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Evan McSwain, a cook at Selah Tea in downtown Waterville, has been uninsured for the last five years.
Staff photo by Michael G. Seamans
Meaghan Carlson, of Gardiner, at her office Thursday.
Staff photo by Andy Molloy
Waterville Public Library will host information sessions for residents seeking information about the Affordable Health Care Act at 2 and 5 p.m. Tuesday.
Meaghan Carlson and her husband, K.C., of Gardiner, have been without health insurance since February when working more hours at her part-time job put them over the eligibility limit for MaineCare.
Meaghan, 34, now works part time for the city of Gardiner, but the job is expected to end in January. K.C., 34, works part time at a farm in Gardiner and is looking for a more permanent position.
Their 2-year-old daughter is still covered under MaineCare, so Meaghan said they didn't think it was big deal that they lost coverage.
Since losing insurance, however, Meaghan said, she and her husband have racked up more than $10,000 in medical bills with back-to-back illnesses.
Meaghan fell ill with an intestinal infection soon after losing coverage. Then, K.C. was diagnosed with pneumonia and a blood issue.
The bills are down to $5,000 to $6,000, but the experience made Meaghan realize the importance of having health insurance.
"I have a folder this thick and it's all medical bills," she said, holding her fingers and inch-and-a-half apart.
"I don't think it's something you can imagine unless you've been through it," she said.
Meaghan estimated that insurance could have cost them at least $300 each per month, if not more, before the Affordable Care Act.
She said she needs to research more about how the law and exchanges work, but they plan to buy health insurance off the exchanges. An online subsidy calculator estimated she and her husband may have to pay only $160 a month, a total they could afford, she said.
Rather than dealing with multiple bills whenever they need health care, Meaghan said she would rather just have one bill for insurance.
"It's just so, so overwhelming when you've already been really sick," she said.
Adria Moynihan Rusk and Bruce Rusk
The Falmouth couple married a few weeks ago, and they said they're excited to buy insurance on the marketplace after having gone without or being underinsured for many years.
With a combined income of $80,000, they would not be eligible for subsidies on the marketplace, although if they had children in future years they would more likely qualify. A family of four can earn up to about $90,000 per year and still qualify for subsidies, and the subsidies will adjust for cost-of-living increases in future years.
Bruce is an independent contractor working in information technology, while Adria is a self-employed artist. For the past five years, Adria has gone without insurance about half of the time, while Bruce has a plan offered through his contractor that offers few benefits.
"It's insurance in that it keeps you from being completely destitute if something really bad happens to you," Bruce said, "but you'll still be mostly destitute."
Bruce, 51, said the plans being offered through the contractor kept getting worse in recent years. He had major abdominal surgery several years ago, and he still owes some of the $5,000 in out-of-pocket costs he had to pay. But he said if he had had surgery last year instead, he would have been on the hook for more than $20,000, based on the deteriorating coverage in his health plan. He said his plan also keeps restricting the number of doctors in the network, reducing his choices.
Adria, 34, crossed her fingers and went without insurance for a few years, getting her primary care coverage from the Portland Community Health Center. But Adria said without insurance, there's a reluctance to go to the doctor.
"When you don't have insurance, you definitely delay going to the doctor, just letting your sickness work itself out more," Adria said.
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Erika Burkhart and her 18-month-old daughter, Lumi Stone, spend time together in their Portland home.
Maine Sunday Telegram photo by Amelia Kunhardt
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Artist Adria Moynihan Rusk and her husband, Bruce Rusk, are a middle-class family but haven’t had good health insurance for years.
Maine Sunday Telegram photo by John Ewing