As health insurance brokers, we talk with people every day who have various pre-existing medical conditions. We go over options with them, although it’s usually a case of picking the lesser of two evils. I just read Kyla’s story about her family’s struggle to get health insurance for their little girl. She wrote more details about it here. Her two year old little girl is sick, which is a crappy enough situation for any family to go through. And now their insurer is going out of business and leaving the family high and dry. The little girl doesn’t qualify for individual health insurance because of her pre-existing conditions. They can’t qualify for the state risk pool because Kyla’s husband does have an option for group health insurance through his employer. But the group health insurance is much more expensive than the family can afford, and the benefits are limited, which means they would still be paying large bills for their daughter’s treatment.
This is obviously a family that has done their homework and researched their options. And the best option they have come up with is for the father to ask for a pay cut at work so that their daughter can qualify for SCHIP. What a sad country we live in. This little girl is two years old and has seven different doctors. She’s been in and out of the ER more than most people 30 times her age. While most mothers of two year olds are busy planning play dates and birthday parties, Kyla has to organize the myriad of therapies and treatments that help her little girl reach the milestones that most kids reach for free and without intervention. And now her husband has to ask for a pay cut in order to provide health insurance for his daughter.
I’m not sure where Kyla’s family lives, but the scenario she describes sounds pretty similar to what we have here in Colorado. Cover Colorado won’t take anyone who has access to a group health insurance policy, even if the available policy is expensive and benefit-poor. Individual health insurance carriers in Colorado won’t take people with serious pre-existing conditions, and from the description of this little girl’s medical history, she would be declined with every individual insurance carrier in the state.
This family has done everything right. And now that their health insurance is abandoning ship, they are left with some very unpleasant choices. They can get extra jobs to pay for the not-so-good group health insurance policy, or ask for a pay cut to qualify for SCHIP, or go uninsured and likely face bankruptcy in a very short amount of time.
Having a child with serious medical problems is enough of a challenge for any family. To also have to figure out how to pay for it all is like rubbing salt in an open wound. I have to wonder how this family’s life would be different if they happened to live in Europe, New Zealand, or Canada?
