In a country discouraged by last month’s health care rollout and corresponding widespread problems, Erin Kotecki Vest and her family are rejoicing.
Obamacare will save them almost $19,000 each year.
“When the president says no family should lose their home because someone got sick, no family should go bankrupt because somebody got sick, that is us. That is absolutely us,” she told msnbc.
Kotecki Vest, 38, along with her husband and two young children, have been covered under an Aetna plan for at least three years in their hometown of Los Angeles. When her husband received an insurance re-enrollment package from his employer earlier this year, the couple decided to compare other plans.
They thought they would be lucky to save even a few thousands dollars.
DIAGNOSIS
In 2010 doctors diagnosed Kotecki Vest with Lupus, an autoimmune disease where the body’s immune system becomes hyperactive and attacks healthy tissue. In the years since, she has visited doctors multiple times each week to receive what she calls simply “treatment.”
But the procedures go much deeper than a single “treatment.” Three days every other week she undergoes intravenous therapy, which lasts three to five hours each visit. And that, she said, is when “everything is going well.”
Additionally, she takes Rituxin, which is also administered to her intravenously every four months in two different six-hour sessions. Doctors have prescribed her Prednisone for the past three years. Complications from her diagnosis caused her to suffer from a stroke, lose her gall bladder and the majority of her colon, and undergo a hysterectomy.
“I’m usually at treatment because it’s sort of never ending. As soon as I go in one round, it starts up again the next week,” said Kotecki Vest, who added that her health-insurance card is the second most used piece of plastic in her wallet after her debit card. “If I’m not at home, I’m hooked up to an IV.”
She began writing full-time for BlogHer in 2008. But her attempt to work was interrupted by surgeries and treatments before her official diagnosis.
“In a minute, the hospital bills started rolling in from the very first surgeries and the very first treatments,” she said. “We were overwhelmed. That added to the stress exponentially in this house and in my life because all I could think about was: ‘I have to get back to work to pay off these bills.’ What else can you do?”
Kotecki Vest has been on permanent medical leave since the summer of 2010. Despite her family’s savings, the couple decided to re-finance their mortgage before they lost their home or fell behind in paying bills.
NEW PLAN
Kotecki Vest’s “crude estimate” of $18,900 in medical savings, which she announced in a post on her personal blog, is based on her current health care and medication bills–she takes 17 prescriptions each month. Once she confirmed the calculation several times (she expects their estimate is lower than reality), she registered her family–in less than 25 minutes–for a new Blue Shield of California plan under the state-run exchange (HealthCare.gov redirected her to her state’s website).
“It has taken a weight off of our shoulders that I can’t describe,” she said. “I don’t know how to explain to people unless you have been through a horrible illness in your family or a terrible accident that has landed one of your loved ones in the hospital, or living paycheck to paycheck.”
Under the new plan, effective Jan. 1, 2014, the family will not pay deductibles, and have lower out-of-pocket maximums, co-pays, and treatment and prescription costs, she said. With Aetna, they paid deductibles, and the maximum out-of-pocket costs were $12,000 per family for in-network providers and $18,000 for out-of-network doctors.
“We were drowning in medical debt, drowning. We had used up all of our savings, we had exhausted all of our family,” Kotecki Vest said. “I still have treatments that are ongoing. There is no end in sight for my treatments.”
WHAT’S NEXT?
There are currently 27 federally-facilitated exchanges, 17 state-based exchanges, and seven state-federal partnership exchanges, including Washington, D.C. In California, a state-run exchange, more than 35,360 individuals have enrolled.
Health care registration numbers fell far below the 500,000 individuals the White House expected to register during the first month of the rollout. Between 40,000 and 50,000 Americans completed applications or registered for insurance plans on HealthCare.gov since Oct. 1.
Related: Health care enrollment falls short of expectations
The president on Thursday took responsibility for the problem-plagued rollout.
The House passed Republicans’ answer to Obama’s health care fix, allowing insurers to continue offering plans that don’t meet the standards of the Affordable Care Act.
Also on Friday, the same day Kotecki Vest waited in her home for the confirmation letter she expected to receive from Blue Shield, her husband declined re-enrolling in their current plan through his employer.
“We’re the lucky ones–and we’ve been through hell–so I cannot imagine what others are going through or what they would go through without the Affordable Care Act,” she said. “We might actually be OK after all.”
Michele Richinick