By: Amanda Compton
What were once considered rumors or hearsay
about the newly-implemented Affordable Healthcare Act (AHA) -- not only the devastating effects it would have
on the American economy, but also on health insurance plans across the
nation -- are becoming reality for millions of Americans.
Meet Kendra Westphalen: A wife and mother of
two children who has seen her insurance costs jump 372 percent since AHA, also
known as Obamacare, passed the Democratic-controlled House and Senate in Nov. 2009.
Between the two of them, Kendra and her
husband, Matt, hold six jobs. In addition to holding two part-time jobs, Matt
works full-time for his father’s small commercial insurance company which
provides insurance for the family of four.
Kendra is a freelance fine artist and graphic
designer and works part-time at Barnes and Noble as a book seller. On her days off at Barnes and Noble, she substitutes at the Child Development Center in Oklahoma City.
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| Matt and Kendra with their two sons, Jack,10, and Hudson, 7. |
“Our out of pocket expenses which include co-pays
and co-insurance are already about seven times what they were a mere three
years ago,” said Kendra. “The effect the law will have on our premium is yet to
be seen.”
She continued, “When questioning the
insurance company directly about what to expect going forward, we are told if
our policy survives, then we will see a dramatic drastic rise in cost. However,
they are still unclear on how Obamacare will affect us, but they know it will
be expensive and drastic.”
In addition to skyrocketing premiums and
co-pays, what makes the reality of Obamacare even scarier for Kendra,
particularly, is that she has Type 1 diabetes, which is controlled by Novolog
insulin and administered with a One Touch “Ping” insulin pump. This pumps acts
as an artificial pancreas, releasing small amounts of rapid-acting insulin
every hour to keep blood glucose levels steady between meals and during sleep.
“Before pumping I was considered a 'brittle'
diabetic, meaning my diabetes was not at all controlled, and I frequently
experienced life threatening episodes of high and low blood glucose levels,
leading to hospitalizations, which sometimes required lengthy ICU stays,”
she explained, adding, “While the pump is work and is rightfully more expensive
than traditional self-injection of insulin, it allows the patient freedom,
flexibility, and blood glucose levels that are not attainable in any other way.”
She also said “pumping” keeps other
complications caused by diabetes at bay, meaning fewer long-term and life-threatening
complications.
“Before pumping my A1C level was running at
9.2 percent which is in the 'brittle' poorly controlled level,” added
Westphalen, who was diagnosed with Type 1 diabetes at eight years old. “Since pumping
my A1C levels run at 5.7 percent which is as good as a Type 1 can hope for.”
Due to the new 2.3 percent durable medical
equipment [DME] tax instituted by Obamacare, the out-of-pocket cost for Kendra’s
insulin pump is projected to soar to $4,000 annually -- from only $1000 a year.
This figure, she pointed out, does not include the rise in her co-pays and
co-insurance for other medications and doctors’ visits.
According to media reports, the medical
device tax will saddle DME companies with an additional $3.5 billion in taxes. To
absorb the costs and remain profitable, these companies are reducing their
workforces, particularly in research and development, and passing additional
costs on to the consumer.
"A pump works much like a cell phone, after
four years it becomes outdated and it’s time for an upgrade,” she explained. “I’m at that point, I need a new pump, but I
can't obtain one due to the rise in cost. My co-pay for the current pump was $500.
Now, with the implementation of the DME law, I’m told it will cost me $4,000
for the new pump. So we face that obstacle now as well.”
“If Obamacare is fully implemented, I suspect
I will be able to pump for about half a year,” she continued. “At this point I
fortunately have a stock of supplies that will last that long.”
Not having the pump will be devastating to
Kendra’s health.
“The great A1C I have managed to obtain with
the help of the pump will rise, bringing with that rise nerve, heart, vision,
and the possibility of brain damage,” she said. “Any fluctuation in blood
glucose levels causes minute to massive amounts of brain damage, the
seriousness of the damage depends on just how high or low your blood glucose
levels raise. The tight control of my blood glucose levels I experience will be
gone.”
Kendra also has recurrent basal cell carcinoma, a form of skin cancer,
that requires multiple doctors’ visits every year. Her sons, Jack, 10, and
Hudson, 7, also have health problems that require regular visits to a variety
of specialists.
“Hudson’s care will also be affected by the
DME tax because he requires appliances for the delivery of his asthma and allergy
medication and a nebulizer,” said Westphalen.
Additionally, both Hudson and Jack are scheduled this summer
to see a pediatric orthodontist for braces. "Due to Obamacare, there has seen a dramatic rise in cost for this procedure," she said. "I'm told that each
child will end up costing us about $10,000 for the full orthodontic treatment.”
Between a $10,000 loss in income and the rise
in general living expenses and healthcare, Kendra said, her family simply cannot
afford anymore increases.
"Unfortunately, we live paycheck to paycheck .
. . it wasn't always this way,” she said. “My husband and I hold six jobs between
the two of us. One job provides us with insurance and the others allow us to
barely scrape by. It’s just simple math, with no increase in income and health
care rising it just isn't possible to make it work.”
Kendra said she and Matt have discussed bankruptcy, but that it would be a last resort. “The only thing we can do is work
more,” she said.
When
asked to sum up her feelings on the current situation, Kendra responded, “Right
now I feel hopeless, there just doesn't seem to be a lot that can be done. There
are really no options and absolutely no help for the middle class. We are the
ones suffering and paying for what was supposed to be such a great thing for
the American people.”
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