We have covered ObamaCare shortcomings many times, from the woman in California who finds the programs mandate to be a serious financial burden, to the woman who lost access to her doctor when she switched to ObamaCare, but Priya Abraham’s experience has to be one of the most agonizing stories we have heard yet.
I thought I was lucky. The last day to sign up for Obamacare had arrived, and I’d managed to purchase a plan on the national Obamacare exchange.
I battle fibromyalgia, a chronic pain condition that has forced me to spend many days working from home. Treatment requires costly prescriptions and specialists. The prospect of help bearing those expenses filled me with hope. I was just the kind of sickly, long-uninsured person Obamacare was designed to help—or so I thought.
Ms. Abraham is right, she is a perfect example of someone who was supposed to be helped by the president’s reform. As millions of other Americans have found, ObamaCare has failed to live up to the hype. Instead of easy access to quality health care at an affordable price, she found nothing but roadblocks before her.
It feels like a cruel trick. With the health conditions I face, my $176 monthly premium for a silver exchange plan is like a dream come true. Previously, after multiple denials, I had to make do with a high-deductible, $476 per month plan. But the level of care I received for a lower rate turned out to be a nightmare.
Only one brand-name drug can keep my pain at bay. Under Obamacare, I couldn’t simply refill my regular prescription, though. Instead the drug had to be pre-authorized, and ultimately my exchange plan insurer denied coverage for the drug, which costs $400 per month without insurance or discounts.
This shouldn’t be a surprise to many conservatives who argued that putting the health care decisions in the hands of government bureaucrats would only lead to worse, not better health outcomes. See Medicaid for an example. Bad policy has real life ramifications, and poor Ms. Abraham is an innocent victim.
What Ms. Abraham was offered by her doctor was a drug cocktail, all medications covered by her insurance company, but she was left with terrible side effects that she didn’t have to deal with when she was on her brand name medication.
It’s better than nothing. But President Obama didn’t barnstorm around the country selling Obamacare with the promise of coverage that was merely better than nothing.
The president isn’t keeping his promise to provide quality health insurance to people with pre-existing conditions. On top of higher premiums or deductibles, critical drugs may not be covered at all. And the costs patients incur by buying them with cash won’t count against out-of-pocket caps or deductibles.
As a patient who has to deal with a chronic condition managed by a careful medicinal regime, Ms. Abraham requires access to certain drugs and as she has found out, a list of which drugs are covered under ObamaCare are hard to find. She got into a plan expecting that she would be able to continue her treatment and instead is facing an expensive and painful life ahead.
Unfortunately, Ms. Abraham is not the only American in this boat.
Don’t get me wrong. I understand that the country desperately needed health care reform—and still does. But I also understand that I’m not alone in struggling under Obamacare. Many Americans sicker than me are doing even worse.
Take Lupus patient Emilie Lamb. Her state-subsidized plan was canceled because it didn’t provide enough coverage—a “junk plan,” according to President Obama. Lamb’s monthly premium jumped from $52 to $373, forcing her into a second job so she could still see her doctors and buy medicine.
Then there’s fifteen-year-old Michigan twins Austin and Micheala Davert. They suffer from a bone disease called osteogenesis imperfecta. Thanks to Obamacare’s mandates, they lost their primary insurance. After failing to resolve technical issues on Healthcare.gov, their parents fell back on an exchange plan bought directly from an insurer. The premium was comparable but the deductible skyrocketed by nearly $8,000.
“The only other plan that had a lower out of pocket maximum,” said the Daverts’ mother, “was a plan that’s not accepted by their doctors.”
Ms. Abraham notes within her piece, “What good are low premiums if the insurance is paying for nothing?”
What good is a national health care system if it is not providing the health care promised? This is yet another example of why ObamaCare is wrong for patients and wrong for America.