It’s not that rare, to be honest. I cry relatively easily. But I cried yesterday morning for good reason, as I sat there–with 800,000 others–watching SCOTUSBLOG refresh in one window, and Twitter in the other, listening to NPR–when it became clear that the United States Supreme Court had upheld the Affordable Care Act (ACA). I cried for all those women who have written to me in the last three years, since I told my own story of battling for health insurance.
In 2009 I gave birth to a beautiful baby girl–we named her Orli Chaim–and then we got the bill. Not a single item, procedure, or moment in the hospital was paid for. In total, if the bill was correct–but how could it be correct?–between pregnancy and labor and delivery, we’d have shelled out over $22,000 for the privilege of beginning to save for college. We could have named her très chere as that was true in both senses of the word, she was dear to us, and very, very expensive.
You are forgiven for assuming that bill came because we had no insurance, but that’s not the case. We were insured, Ian, my partner (Orli’s dad) and I, but we were insured in the wild west of health insurance, as individuals on the individual market which had, we learned, virtually no rules, and no federal oversight.
We purchased our insurance after a few years in the land of the socialists (Europe), and we had anticipated (hoped!) we might have a baby after our return. So we investigated how to go about doing that. We talked to a broker who assured us: do not get pregnant first. Pregnancy is a pre-existing condition. That said, he continued, there are no plans on the market that include maternity. Maternity was not “normal women’s care.” For that we had to buy an additional package–called a “rider”–and we had a waiting period before I could be pregnant and covered.
We did all that. But, somehow, we didn’t read the fine print. Even though we were paying hundreds each month, it was still perfectly legal to cap our coverage for pre-natal care and labor and delivery at $3000. Total. There is not a labor and delivery in America, let alone pre-natal care, that can be purchased for that fee. The average vaginal delivery hovers between $7000 and $8000 nationally. The average c-section at $13,000 to $14,000.
We fought the bill for eight months. We were called by creditors constantly. We were told to “throw it on a credit card.” We were told to pay, in full, immediately. My entire family–all in medicine except for me–were sure there was a mistake, but there was no mistake. We’d been sold a virtually fraudulent policy. And then I decided to write about it. And go on NPR to talk about it.
I realized at that time, in those dark hours, that I once thought health care reform was important, because I’m a progressive. But I never realized I was a part of the conversation. I never realized how vulnerable we all are.
As my stories began to appear, suddenly doors opened at Blue Cross Blue Shield. Suddenly someone discovered that there was a way to ameliorate our enormous bill. They swore it wasn’t because I was a journalist, but the timing was suspect. And then–just as the National Women’s Law Center told me they would–our premiums began to rise, and rise and rise. “Don’t celebrate too much,” one policy analyst had said to me–“they’ll make you pay for it, in the end.”
I was called by the Democrats to testify on the Hill about our experience. And then the letters began to come in. From women in Nevada, from Missouri, from Washington, from Hawaii. Women who wanted to get pregnant and couldn’t find a way to afford it, women who had received bills like mine and were drowning in debt as a result, declaring bankruptcy. Women who didn’t have my soapbox. “My husband and I are thinking about alternatives–a homebirth or self-paying for a birth at our local birth center. Or going on his school’s health insurance, which is over $1000 a month for all three of us. Or waiting until 2014,” one woman wrote me.
I’d been told the same thing, to wait until 2014 to have another kid.
I told a friend who worked at the White House: have Michelle Obama do a woman’s event! Who could make Affordable Care make more sense than moms? But they never did.
Not everyone was supportive. There were those who wrote me, telling me I’d set fire to my own house. That pregnancy was my own decision, and I’d better pay for it. I got those, too.
And so I cried yesterday morning because the Affordable Care Act should ensure that women will never again be told a pregnancy is a pre-existing condition. And women will never again be told that a cesarean section is a pre-existing condition (as some insurers were claiming, asking women to be sterilized before coverage). Women will never again be told that maternity care is not normal women’s care. Or that having a baby is a lifestyle choice.
And I cried thinking that women who are not employed, or work for themselves, or are between jobs, might be able to leave the hospital feeling overjoyed, rather than overburdened.