Jessica Palys, a CBHC Navigator, first met Chris in October 2013. They initially had several phone conversations in which he explained that he strongly preferred not to enroll in the Medicaid program. Chris changed his opinion following a health crisis and he now claims to be a “poster boy” for Illinois’ expanded Medicaid program. To respect Chris’ privacy, we’ve agreed not to use his last name.
Chris lost his well-paying job due to downsizing in early 2013. Despite holding multiple college degrees, he still hasn’t been able to find work. “I had offers for $20 an hour and passed those by,” says Chris, who is over fifty years old, “Had I known what I was getting into, I would have taken those jobs.”
His former employer paid COBRA premiums for the first 6 months as severance. Chris then took over the payments himself. On his fourth month, he was one day late with his payment and his policy was immediately cancelled. “Consider that we paid them around $9,000 without a single claim, and they cancelled me for being one day late. What kind of business does that?” This was in late 2013.
Chris had already tried unsuccessfully to purchase insurance independently as COBRA is very expensive. He was denied coverage due to “trumped up” pre-existing conditions, which was a common practice at that time. When his COBRA policy was cancelled, Chris was told by a health insurance broker his only option was to wait for ‘Obamacare’ to take effect and pray nothing happens in the meantime. Imagine how that felt, for the first time his life Chris had no health insurance whatsoever!
In early October 2013, Chris attended an event to learn how he could get coverage through the new Health Insurance Marketplace. Afterwards, he completed an application on healthcare.gov. He was dismayed, however, when the system found him eligible for Medicaid. He was very resistant to the idea of being on Medicaid, and tried to figure out ways to conjure up enough income to qualify for Marketplace coverage, a difficult thing to do since he was still unemployed. He eventually relented and applied for coverage through Illinois’ expanded Medicaid program. After several months of waiting, he received his medical card in May of 2014.
6 months later, Chris had reason to be thankful for his Medicaid coverage. The weekend before Thanksgiving, he noticed severe stiffness in his calves, which was soon accompanied by pain in his rib cage. Soon the pain became so intense that he decided he needed to go to the emergency room. There he was given an x-ray and CAT scan in an effort to determine the cause of his overwhelming pain. After hearing about the stiff calves, the doctor immediately suspected the pain in Chris’ rib was actually a blood clot in his lung (Pulmonary Embolism). Chris was also developing pneumonia and coughing up blood, and he thought about the possibility that he may die that day.
The doctor did more tests and found 2 clots in Chris’ lungs and 2 more in his legs. Chris was admitted to a hospital on a Tuesday night and discharged the following Friday. “It was the worst Thanksgiving meal I ever had,” he says. Yet he survived thanks in no small part to his Medicaid coverage.
Chris’ long-term treatment is coordinated by a Primary Care Physician who is working with a hematologist to get Chris off blood thinners, and a pulmonologist to ascertain the damage in his lungs. Shortly after Chris’ hospital stay, his pulmonologist ordered another sonogram, a CAT Scan, and a PET scan to rule out cancer. After 6 expensive tests and 3 nights in the hospital, Chris is certain he would have been in debt somewhere between $50,000 and $100,000 if he had been uninsured. “If I still had my COBRA insurance, I might be on the hook for ten or twenty thousand dollars while being unemployed,” he says. “Before Obamacare, I couldn’t get insurance.”
As he continues to work through these serious medical issues, Chris is incredibly thankful for his Medicaid. “I don’t know what I would do if I was in Texas, or North Carolina. I’m fortunate to live in a state with strong Democratic influences that embraced Obamacare. In fact I have become a “poster boy” for Illinois’ expanded Medicaid program and I am grateful!”