John Cornyn wants to hear your Obamacare stories

I am a Clinical Social Worker. I have at least 7 clients that would not have insurance, let alone the ability to see a counselor if not for the ACA. They do not qualify for Medicaid in Texas because we didn’t participate in the expansion, and they cannot afford traditional insurance because it is overly expensive.

I know one family where their insurance became too expensive, and it was more worth paying the penalty because of the prices. There needs to be some balance. $1400 a month for medical insurance is too expensive, and people need to be covered.

What I think you miss is that if people without coverage use the emergency room as their Dr., we are paying more than we would to help them be insured. Insurance for the family per year vs ER visits for strep, and regular illness, and diabetes visits. We are paying for these families either way. And they are healthier with regular medical care, so we actually pay less to give them insurance that lets them see a Dr. and a therapist. If you are coming from a strictly financial perspective, we pay less to insure people than to not.

Dear Senator Cornyn –

In response to your request for my story re: Obama Care.

I am a small business owner. My husband is also a small business owner. Our businesses are too small to participate in group insurance. We can sign up for insurance with any carrier – Aetna, Humana, etc – but we are offered only individual plans. Therefore for years we have had to purchase our family’s health insurance through the individual market. As you know – prior to the passing of the ACA – and actually prior to the plan going live in 2014 – anyone purchasing an individual plan was subject to exclusions due to existing conditions.

I doubt that you have ever had to fill in an application for health insurance. Prior to 2014 (and ACA), when one applied, one had to fill in a detailed accounting of every doctor visit and issued medication for the past FIVE years. I doubt that you have those types of detailed records. No one does. The reason why we don’t have them is because each doctor issues a different type of report, all hard copy, and none of which are searchable, or understandable. They use codes that we do not understand because they are not meant for patients or in our case, consumers.

Once you fill in your best effort of of the past FIVE years – you know that the insurance company now has justification for excluding any condition you may have in the future. I have two children. They have had sore throats and whooping cough. So is that a pre-existing condition for something more serious? That is up to the insurance company. I essentially have to sign on to pay upwards of $1300 / month for a family of four – and assume that the insurance company can exclude any condition for payment.

In about 2010, my husband, whose father served in the US Navy and was decorated as a POW, and died of a heart attack at a relatively young age of 55, had what he thought was a strange tingling in his arm. Given his father’s death from heart attack, my husband took the safe route and went to the hospital. They checked him out and wanted to do a procedure to scope his arteries. Would you turn that down if the hospital told you it was necessary? He did not turn it down because the cardiologist told him it was necessary and he wanted to be alive to raise his two children.

The next time we went to apply for individual / family insurance – we were denied, due to the procedure above. The procedure found nothing, actually found he was very healthy. But because he wanted to have the procedure recommended by his cardiologist, we were no longer able to get health insurance.

The ACA changed this, and we are now able to get health insurance. We are also able to apply without having to fill in details of every medical conversation, visit, prescription for the last FIVE years.

ACA is not perfect. In Texas it has been implemented horribly. There are many insurance carriers offering insurance for individuals and families – however there are no providers who will accept the insurance. The main providers in Texas – Texas Children’s, Methodist, St. Luke’s, MD Anderson – will ONLY accept group insurance. This seems unlawful to me, but that is how the Texas legislators are letting the market operate. My assumption is that if the ACA had been voted in by a Republican Executive / Legislative Branch, Texas would be supportive and actually try to support families, versus working hard to make ACA inoperable.

There is one provider however, Memorial Hermann who offers insurance that can be used for families like mine. There is no regulation on their fees however – and I am paying $1300 / month for a HMO for a family of four. And the insurance has a very high $10,000 deductible.

What you are doing is tearing down the ACA and offering horrible options to replace it. We are your constituents and deserve better.

If you repeal the ACA, then we have to deal with pre-existing conditions and will be back to being denied insurance. Why can’t you focus on improving it. It is very clear that providers like Texas Children’s etc should be accepting individual / family insurance. Why are you not focusing on fixing this? Is it fair that ONLY people who work for large companies and have access to group insurance can use services of Texas Children’s, Methodist, St. Lukes etc? No that clearly is not fair.

You represent us. Please focus on helping instead of tearing down something just because you ‘can’. I am not interested in the political back and forth. I am interested in knowing that my children can access healthcare. I assume you understand this. You have a premium healthcare plan. And so does your family.

I am just as valuable as you, and my children are just as valuable as the children of elected officials.

Please work for us.