But she considers herself lucky.
Only a few months before her accident, Ames had been able to get back on her parents' insurance, thanks to a provision of the health care law that lets young adults keep that coverage until they turn 26. Nationally an estimated 2.5 million young people have gotten insurance as a result.
Ames says it's unclear if the student health insurance she had been relying on previously would have covered her surgery. In any case, the copayments would have been steep. She would have had to postpone the operation, risking another — potentially crippling — injury.
"The fact that I was able to get on their plan is the reason I can walk today," said Ames. "Very rarely have I had something political affect me this personally."
___
Name: Sharon Whalen
Home: Springfield, Ill.
Age: 59
Occupation: Publisher of a weekly alternative newspaper
Insurance coverage: Small group plan.
As a co-owner of the Illinois Times, a weekly newspaper, Whalen wants to keep her small staff healthy. So she and her business partner provide them with health insurance and pay half the cost of premiums for their 10 employees.
Keeping that employee benefit is getting more and more expensive. The company saw a spike in premium costs after one employee's child had chronic health problems.
With costs climbing, the company switched to a managed care plan with higher copays for some services in 2009. Whalen's company also contributes less than it once did to cover the premiums of employees' family members.
The health care law brought some relief: a tax credit for small businesses that provide health coverage. The Illinois Times qualified and received a $2,700 tax credit last year.
"We see ourselves putting that money right back into the company," Whalen said.
Whalen heard about the tax credit from a health care advocacy group, not from her accountant.
"I had to practically beg them to look at this," Whalen said. "They weren't familiar with it."
The Obama administration has proposed expanding the number of businesses eligible for the credit, and simplifying the paperwork.
___
Name: Melissa Pearson
Home: Prineville, Ore.
Age: 53
Occupation: Retail sales, part time.
Insurance coverage: High-deductible plan purchased on individual market.
A few years ago, Pearson's doctor ordered her to have a routine colonoscopy. It's one of several colon cancer screening methods highly recommended for adults ages 50 to 75.
Pearson kept putting it off, in part because of the cost. Her high-deductible health insurance plan requires her to pay the first $5,600 out of her pocket each year. She knew the colonoscopy would be expensive and figured she'd be paying.
Then she learned that a provision in the health care law requires health plans to cover all costs for preventive care including colon cancer screening — with no out-of-pocket costs to the patient.
"That's what made me make the appointment," she said. She also scheduled a mammogram and cervical cancer screening, which also are covered preventive services under the law. In all, she saved nearly $3,000 in out-of-pocket costs last year because of the Affordable Care Act.
"I said to my sister, 'Thank you Obamacare," Pearson said.
The Obama administration says the Affordable Care Act provided about 54 million Americans with at least one new free preventive service last year through their private health insurance plans.
But Pearson is worried that covering preventive services will mean her insurance premiums and her taxes will go up. "It's being paid for by somebody," she reasoned. She recently talked with a student from Norway who told her about the tax levels in that country. "I'm fearful our world will turn into that."
___
Name: David Zoltan
Home: Chicago
Age: 34
Reader Comments