FAIRMONT, W.Va. — “All the pieces need to work” is the reminder a Marion County cancer survivor and certified application counselor for those seeking health insurance on the exchange created in the Affordable Care Act is offering with a possible law repeal pending.
“It’s really important to get all the pieces right because there’s real people who are benefiting from this,” Mina Schultz said as members of the U.S. Senate and U.S. House of Representatives move forward with the GOP-promised dismantling of Obamacare.
The law President Barack Obama signed in 2010 has made a difference in her life.
When Schultz finished graduate school, she planned to go without health insurance before joining the Peace Corps. At the time, she was healthy, had never had any big health issues and didn’t think much about health insurance at all.
“My parents foresaw that gap and said, ‘There’s this new law that lets you be on our insurance until you’re 26, if you want to join our plan just for that gap in time,'” she recalled. “I said, ‘Sure, whatever, I don’t really care.'”
About three weeks post-graduation, at the age of 25, Schultz was diagnosed with osteosarcoma, an aggressive bone cancer, after an MRI to investigate knee pain revealed a tumor.
Her cancer treatment plan was nine rounds of inpatient chemotherapy with three treatments each time over the course of a year and a total knee replacement. Her parents’ insurance helped cover the costs of the expensive procedures.
They worked. She’s currently cancer-free. “Just the placement and the fact that they caught it early and my response to the chemotherapy gives me a pretty good prognosis, so I’m hopeful,” she said.
Now 30 with a pre-existing condition, Schultz buys her insurance on West Virginia’s exchange and works to guide those like her through the process. The exchange is mostly for people who don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program or another source of qualifying coverage.
Subsidies to assist with premium costs are available for those who qualify.
In all, West Virginians for Affordable Health Care has estimated 37,000 people are covered by private insurance policies purchased on the exchange.
Even with uncertainty looming about ACA, the enrollment deadline for 2017 coverage is Jan. 31 and, ahead of that, Schultz said signups are up, “busier than last year,” as far as she’s seen.
“I think there’s a lot of confidence that it’s going to get worked out, one way or the other,” she said. “I’m hopeful that that’s the case. We’ll see. It’s very up in the air, as everyone knows, with the incoming president. We don’t really know what’s going to happen.”
For 2017 at least, the penalty for not having health insurance is the larger figure of either 2.5 percent of household income or $695 per adult, $347.50 per child in a household.
The parts of the existing law that many don’t like, like the insurance requirement, Schultz said, make the law work.
“The individual mandate is a very unpopular part of the law, but if you don’t have that, then healthy people aren’t going to sign up and balance out the people who use their insurance,” she said.
“It’s very complex.”
As of last week, members of the U.S. House and U.S. Senate had taken the initial steps toward repealing the Affordable Care Act which could happen within a matter of weeks.
No specific plan for a replacement was immediately offered.