Let’s bask for a moment in the good news: M has landed a job! He has done a few ‘ride on’ days with a local company, so they could see him in action and assess his skills — something of an audition, if you will — and today he had his interview with the company owner. It went well, he got good reviews from the employees he worked with, and they have offered him the job! He starts on Monday. It’s wonderful news. Wonderful! And to make it even better, it appears that the work the company does is actually more suited to his experience than the last place. Sink back in the chair, take a deep breath, and relax. He has a job again.
So I didn’t understand it at all when we sat at the kitchen table and just looked at each other, with faces awash with fear and trepidation. We’ve been waiting for this day — I was expecting that wave of relief and euphoria, but it never came. Something didn’t feel right, and we both found ourselves staring at each other across the table with our stomachs in knots.
The thing is, getting a job was only part of our problem — and, really, it was the relatively easy part. The more worrisome things were securing a high enough payrate and getting the health insurance sorted out. And we’re neither of us really sure that’s been done. M managed to negotiate a slightly higher wage than he was on before — full kudos to him! — but the insurance arrangements at the new company are not as generous, so the net effect is that we will actually be worse off each month, both because the higher monthly premium, and then again when we use the insurance because of the higher deductible. The previous company was also going to cover M’s tuition for the night-classes he needs to take to get his local qualifications, but now these will come out of our pocket. Given that his last job only just covered our basic expenses, leaving us with nearly no spare change, these extra expenses are a bit worrying.
And, this being America and health cover being considered a benefit, there’s a delay before it kicks in. This new company insures the employee after 3 months, the spouse after 6 months, and the children only after a year — before that point, it’s up to employee to find (and fund) private cover. Aside from the fact that I find this practice of witholding basic benefits to be utterly sinful, we have been warned that the COBRA cover is prohibitively expensive, but when we look for other options, we keep running into that same problem we had before because we have not been resident in US long enough to qualify for most insurers’ policies. When M explained this dilemma, the company offered to insure the whole family after a six-month delay instead, and I have spent most of the day on the phone, trying desperately to find companies that will cover us for either of those periods in order to determine which option would be better.
After I mentioned it to my mother, she was quickly on the case and evidently began by plugging our details into various websites because, within the hour, I was receiving phone call after phone call from insurance sales agents. I began every conversation by explaining that we’d only been in the country for four months, and that brought most of the calls to a screeching halt. Now and again, there were rays of hope: a travel policy that might be able to cover M, a high-deductible catastrophic policy for me and the girls. One call was particularly promising — the first one that had a plan that could cover all of us! And right away! And for a reasonable price! I was transferred to a senior agent because of our ‘special circumstances’, and he began to explain the coverage. The company was a huge insurer, I was assured — huge — who usually only worked with large corporations but offered 5% of their policies to a limited number of individuals… This sounded odd, and the cover sounded even odder. It wasn’t being laid out the way other policies were: there was no deductible, no total-out-of-pocket figure… Instead, we would get a set reimbursement when we went to the doctor and while it paid 70% of hospital costs, I heard nothing about a cap on the other 30%. I asked if I could have the details in writing — I wanted to digest it slowly, run it past my father, as he’s much more experienced in this than I am — and was told that an email with all the details and my ID card would arrive within the hour of my signing up. No no no, I said, wasn’t there anyway to read all this before I signed up? The reply sent alarm-bells ringing: this was not offered to the public, so it wasn’t on any website. It was a limited offer, and if I didn’t sign up now, they might fill their quota before I rang back and I’d have lost my chance. Mmmmm… ok. I explained that I did not intend to sign up now but I’d take his number… This resulted in more urgency: I did realise, didn’t I, that I had no other option? The COBRA would cost ‘millions’ and no major medical will take us without meeting the residency requirement. Didn’t I realise I had no other choice? I suddenly wanted this conversation to end, and I should have hung up then, but I am inexperienced at this health insurance lark, so I carried on. I insisted I was not going to sign up now, I was willing to take the risk, on my head be it. Ok, he said, he couldn’t do anything, but would I hold while he talked to a colleague…?
Moments later, the thundering voice of Bill, the Enrollment Director, came on the line. He understood there was a problem… what was the problem? I explained I wanted to think about this policy before signing up, look it over in writing. He repeated the same guff about missing my chance and I repeated that I was willing to take that risk. “But I don’t understand,” he said, “This is your only option. You have no other choice. You don’t qualify for major medical coverage. We are offering you and your family a chance to be insured…” I was sick of this and wanted off the phone, and said that I felt I was getting the hard sell and… He cut in, “No, not at all! We are just trying to offer you the chance to insure your family when no one else will…” He was beginning to become angry, his tone rising. “Do you realise there are 50 million people in the US who are uninsured because they don’t qualify? Just like you. You don’t automatically receive insurance in the USA! This isn’t…” he spat the words, “socialised medicine!!” He was lecturing me. He was lecturing me! I started to say that this was beginning to… but he cut me off, not even trying to hide his anger now, “Listen, you know what?!?…” I knew what was coming but I listened anyway, frozen in shock and disbelief. “We’re going to offer this chance to someone else. We don’t need you as a customer. Good luck getting insurance!” and he hung up on me.
I was shaking. I went in the other room and cried for awhile. M came to look at me in sympathy and uselessness, but I sent him away again. This isn’t what I came to America for. This isn’t what I’d jumped through all those hoops for. I didn’t expect it to be so difficult to do… well, everything! I don’t know what I’m doing here. I don’t understand how anything works here and it takes so much time and energy to figure it all out. I am tired of discovering that my car is due for an inspection I didn’t know about, tired of being suddenly surprised by the local municipality’s tax bill, tired of having to read the small print on every single thing because I have no previous experience of any of it. It’s hard work and it makes everything so slow. And then… and then… and then I get to talk to assholes like that as well, trying to bully me because they know how vulnerable all this makes me.
I hid for a long time in the other room so the girls wouldn’t see me crying. After awhile, an email came through from my mother with a link to the CHIP programme, which I knew required children to be uninsured for six months before they were eligible to enroll. That fact had angered me so much when I’d read it back in December that I hadn’t looked at CHIP again, but my mother had re-read the small print. There was a chance the girls were eligible now because our new situation was involuntary. Still unable to control my voice completely, I gathered my nerves and rang the number.
I spoke to a lovely man who treated me with courtesy and perhaps even a little compassion — my voice, I expect, was betraying me. I explained M had been laid off — did that make my girls eligible? He asked whether we were insured at present. Well, I began, I’m not sure because we have the option of COBRA but the paperwork hasn’t arrived yet (M has chased it with his previous company four times already!) — it should be here this week — and our normal coverage ended on 31 May… “Ok, you have no insurance — you are uninsured,” he said. “Your girls are eligible. You need to fill out a application and send it in. It will take about an hour to do, and then four to six weeks to process. If you take up the COBRA option in that time, your daughters will no longer be eligible. The coverage with CHIP is very good. It includes…” I was overcome with relief that my girls could be covered — it ran warm over me. But his first words struck a chill in my heart: we are uninsured.
Somehow I hadn’t fathomed that, even though I knew our coverage was ending. Because we had the COBRA option, and it had been explained to M that COBRA can be enacted retroactively up to 30 days after the insurance cover ends, in my mind I still thought of us as being ‘covered’. We’d been told that if we were ill or in an accident and needed medical care within those 30 days, we could apply for COBRA afterwards and the bills would be covered. Ok, so the insurance ended this past Saturday but, with the COBRA option still live, we weren’t uninsured. Not really.
But when he said it out loud — you have no insurance, you are uninsured – it became suddenly, terrifyingly real. My eyes dry now, my senses sharp again, I walked back out into the kitchen. E1 was eating her dinner, swinging her legs back and forth under the too-tall chair. E2 was standing on another chair and, with a look of mischievous delight, perching one knee on the table in an attempt to climb up. I looked at my daughters, so blissful… so blissfully unaware. They trust that we will ensure they are taken care of.
We are uninsured. After four months in America, we have joined its 47 million uninsured. Looking at my daughters, the realisation hit me like a slap in the face.