A letter came in the post last Friday and after I read it, all I could do for a few minutes was stare at it in shock. I sat down and put my hand on the couch to steady myself, and then read it again. It wasn’t so much the news that it brought — though that was bad enough — but the way it made me feel: vulnerable… so, so very vulnerable and out of control. The letter was from the girls’ insurance company and it informed me that, due to “increasing [insurance company] financial losses”, the premiums for their cover will be increased from October by 350%.
The girls are covered by the state’s CHIP programme — the only long-term cover I could find that they qualified for when we lost our health insurance because M was suddenly laid off three months after we arrived in the US. Because the girls are US citizens, they did not qualify for the insurance policies that are usually offered to incoming immigrants. And because we had just moved from abroad, they did not qualify for most normal insurance policies which, I discovered to my utter bewilderment, all seemed to have “residency requirements” that disqualified anyone who had not lived in the US for the last 6 to 24 months. My daughters had both been recently diagnosed with potentially life-threatening food allergies (my elder daughter to eggs, my younger daughter to no less than eight foods, which later rose to 12) which had had a huge impact on our daily lives, and I was desperate to get them onto a good, long-term policy that would give us some peace of mind. We were still reeling from a string of devastating events that had begun almost as soon as we arrived and had consumed nearly all our mental, physical, and financial resources (besides M losing his job and our insurance, I suddenly developed incredible pain that debilitated me for months before we got on top of it, the medical bills started rolling in and ate up half our moving fund, we found we had to pay the IRS a huge sum which wiped out the other half of our moving fund, the house we were renting was put the market, we were going through all the stress, isolation, and disorientation that an international move almost always brings, and it felt like we were doing everything wrong). Looking for insurance under these circumstances was turning into a nightmare and when I found out the girls qualified for CHIP, the relief was so strong I burst into tears.
The coverage was excellent; the price surprisingly affordable. The programme is funded by the state, but administered through a choice of several large insurance companies. I picked the one that we’d been on with M’s previous job, out of sense of familiarity more than anything, and got the girls signed up as fast as possible. Each month a bill arrived with bold letters telling me that one missed payment would result in permanent cancellation of the policy — I began sending the premiums in two months in advance just to make sure I never paid that price. In a world that felt like it was falling apart, knowing the girls had such excellent coverage gave me a sense of stability that I clung to like a rock in a stormy sea.
So as I read that letter — and reread it, and then read it again — all that stability seemed to drain away and the horrid, terrifying, desperation of a year ago rushed in to fill its place. Could they do this?!? Could they just casually send me a one-page letter which matter-of-factly stated they were increasing the premiums not once, not twice, not three times, but a full three-and-a-half times what they were now? No warning, no alternatives, no choice… This is our only option, this is our salvation!.. Could they do this?!? I rang M up at work and he listened patiently while I told him the news, then began to cry, and then composed myself and told him I’d be alright and thanked him for listening. My tears were more out of fear and uncertainty; we will be able to make the new payments (just, and with sacrifices), but it’s what they represented — the lack of control — that put me over the edge.
When I told my mother, she was shocked, then horrified, and then began to rant. Was this what Obama had in mind for the middle and lower classes?!? Or was it the Governor’s doing?!? It didn’t seem ethical! I pointed out that it wasn’t Obama’s doing — his reforms haven’t even taken shape yet, let alone been enacted — and it wasn’t the Governor’s either. It wasn’t to do with the CHIP programme itself at all. It was the insurance company’s doing: they take the money the state gives them and then set their price within an approved range — but times are harder now than were before, there are these “increasing financial losses”, and so they’ve raised their price. And, no, I told her, it didn’t seem ethical… but I don’t know that I think ethics plays any part in this.
I have to admit to feeling rather annoyed with her, to harbouring some deep-set and mostly unjustified feelings of blame. I had been concerned about healthcare before I moved back to the US… concerned… afraid… frightened… But my mother and my father and my sister had all assured me that I was making a mountain out of a molehill. It’s fine, they told me. It’s a system! It’s not the system you’re used to, but it’s a system. As long as you work hard, you’ll be fine. My husband, I thought to myself, does work very, very hard. And I do too, in my own way.
My had mother added that she didn’t know anyone who had a healthcare problem. What about my sister?, I asked, pointing out that she’d gone for years without health insurance, avoiding going to a doctor even when she needed one. “Oh… yes… ” my mother’s voice trailed off, and then came back again with strength, “But she never had a problem!” I felt misgivings at that, paused, and then… brushed them aside. It would be fine. It would be fine. …And so if there is blame to laid, perhaps some goes to my mother for closing her eyes to the problem, but some goes to me too for choosing to believe.
There is series of ads for one of the largest insurance companies in the region which they run on television all the time. It shows someone walking a dog, or jogging, or riding a bike. At some point the camera closes in on the person, and they look directly into it, before raising a hand and pressing it with palm forward and fingers spread, so that it appears to be just on the other side of the glass of the television screen. And as the person fades out of focus, the handprint remains, glowing blue and pulsing gently, and a warm and reassuring voiceover says, “Giving you a greater hand in your health.“
As I sat there staring at this letter, with its incredible, horrible news, I had to wonder: is that hand meant to be pulling us up… or pushing us away?