"This makes me shake and cry," wrote Erin Kotecki Vest right after she signed up for Obamacare and realized that she would save $18,900 an year. And that's a conservative estimate.
The relief is intense: "For a family that is swimming in medical debt, with no end in sight, we can now see light at the end of the tunnel."
Her former insurer Aetna tried to cancel her plan repeatedly. "They'd been doing that since the moment I got sick," she told Politix. "One of their excuses was 'well we got your premium early' and that might be grounds for terminating you from the policy."
Kotecki Vest is married with two young children and used to work full-time at BlogHer. But she became unable to work following her 2010 diagnosis with lupus, "one of the world's cruelest, most unpredictable, and devastating diseases," according to the Lupus Foundation of America. Kotecki Vest needs regular treatment to manage the auto-immune disease, which attacks healthy tissue. Her basic treatment regime involves 3-5 hours of intravenous therapy three times a week, and she has also needed expensive hospital stays.
"We automatically hit the deductible and hit the max out of pocket with my first treatment every January," Kotecki Vest told Politix. "So we'd have to think, how many credit cards can we mash together? How much do we borrow from family again?"
"We are one of those families who have been buried in medical debt since I got sick...the ones who are so close to losing everything because Mom got sick," wrote Kotecki Vest at her blog. 'We've re-financed our mortgage."Saving $19,000 Per Year and More
In fact, $19,000 may be a lowball. "I am positive I under-estimated the savings" under Obamacare, Kotecki Vest told Politix. "We are going to keep track this year and document it on my blog. ...We want to show what it really works out to at the end of the year."
Her old plan had deductibles, and out-of-pocket costs of 6k for individuals and 12k per family. The new plan from Blue Shield of California? No deductibles, lower out-of-pocket maximums, lower copays, lower drug costs, she said.
Can she keep her same doctors?
In her new plan, a PPO, all of her doctors are in-network except for one. It's also a 90/10 which means she pays 10% of things normally not totally covered like hospital stays and procedures like MRIs. Her old plan was 80/20 in network and 60/40 out of network. "Keeping in mind just about EVERYTHING for me was out of network," she wrote.
More Than Just Financial Benefits - Quality of Care Has Gone Up, Not Down"Our quality of care has not gone down AT ALL," says Kotecki Vest. "And we have been utilizing [Obamacare] since it kicked in. So trust me, my quality of care has not gone down one bit. If anything it's gone up."
Since the Affordable Care Act was enacted in 2009, Kotecki Vest said she has experienced dramatically less stress. "We knew that the lifetime caps wouldn't be an issue anymore. Pre-existing conditions wouldn't be an issue any more. Aetna couldn't try and kick me off the plan anymore. To know that they can't do that anymore, that has been peace of mind like you wouldn't believe," she added. "So it's not just financial."
Kotecki Vest can also now get drugs that her doctor recommends more easily. "It used to be that my doctor would say we had to try one drug first instead because of the insurers," she told Politix. "We haven't run into that since Obamacare has kicked in."
She Was Attacked by Obamacare Foes:
Kotacki Vest says she's received two very different kinds of feedback on telling her story. "I've had people going yes, this is what happening to us too...We wish we could hear more positive things!"
But her story has also met with hostile feedback from "around 40% who wouldn't believe it."
"I've heard, 'oh, you're a liar, you're set up by the Obama administration. They put you up to this, you're nothing but a shill. This cant be real, this can't be true,'" Kotecki Vest explained, describing the attacks. "But I've made public everything except my social security number and birthdate so you can see it's real." (You can see screenshots of her insurance documents here.)
She has arguments ready for those who tell her she should have planned better or saved more or asked family for money. "Let me be clear - you can plan and save all you want, but when you are chronically ill or in a serious accident or get an unexpected illness, ONE hospital stay can set you back more than your home costs. You can't plan for that in regular America. We have insurance, we had savings, we have family support and we are still hanging on by a thread.
Why Aren't More People Are Telling Positive Stories?
It may be because they haven't done the math for their payments over a whole year. Many recent stories of "rate shock" involve people whose monthly premiums went up. Some of them realized, on closer inspection, that they would save money overall. Kotecki Vest may be the exception rather than the rule in calculating all her different medical outlays before she chose a plan, rather than just noticing the premiums per month.
You can read Kotecki Vest's powerful story of how Obamacare helped save her family from financial ruin at her blog, the Queen of Spain.