Our cover story this week
takes a look at some of the more than 150,000 Arkansans who have gained coverage under the private option
, including Tamara Williams, a North Little Rock mother of three working full time and making $11 an hour. If the state had not expanded coverage, people like Williams would fall into a coverage gap
(an estimated 5 million Americans are without insurance because of the refusal of 24 states to expand Medicaid). Williams enrolled in a plan with Ambetter via the private option, and was able to get the treatment she needed for high blood pressure, as well as breast cancer, diagnosed shortly after she gained coverage. Her story after the jump. More stories of people who gained coverage under the private option here
For Tamara Williams, a North Little Rock mother of three, gaining health insurance came in the nick of time. Williams had her first mammogram in late February and it came back abnormal. After a follow-up and a biopsy, doctors informed her that she had invasive ductal carcinoma. She had surgery in late March and is scheduled to begin chemotherapy this month.
A year ago, Williams likely never would have gone to the doctor. "The Affordable Care Act saved my life," she said.
Prior to gaining coverage under the private option, Williams had been without health insurance for 10 years. Her kids — an 18-year-old son who has ADHD, a 17-year-old daughter who has sickle-cell anemia, and an 8-year-old son who has chronic asthma — were covered by ARKids, but Williams herself didn't have options.
She has always worked — she's been everything from a lab technician to a cosmetologist — but didn't have coverage through her jobs and made too much to qualify for the Medicaid program under the old state laws. "You have one job that doesn't have coverage, so you try to find a second job, a third job, trying to pay for insurance," she said. "If you're trying to take care of four people, you're already strapped. To figure out how to budget that in, it just wasn't possible."
Due to a pre-existing condition — hypertension — Williams wasn't able to find affordable health insurance. "Because my blood pressure was so high, insurance companies didn't want to touch me," she said. "I just had to pray that I didn't get ill."
She couldn't afford the medicine she needed to keep her blood pressure under control or the blood work she should have been getting to monitor it. She ended up running up more than $10,000 in credit card debt to pay for medical expenses. When she did have her medicine, she would take it every other day "to try to stretch it."
Eventually, she simply avoided seeking the care that she knew she needed but didn't have enough money to pay for. "It's between do I feed the kids or do I get the medicine?" she said. "I knew sometimes my pressure would be extremely high, at stroke level. I would drink vinegar and lay on my side. I taught my oldest son how to take my pulse and make sure I was OK. I told him, 'If it gets too high, just call the paramedics, it's going to be OK.' Thank God we didn't get to that point."
Williams was laid off from her job as a medical records analyst at the state hospital in July and started working full time for $11 an hour as an IPA guide, one of the federally funded outreach workers charged with helping people navigate new options under the Affordable Care Act.
She loves the work, she said, because she loves helping people and is able to share her own experiences to convey the value of health insurance. "I've met people who had to file bankruptcy just because of medical bills," she said. "I'm thinking, wow, and I thought I had it bad. My heart goes out to them."
Williams herself got covered under Ambetter and got her card the first of February. "It has been wonderful," she said. "For the first time in 10 years, I actually have normal blood pressure. I'm actually getting treated, and I don't have to wait and figure out how I'm going to pay for it. The health care system without insurance — you're going through and you're scared and you can't afford things. Sometimes you feel like you're less than human. Now I'm not worried. They asked about insurance and I had my card to give them. I know my insurance is there. If I do get a bill it's not something that's going to take me 10 years to pay off."
Williams is not out of the woods with the cancer but she is feeling upbeat.
"You kind of feel like you're getting the VIP treatment because it was like boom, boom, boom, let's get it out," she said. "I was like, wow, insurance really does mean something. You have good days and bad days, but I'm optimistic. It's mind over matter. If you hope for the best, you have better outcomes."
Williams is hoping that she'll still be able to work four days a week during her chemo treatment.
"That's me being optimistic but I can't be down more than a day," she said. "Life goes on, I've still gotta take care of my kids, I've still gotta work." Williams will likely have to look for a new job soon; the future of the guides program is in flux after the legislature banned the state from appropriating funds for outreach for the Affordable Care Act in the new fiscal year in July.
"I'll be out hitting the pavement every day," she said. "I've always showed my children you have to get out and work. I'll go dig ditches to feed my kids before I stand in line and wait for the government to hand me something." Williams added that she believes that health care is different. She doesn't consider the private option a "handout."
"I think health is something you need," she said. "How can you go to work if you're not healthy? Now that I have my medicine, I have the energy to get out here and do whatever it is I need to do to support my family."
Williams said that she was "sweating bullets" as the legislature debated whether to reauthorize the private option during this year's fiscal session. "It was like getting the breath knocked out of you. I honestly feel like the private option saved my life. Had I not had insurance, I don't know what I would have done. What do people do who find out they've got cancer and don't have insurance?"
"I feel grateful," Wiliams said. "It's about time."