How to survive the ACA health care uncertainty?

July 24, 2017 9:18 PM

I know that no one can predict the future, and the current Administration is acting erratically at best. However, I'd like to know how to survive ACA health care uncertainty. I also realize that this may be an impossible question to answer.

My situation: FTM, chronically ill, on WA State Medicaid as I'm a student. However, I'm set to graduate next month, and then I'll be looking for work as a Web Developer a couple of months after that. I also have extensive experience as a QA Engineer, and some as an SDET. A lot of the work I do is contract based, which means that I buy my own plan on the ACA website through the Washington State exchange.

My illnesses: I have persistent Asthma, that requires daily inhalers like Advair, as well as Omeprazole for GERD and Buspar for Anxiety. I am lucky that my medications only cost hundreds of dollars per month instead of thousands, like other people, but I also can't go without any of them. I also have a couple of surgeries coming up; a laparoscopic hysterectomy this late September (fibroids), which is already booked and approved, and Top Surgery sometime in the nebulous future. I have the consult for that in a couple of days. Other than that, I am in good health, and I concentrate on eating well and exercising. However, because of the hysto, I don't expect to be realistically healed up and ready to job hunt until October, possibly November.

So, how do I buffer against possible health care changes? Try for Full Time work? Stay on Medicaid? Try to buy a plan outside the Exchange, like through Premera Blue Cross, once I'm employed again? Start looking for work in another country? (I'm single with no kids, so I'm highly mobile.) Does anyone even have a realistic timeline of what will happen, if the Senate does vote to repeal tomorrow?

Thanks all - and in the meantime, I'll keep on calling Senators, and monitoring the Megathreads; the actual news gives me too much anxiety for me to focus on.

posted by spinifex23 to Health & Fitness (7 answers total)

I think your best option is to find full time work with a company in Seattle that offers health insurance. It seems like most non startup tech companies in the area have decent insurance plans that are better than what you'd get on your own. Plus the better companies in town will give you ample sick leave to cover your upcoming surgeries, options to work from home or take a day off if you are having a bad anxiety day, etc.
posted by joan_holloway at 10:30 PM on July 24, 2017 [6 favorites]

Seconding finding full-time employment at a non-startup company that's large enough to be required to offer FMLA and a good short-term disability insurance policy. I believe it's still the regulation that FMLA applies to any company with at least 50 employees. FMLA is a federal mandate (unrelated to ACA) that protects your job when you have to take leave to recuperate or care for recuperating family. It means you cannot be fired when, say, you are out for six weeks recuperating from surgery. Short-term disability is a policy most non-startup companies offer that keeps you drawing some percentage of your salary while you're on medical leave. Typically it kicks in after you've used x amount of PTO/vacation/sick days and lasts for 6-12 weeks depending on the company's policy.

Because no one knows what will happen to the pre-existing condition rules if the ACA is repealed, it's advisable to get on some company's insurance plan now and plan to stay on it for a while.
posted by ImproviseOrDie at 11:54 PM on July 24, 2017 [1 favorite]

Full time work with insurance does sound like a good option for you, even if your take-home may not be quite as high as contract work. I would be remiss not to mention that FMLA leave rights do not generally kick in until after you've been with an employer for 12 months, so it may not dramatically decrease the uncertainty levels in terms of leave.
posted by LadyInWaiting at 1:00 AM on July 25, 2017 [6 favorites]

Agreed on a full time job, but in case this helps ease your mind there are options for those drugs. Even if you didn't qualify for medicaid, there are discount pharmacy cards you can get for free so you're only paying what insurance would pay for those drugs. I never took buspar, but I took zoloft and it was $12 out of pocket. I'm a diabetic and I was able to apply for relief from the company who made my insulin because I was unemployed. It was a real pain in the ass and I had to harp on them, but I did get the medication I needed. Even if you didn't qualify for assistance there are nonprofits that can help you. It can be exhausting. You have to advocate for yourself really strongly. It's not fair, but there are options. You just can't give up. I only bring this up because I'm also spiraling about healthcare in this country and it helps to give myself a reality check sometimes.
posted by Bistyfrass at 8:16 AM on July 25, 2017 [1 favorite]

Just FYI: Buspar shouldn't be costing you even half of hundreds of dollars per month! Unless something weird has happened, it's available in generic form.
posted by praemunire at 11:13 AM on July 25, 2017 [1 favorite]

Response by poster: All of my meds are inexpensive and generic, except for the Advair. That's the one that costs hundreds of dollars.

Thanks for the good advice; now I know where and how to focus my job hunt!
posted by spinifex23 at 12:07 PM on July 25, 2017

In the mean time, before you get other coverage through an employer, make sure that you maintain continuous coverage under Medicaid. If you have 90 days without coverage, you may be subject to a penalty on your tax return next April. Once you have regular income, either from an employer or as a contractor, you can switch over to either employer insurance or ACA exchange coverage.
posted by JackFlash at 7:00 PM on July 25, 2017 [1 favorite]