Even The Young And Invincible Need Health Insurance

Even The Young And Invincible Need Health Insurance
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Andrew recovering from heart surgery
Photo courtesy of Andrew Blackshear

Andrew recovering from heart surgery

All Andrew Blackshear did was breathe.

Driving through California’s San Joaquin Valley on his way back from a summer break in August 2015, the college student rolled down his car window to take in some fresh air. What he inhaled instead were fungus spores that would ultimately leave him gasping for life – and buried in health care bills.

They call it “Valley Fever.” It’s an infectious disease caused by a fungus the California Department of Health says lives in the state’s bone-dry soil and dirt. If infected ground is moved in any way, the spores become airborne and can infect the lungs and other parts of the body of anyone unlucky enough to breathe it in. Over 75 percent of Valley Fever cases have been found in the residents of San Joaquin Valley, nowhere near Andrew’s hometown of Benicia in the San Francisco Bay area.

The big gulp of fungal spores he took in that day soon caused Andrew to develop a high fever that lasted for almost three weeks. By the time he sought treatment at a hospital, the disease had reached his heart. It got there via lung tissue, leaving a buildup of fluid between his heart and the pericardium – the membrane that encloses it. Emergency surgery followed to get rid of the fluid.

Andrew had health insurance, but it wasn’t exactly high quality. Only 26, he thought he didn’t need it. His family insisted, so to make them happy he’d signed up for short-term coverage with a not very well-known company. Andrew jokes that he talked to the same two people every time he called the company, leaving him wondering if they were the only employees, perhaps operating out of a trailer.

But now he needed that company.

Following his first surgery, his health insurer tried not to pay the bills. In search of a pre-existing condition, company representatives requested every record from every doctor Andrew had ever seen – including his childhood pediatrician.

Within weeks of his first surgery, he went into heart failure and desperately needed another operation to completely remove his heart membrane. While coping with a heart struggling to beat, Andrew trudged from doctor’s office to doctor’s office, filling up manila envelopes with his healthcare history to persuade his insurer to pay the $100,000 he owed the hospital.

But then, as Andrew puts it, “Enrollment time came like Christmas.”

In November 2016, the Affordable Care Act (ACA) kicked off its fourth open enrollment period and Andrew signed up immediately for health insurance. Much to his relief, the plan he chose on the exchange paid for his second surgery with no questions asked.

After several months of bed rest and cardiac rehabilitation, Andrew is back on his feet and studying to be a nurse. His frightening experience with Valley Fever has made him a strong advocate for affordable and accessible health care insurance.

“I talk to everyone about it, because I am living proof of what we need from health care,” he said.

In June, he traveled to Washington, D.C., and participated in the American Heart Association’s 2017 You’re the Cure Lobby Day. As one of 300 volunteers, Andrew met with his congressional members and their staffs and urged them to support the ACA.

Under the ACA, millions of Americans like Andrew, who are wrestling with heart conditions, have been able to focus on improving their health instead of trying to find or fund the quality care they deserve.

As this year’s open enrollment period for the Affordable Care Act gears up (Nov. 1 to Dec. 15), our association is encouraging anyone who is uninsured to sign up for health care coverage. While we have strived to enroll as many Americans as possible during past years, this time our work is cut out for us.

Federal outreach efforts to boost enrollment have been limited this year. Advertising has been reduced and funding for “navigators,” who offer in-person assistance, has been slashed. As a result, we, alongside our public health partners, are helping to raise awareness and promote the enrollment period.

It’s important to remember:

  • If you have cardiovascular disease and are uninsured, you will have higher mortality rates and poorer blood pressure control than those who are insured.
  • If you have a stroke and don’t have insurance you could suffer from greater neurological impairments, longer hospital stays and have a higher risk of death.
  • Uninsured and underinsured patients are also more likely to delay seeking medical care during an acute heart attack.

So, don’t wait.

Cover your heart now by taking advantage of what is available to you and your family under the ACA. Whether you’re a millennial like Andrew, middle-aged or a baby boomer, you need health insurance.

Take steps to get covered before Dec. 15. It’s only a click away at HealthCare.gov.

Andrew with his sister, Jacquelyn Carpiaux
photo courtesy of andrew blackshear

Andrew with his sister, Jacquelyn Carpiaux

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