Elleni Maureas, 36, has a lot at stake in the Patient Protection and Affordable Care Act. Her health, her career, her family—all have hinged at one time or another on whether she had health insurance.
“The whole issue of health care comes down to this for me,” she explains. “In 2000, right after I graduated from UCLA, I discovered I had Graves’ Disease. I was uninsured and the sickest I’d ever been. And I probably wouldn’t have been able to get through it if I hadn’t found Venice Family Clinic.”
But as happy as she was with Venice Family Clinic, the experience had opened her eyes to the threat that “uninsurance” can pose. Ever since then, she has made getting and keeping health coverage a top priority, but she hasn’t always succeeded.
The daughter of professional musicians, Maureas, a flutist, is now a substitute music teacher in the Santa Monica-Malibu Unified School District, eagerly seeking a permanent position. Her husband, too, teaches for the school district. But both are part-time, so neither qualifies for health benefits.
“Given my pre-existing condition, the only way I can get insurance that I can afford is through a job. This is why I decided to become a teacher,” Maureas says emphatically. “So it’s frustrating now with the cuts in education. I haven’t been able to get full-time work to qualify for benefits. And where does that leave me?”
The answer, again, is Venice Family Clinic, where she makes regular visits to have her condition monitored and has her Synthroid prescription filled as needed.
But with each passing day, she becomes concerned with more than just how to deal with Graves’ Disease. She is worried that her window for having a child is closing, and her insurance status—not necessarily her condition—could be the deciding factor.
“I got pregnant last year, but I miscarried,” she explains. “Then we thought we should wait until I have insurance, but we can’t wait too long because eventually my age becomes another risk factor. So I’m now in this perplexing grey area.”
The question at the heart of Maureas’s situation, and others like it, is really whether it is appropriate for health insurance to have such a dominant influence in American life. After all, insurance is meant to guarantee against loss or harm. But in its current form, health coverage is compelling Americans to make decisions—life decisions, no less—that they would not otherwise make. The health reform law seems to provide an unequivocal answer to this question, manifest in its numerous new rules.
“One thing that’s really exciting is that insurers won’t be allowed to refuse coverage to someone because of a pre-existing condition or to cancel someone’s policy if they get sick,” Maureas says, noting that her brother also has Graves’ Disease and her late father had it, too.
“I’m also excited that adult children will be allowed to stay on their parents’ policies a bit longer. Looking back on my personal history, if that had been in place ten years ago, I probably still would have been covered by my mom’s insurance when I got sick.”
As a matter of fact, she estimates at least ten members of her family will benefit from various elements of the health reform law.
“This is a humanitarian issue,” she says. “These things are necessities.”
Of course, it will take years for the law to take full effect, with the most sweeping changes arriving in 2014. In the meantime, Venice Family Clinic will continue to be a safety net for the low-income uninsured. And in the long term, given that there is a shortage of primary care providers, that the Clinic has expertise working with low-income populations, and that not everyone will be covered by the health reform law, Venice Family Clinic could become more important than ever to the local health care system.
“Unfortunately, getting sick is something that can change the course of someone’s life and limit their potential,” Maureas says. “I was lucky enough to have found the Clinic when I needed it. But what if I hadn’t? I can’t even imagine how differently my life would have turned out.”
Where to Look for Information about the Health Reform Law
The California Health and Human Services Agency set up this site to help residents track the implementation of the health reform law at the state level and understand the various programs available to them.
The U.S. Department of Health and Human Services created this site to help consumers navigate the health care system. It features a step-by-step interactive process for determining your options for obtaining health coverage, as well as resources for learning more about preventive care, comparing the quality of care offered by various types of providers, and understanding the changes set forth in the health reform law.
The Kaiser Family Foundation serves as a non-partisan source of facts, information, and analysis for policymakers, the media, the health care community, and the public. Its web site includes intensive research and policy analysis, as well as basic information about the health reform law, surveys of public attitudes related to the law, and implementation news specific to all 50 states.
President Barack Obama’s official web site provides easy-to-understand information about how the law works, examples of how it will benefit patients, stories from individuals and families who need reform most, and facts addressing various myths about the law.
This story appeared in the Fall 2010 issue of Encounters. Click here to download the entire newsletter as a PDF.