By AMERICAN HEART ASSOCIATION NEWS
The third round of open enrollment under the Affordable Care Act, widely known as “Obamacare,” opens on Nov. 1.
Window-shopping for consumers began last week when the Obama Administration released premiums. The rates are going up in many parts of the country, but people do have the option to shop around. An upgraded government website can help compare costs and benefits.
This is the third year for HealthCare.gov and state-run insurance markets. Since their introduction, nearly 16.4 million Americans have gained health coverage. The share of Americans who are uninsured is about 9 percent, a historical low.
Young people are playing an important role in the success of the ACA since the plans are not priced by risk. The Obama Administration, which has dubbed this group “Young Invincibles,” has said that many in this age group believe they are immune to severe health issues and forgo health insurance.
Maria Acereto was 23 years old and working in Los Angeles in 2013. Like many her age, she didn’t believe she needed insurance because she was healthy. Insurance wasn’t offered at her work, and she was unable to afford coverage on her own.
Then, on Nov. 6, 2013, Acereto began suffering chest pain. She was rushed to the emergency room and diagnosed with severe pulmonary hypertension.
After multiple tests, doctors discovered Acereto’s problems were caused by a congenital heart defect that prevented her heart from pumping blood efficiently. She needed open-heart surgery as soon as possible, but she couldn’t afford it out of pocket.
So, she waited.
Acereto spent nearly four months in and out of the hospital, celebrating Thanksgiving and Christmas with family in her hospital room.
Finally, realizing time was running out, and vowing to never spend another holiday in the hospital, Acereto began to look into health coverage options. With the help of a hospital social worker, she learned about the newly opened health insurance marketplaces and the ACA’s Medicaid expansion provision.
California had opted to expand Medi-Cal, its Medicaid program, and she learned she met the qualifications to enroll.
Acereto’s coverage began the day she was scheduled to undergo surgery. In addition, the program retroactively covered Acereto’s medical expenses that occurred before she gained coverage.
Now, Acereto is out of the hospital and devoting much of her time and energy to teaching other “Young Invincibles” the importance of insurance coverage.
“Before my heart attack, I didn’t really find health insurance important because nothing really happened to me,” said Acereto, who serves as a Go Red for Women ambassador. But now she knows that “you never know what might happen to you.”
“Don’t just brush things off. Ask for help or even an interpreter to make sure you understand information” about your health and health care choices, she said. “It could save your life.”