Health Care Exchange
Thu October 3, 2013
Back To Work After A Baby, But Without Health Insurance
Originally published on Sat October 5, 2013 6:13 pm
Pardit Pri had health insurance until she decided to quit her job as a legal administrative assistant and stay home with her newborn son 20 months ago. She thought she'd have coverage by now. But it didn't work out that way.
"I knew that I wasn't going to be working for a while because I decided to stay home with my son, and I thought ... 'OK, fingers crossed. Nothing will happen during that time,' " she says, as she plays with her son in their Orange County, Calif., apartment.
She had planned to return to work when her son was about 8 months old and get insurance through a new employer.
What she found instead was an economy still sputtering toward recovery, and employers willing to hire workers only on a contract basis with no benefits. As a result, the 29-year-old Pri has been without insurance for nearly two years.
Her partner, who runs a local pharmacy, provides insurance for their son. But she and her 7-year-old daughter from a previous relationship have no health coverage.
They are part of the legions of the uninsured, including 20 percent of California's population. The Kaiser Family Foundation surveyed 2,000 of California's uninsured on the eve of the opening of health care exchanges that were created under the Affordable Care Act. Pri is one of those people, some of whom will be followed over time by Kaiser Health News to see how they fare. (Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.)
That lack of health coverage adds anxiety to seemingly benign events, like when Pri's daughter asked about tennis lessons. "She asked me the other day, 'I thought I was supposed to be in tennis?' And I'm like, uh oh. There's no insurance yet. They won't let you play sports unless you have proper insurance."
Even though she and her daughter are healthy, the fact that they don't have health coverage is always in the back of Pri's mind. What if there's a car accident? Or she catches pneumonia? These are poor people's problems, Pri once thought — not the problems of a solidly middle-class family aiming for success.
"If I ever mention it to someone or someone knows I don't have health insurance, which I wouldn't want to hide, they'd be like, 'Oh, OK. Well, what kind of a job does she have where she's not able to get health insurance?' "
Pri says she would like to look into insurance through the health care exchange, and she has a vague notion that under the Affordable Care Act she will have to buy health coverage soon or pay a fine. But she's concerned about the costs. She hadn't seen ads yet for Covered California, the state's online insurance marketplace, nor had she gotten anything in the mail.
"If you can get insurance for $95, $100, it's worth it. I'd rather get the insurance than be fined. But if the insurance is like $400, I might just think about getting fined then. I don't know. ... Right now it feels like a lose-lose situation for me."
Pri thinks she will earn just under $40,000 next year. So a fairly minimal plan might cost her about $260 a month, but with lots of out-of-pocket costs.
Another possibility weighs on her. "That's my projected income, and I go and buy insurance based off that projected income, then I lose my job. What happens then?"
One of the uncertainties for people like Pri is that her income in the coming year is uncertain. That means that the amount she would pay for health insurance, as well as the size of possible government subsidies, is hard to predict. If she pays too much, she could receive a refund when she files her taxes for 2014.
The process seems a little dizzying, and the dawning awareness of the law's intricacies and monthly costs raise Pri's anxiety about the new requirements.
She says, "I'll figure it out before Jan. 1."
RENEE MONTAGNE, HOST:
And now that open enrollment is underway for the Affordable Care Act, seven million Americans are expected to sign up in the six months that they've got before enrollment ends. Forty-eight million people currently lack coverage. And we'll be bringing you stories of those uninsured as they try to maneuver the new process.
This morning, reporter Sarah Varney introduces us to a young woman in Orange County, California who only recently learned that she would be eligible for Obamacare.
PARDIT PRI: Ah, push it. Good job.
UNIDENTIFIED CHILD: Yay.
My name is Pardit Pri. I'm 29 years old, and I have two kids: one seven-year-old daughter and one 20-month-old son. And the first time I would say I was uninsured, it's been about - it's been over a year.
SARAH VARNEY, BYLINE: Pardit sits on a colorful play mat with her young son. She has long, thick black hair and dark eyes expertly painted with eyeliner and mascara. She lives in the middle-class suburb of Tustin, in a well-kept duplex apartment. After her son was born, Pardit decided not to return to her job as a legal administrative assistant. She knew she couldn't afford the $400 COBRA payments to keep her health insurance, but she assumed she'd be able to find another job with benefits when she was ready to go back to work.
PRI: I knew that I wasn't going to be working for a while because I did decide to stay home with my son and I thought, kind of, OK, fingers crossed, that nothing will happen during that time. But I was looking to go back to work around the time he would be eight months old to a year old. So that's when I started looking for a job, because I thought that's the best way to get insurance was through an employer.
VARNEY: What she found instead was an economy still sputtering toward recovery and employers willing to hire workers on a contract basis with no benefits. Her partner, who runs a local pharmacy, provides insurance for their son. But she and her seven- year-old daughter from a previous relationship have no health coverage which makes it difficult for her daughter to participate in activities.
PRI: She asked me the other day: I thought I was supposed to be in tennis? And I'm like, uh oh. You know, the insurance didn't, there's no insurance yet. So she can't play sports. I mean they won't let you play sports unless you have proper insurance.
VARNEY: Even though she and her daughter are healthy, the fact that they don't have health coverage is always in the back of her mind: what if there's a car accident or if she catches pneumonia? These are poor people's problems, Pardit once thought, not the problems of a solidly middle-class family aiming for success.
PRI: If I ever mention it to somebody, or somebody knows that I don't have health insurance - which I would want to hide, they'd be like oh, OK. Well, what kind of job does she have where she's not able to get health insurance?
VARNEY: Pardit has a vague notion that under the Affordable Care Act she will have to have health coverage soon or pay a fine.
PRI: I would like to look into finding, you know, how to shop around for insurance, but I'm scared. I don't know how much it's going to be or I mean I have no idea right now at this point.
VARNEY: She hasn't seen any ads yet for Covered California, the state's online insurance marketplace called for in the Affordable Care Act. Nor has she gotten anything in mail. Covered California was not a phrase she'd heard until I mentioned it.
How much do you think you're willing to pay for insurance out of pocket every month for you and your daughter? What seems like a good price to you?
PRI: I don't know. If you can get insurance for like $95, $100, then it's worth it. And I'd rather get the insurance than rather be fined. But if the insurance is like $400, I might just think about getting fined then. I mean I don't know.
VARNEY: Pardit and I look up online how much of a subsidy she might qualify for. Based on what she thinks she'll earn - just under $40,000 a year - a pretty slim plan starts at about $260 a month, but with a lot of out of pocket costs.
So it will be your projected income for the year 2014.
PRI: OK. That's my projected income, and I go and buy insurance based off of that projected income and then I lose my job. What happens then?
One of the uncertainties for people like Pardit is that her income will likely fluctuate over the coming year. That means how much she has to pay for health insurance - and how big or small of a government subsidy she'll receive - is hard to predict.
VARNEY: The process seems a little dizzying, and the dawning awareness of the law's intricacies and monthly costs raise Pardit's anxiety about the new requirements. Hopefully, she says, I'll figure it out before January 1st.
For NPR News, I'm Sarah Varney.
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MONTAGNE: And that report comes to us from the non-profit news service, Kaiser Health News.
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MONTAGNE: You're listening to MORNING EDITION from NPR News. Transcript provided by NPR, Copyright NPR.
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