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Neighbors Growing Together | Jan 23, 2018

I’m a pre-existing condition

By Karyn Spory, Mt. Pleasant News | May 12, 2017

Like many Americans, I tuned in last week to watch Jimmy Kimmel’s emotional and heartfelt plea to Congress to not pass the American Health Care Act (AHCA) as it stood.

For those who haven’t watched, and I recommend you do, Kimmel and his wife, Molly, welcomed their second child into the world; a boy named Billy. The delivery went wonderfully, Kimmel told the audience and viewers at home. That was until several hours later when a nurse discovered Billy was beginning to turn purple – a clear indication something was wrong.

Billy was born with a congenital heart defect - Tetralogy of Fallot with pulmonary atresia. It’s a mouthful, I know. What it means, however, is Billy was born with a hole in his heart and the pulmonary artery was completely blocked. It’s a diagnosis that can only be fixed through open-heart surgery.

“That was the longest three hours of my life,” Kimmel told his viewers.

My parents can relate. I, too, was born with a congenital heart defect and my parents can attest my six-hour surgery was the longest moment of their life.

Unlike Billy, my heart condition wasn’t caught until I was 17. Ask any medical professional and they’ll tell you there is no medical explanation as to why I survived other than there was so much wrong with me it all just kind of worked. The silver lining to all of this, I’ve found, is whereas Billy will have to have at least two more surgeries to fix his defect (children’s hearts grow rapidly in their first five years of life) I only had to have one.

This is where Kimmel’s plea comes in. The AHCA bill, which passed the House 217-213, allows states to apply for waivers that would allow insurance companies in the state to do one of three things, according to NPR:

1. Charge older people more than five times what they charge young people for the same policy;

2. Eliminate required coverage, called essential health benefits, including maternity care, mental health and prescription drugs, that were required under the Affordable Care Act:

3. Charge more for or deny coverage to people who have pre-existing health conditions, such as cancer, diabetes, arthritis, or a congenital heart condition, like Billy and myself.

During his monologue, Kimmel said, “Before 2014, if you were born with a congenital heart disease like my son was, there was a good chance you’d never be able to get health insurance because you had a pre-existing condition. And if your parents didn’t have medical insurance, you might not live long enough to even get denied because of your pre-existing condition.”

“If your baby is going to die, and it doesn’t have to, it shouldn’t matter how much money you make. I think that’s something that, whether you’re a Republican or a Democrat or something else, we all agree on that, right?”

Some have called out Kimmel and his speech because he’s a late night TV host, obviously he can afford his son’s medical bills. And of course he can, but they’re completely missing the point.

Kimmel’s plea wasn’t just for his son. It was for the millions of American families that shouldn’t have to decide what kind of health care they can provide for their children and themselves.

My parents had health coverage when we discovered my heart condition. It was the only reason my dad has stayed at a job he detests. But until 2014, I lived in fear of being dropped from my insurance. After my surgery my senior year, I went directly to college, for one it was an expectation, but it was also the only way I could retain my health insurance and I didn’t know if anyone else would cover me. I’ve written before about the state of my mental health after my surgery – I was depressed, to the point where I had trouble getting out of bed some days. I had also lost myself during the recovery period. I was someone who may have done well with a gap year, but it wasn’t an option; children couldn’t stay on their parents’ insurance until 26 like they do under the ACA.

Other critics have said that if a child is born with a heart condition, like Billy, obviously doctors will operate right away without waiting for payment. And that is true. The footnote many are skimming over is many children like Billy require several surgeries and if they’re deemed a pre-existing condition that insurance companies won’t cover or by putting them in a high-risk pool with astronomical rates, parents are forced to decide, “how will I save my child.”

And then you have representatives like Mo Brooks (R-Alabama) who told CNN that charging people with pre-existing conditions more helps save money for those who “live good lives.”

“They’re healthy, they’ve done the things to keep their bodies healthy” he said of individuals who don’t have pre-existing conditions. “Right now those are the people who’ve done things the right way, that are seeing their costs skyrocketing.”

Right now the bill is in the hands of the Senate, but that doesn’t mean it’s too late for the voices and concerns of citizens to be heard. So if you think you can live a good life but still have a pre-existing condition, call your representatives.

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