Faces of the Affordable Care Act: Health law provides a new optimism

Cancer survivor relieved insurers can't deny her

By Marissa Harshman, Columbian health reporter

Published:

 

Health insurance profile

• Name: Laurie Wakefield.

• Age: 39.

• Family members: Two children, Lucy, 13, and Griffin, 9.

• Annual family income: $30,000.

• Current coverage: State Basic Health (Laurie) and Apple Health for Kids (children).

• Qualify for federal subsidy? Medicaid.

• New coverage: Medicaid.

For Laurie Wakefield, one component of the Affordable Care Act brought more relief to the mother of two than anything else the new law offers.

Beginning in 2014, insurance companies can no longer deny coverage or charge a person more for having a pre-existing condition. For a cancer survivor, like Wakefield, that's potentially life-changing.

Eight years ago, Wakefield found a lump in her neck. She was recently divorced and had just moved to Vancouver from Eugene, Ore. She was a single mother of two kids, ages 2 and 4. Wakefield was working at a day care making minimum wage. She and her kids qualified for Medicaid.

Wakefield went to the doctor after finding the lump and, a couple weeks later, was diagnosed with Hodgkins lymphoma. She had to quit her job because the germs were too risky for her compromised immune system.

After completing treatment, Wakefield decided to open her own in-home day care. Once she started making decent money, Wakefield said she lost her state insurance, though her kids remained on Medicaid. Wakefield did, however, qualify for the state's Basic Health plan.

Editor’s note:

This is the fifth in a series of stories looking at how the Affordable Care Act affects residents of Clark County.

The Columbian is sharing the stories of residents who have found cheaper health insurance through the state-based exchange, qualified for expanded Medicaid, opted to pay a penalty rather than purchase a health plan or are unhappy with the new insurance offerings.

"Thank God they had Basic Health because nobody would have insured me," Wakefield said. "Or if they did, it would be for thousands of dollars."

On Basic Health, Wakefield pays a monthly premium of $122. The plan has $15 co-pays and requires her to pay a portion of the cost of some medical services.

"It was really good insurance actually," she said.

But last month Wakefield got a letter informing her the Basic Health plan was being eliminated and directing her to the new state-based insurance exchange, Washington Healthplanfinder. Wakefield submitted an application on the exchange website, http://www.wahealthplanfinder.org, but received an error code. After weeks of calling the help line daily, Wakefield finally got through and got the error fixed.

Like her children, now ages 13 and 9, Wakefield will qualify for Medicaid on Jan. 1. She's eligible due to the Medicaid expansion implemented under the Affordable Care Act that extends coverage to people ages 19 to 65 making up to 138 percent of the federal poverty level.

"I'm scared but excited at the same time," Wakefield said. "To know I won't be discriminated against because of my pre-existing condition is a relief. But I'm also scared to jump into this new system."

Wakefield is also excited for the freedom the Affordable Care Act provides.

For the last several years, Wakefield has been hesitant to expand her business for fear of making too much money to qualify for Basic Health. Even with a slightly higher income, Wakefield wouldn't have been able to afford the more costly health plans offered to people with pre-existing conditions. And with the type of cancer follow-up care Wakefield needed, she couldn't afford to go without insurance, either.

For five years after completing treatment, Wakefield needed PET scans and blood tests at least twice a year. Without insurance, the follow-up care would have cost her thousands of dollars every visit, she said.

"I felt stuck," Wakefield said.

So she continued to play the game, making sure she didn't become too successful to lose her insurance. So while she's thankful for the state's Basic Health program, Wakefield said she's ready to move forward. And if, in the process, she ends up making too much money to qualify for Medicaid, Wakefield said she is optimistic she will find affordable insurance through the exchange.

"There's so many things I would like to do and have the opportunity to do now," Wakefield said.