Insured, but living premium to premium

In my lifetime I have spent over $200,000 on health insurance premiums --- more than on anything else: rent, cars, clothing, food or business expenses. I was 13 when my father began his battle with cancer and 15 when he lost it. In those two years I saw how brutal the war with unexpected disease can be and how expensive. So I have done whatever was necessary to make sure that I always had insurance.

It has not been easy, and now that I have turned 50 --- putting me in a different insurance age bracket -- I am afraid that it may become impossible. In my experience, our insurance system seems designed to take your money when you are young and price you out as you get old and/or sick.

It may seem passe to talk about health insurance. Reform was passed, whether you agreed with it or not, so isn't this old news?

Hardly. The changes that will affect people like me the most (no denial for pre-existing conditions and a national insurance exchange) don't get here until 2014, and I am afraid they will be too little, too late.

In March, my monthly premium was $388. This month it is $560, an increase of almost 45 percent. I don't have the money to pay that much but the only way I can get an affordable rate is to reapply for a new policy. To do that I have to fill out a health history questionnaire and, if there are enough red flags, they can turn me down.

I've been through this twice before. When I was in my 20s and too old to stay on my mom's insurance, the secretarial job I had didn't come with insurance so I had to apply for an individual policy. Many of my friends just went without. But my father's death at 49 taught me that health crises don't always wait for old age, so I applied to the same insurance company that had covered me until then. I was lucky and hadn't had any major health issues --- yet. I was accepted.

The premiums started out fairly low --- not as low as if I'd been in a group, but affordable. There were annual increases of varying percentages but they stayed manageable for quite a while.

When I started my own business I researched group coverage for the self-employed, but the cost-benefit ratio of the policy I had was the best so I stuck with it.

When I was in my 30s, the premiums crept up to over $500 per month. Annual increases were on a percentage basis, so the higher your premium got, the higher each increase. It was long past time to be putting money in a retirement plan, but every penny went toward health insurance.

By the time I was 40 I was paying more than $700 a month. I'd starting having some health issues, which caused financial strain, but I begged, borrowed and sold to keep paying my premiums.

It was tempting to just drop my insurance, but the specter of my father remained with me. If anything happened to me, I didn't want my siblings to be faced with the decision of whether to bankrupt themselves to pay for my medical treatment.

The only way to get my premiums down was to apply for a new policy again. But now I was afraid I'd be denied because of my pre-existing conditions. I signed up with my same insurance company for a portability plan (an option passed during the Clinton administration) that meant they couldn't turn me down as long as I could prove I'd had continuous health insurance. The coverage wasn't as good as a regular policy, but the premiums were lower and it was better than having no insurance at all.

That was six years ago. There have been annual increases but they've been manageable. A few months ago I was paying $388 a month.

Then I turned 50 and my premium shot up. I do not have $560 to pay each month. Once again, the only way to afford insurance is to get a new policy. It's the same insurance company I've been with my whole life, but a new policy still means another application and another health history questionnaire. I don't have any of the big four -- cancer, heart disease, diabetes or AIDS -- but I've got enough other red flags that I'm afraid I will be turned down.

If the underwriters deciding whether to accept me do the math on an annual basis, it will likely show that they risk spending more on my health care than what I pay in premiums. But that's annually; what about the past 30 years?

They have my money -- more than $200,000 of it. This is the same company I paid all the years I didn't use my benefits much. Why is it that now, when I need those benefits, I am in danger of losing them? High-risk pools are not the answer; high risk means high premiums, and insurance with high premiums is of no help to people already struggling.

I've always been in favor of universal health care in a vague, liberal "yes, we should have that" sort of way. But now I get it. I suspect removing the fear of not having access to health care would also do a lot for public health -- stress is notoriously bad for you.

The reforms of 2014 are four long years away, and even then it remains to be seen how well they will work without universal care or a public option. In the meantime, people like me will continue to fall through the cracks of our broken insurance system.

I sent the application in today. Cross your fingers.

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Nancy Donoval is a storyteller, humorist and campus rape awareness speaker.

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