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Utah's Uninsured

Having health insurance would
take so much money out of my paycheck, it wouldn’t even be worth it. My paycheck Would end up being about $50!

Danny, Age 25

Danny was born and raised in Bountiful, Utah. In December 2005 he was married and subsequently forced off of his parent’s health insurance. In order to cover tuition and living expenses, Danny is currently working two jobs. His first employer does not provide health insurance to part-time employees. His second employer offers insurance, but with a premium so high that Danny can’t possibly afford it. “Having health insurance would take so much money out of my paycheck; it wouldn’t even be worth it. My paycheck would end up being about $50.”

Avoiding the doctor…

Recently Danny broke his finger, which he unsuccessfully attempted to set himself. Although he admits he’s in pain, Danny insists that he can’t go to the doctor because of the inevitable expense. Danny’s teeth remain a problem for him, too. “I had two root canals and two cavities filled before we got married. The sealants they put on weren’t permanent and I’m supposed to go back for crowns, but I can’t afford it. Now the sealants are wearing away. Sometimes it keeps me awake. I take aspirin when it really hurts.”

Stopping prescription medications…
Danny’s prescription allergy medication costs $70-80 a month without insurance. Opting to pay for food and utilities instead, Danny now wakes up every morning feeling sick and perseveres through work and school with a sore throat and a stuffy nose.

Taking a risk…
Danny knows that going without insurance involves taking a real risk. Before he was married, Danny was rushed to the emergency room and treated for kidney stones. “It was REALLY painful. I get worried that I’ll get them again, or that I already have them again now. I’d like to get it checked, but I just can’t do that.” Like many uninsured, Danny often finds himself trying to take care of his health problems at home. He takes vitamin C and calcium religiously, referring to the Internet with any concerning symptoms and scouring the local pharmacy for any possible cures.

The reality of being uninsured…
“Insurance is a gamble… Being uninsured, you kind of walk on eggshells. If you get sick, you just live with it and hope it’ll go away. For us right now, it’s more worth taking the risk than losing the pay.”

The Patient Protection and Affordable Care Act helps Danny in the following ways:

There will be increased funding for Community Health Centers to allow for nearly a doubling of the number of patients seen by the centers over the next 5 years.  Community Health Centers charge a sliding fee scale based on income, thus making care more affordable.

The creation of an interim high-risk pool will provide immediate access to insurance for Utahns who for at least 6 months have not been able to get coverage because of a pre-existing condition. This pool will operate until 2014 when the full health reforms come online.

In addition, lower income Utahns will be eligible for subsidies to help them purchase coverage through the high-risk pool.  This interim high-risk pool has consumer protections to ensure Danny gets quality insurance.  The plan must cover at least 65% of patient care costs and cap out of pocket charges at $5,950 a year for an individual or for a family, $11,900.  The plan cannot exclude coverage of pre-existing conditions or charge older Utahns more than younger people.

In September 2010, adult children will be able to stay on parents insurance until age 26 unless they have access to employer sponsored coverage.

And by 2014, Danny will be able to obtain insurance even if he has any pre-existing conditions; Individuals will be able to buy insurance through a new online, state-based marketplace called an exchange; and families may receive subsidies to help buy coverage from their state’s health insurance exchange.  Based on income, there will be a cap to the amount a family will be charged for premiums and out-of-pocket.