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Married Friend for his Health Benefits.(Affordable Care Act not yet law)

Theresa BrownGold's painting "Married Friend for Health Benefits" for her art project, Art As Social Inquiry.

(Interview 2/2011. Acrylic on linen, 40 ins. x 30 ins.)

Update 2021

I thought I had seen everything. In 2011 I was still naive. My dismay at seeing our country plant its heel into this subject's head and pin her to the ground was only surpassed by my disgust at watching her grovel for her life. She had cancer, no health insurance and no honest way to get it.

She was 64 years old in 2011. This was 2011 before the Affordable Care Act's (ACA) online marketplaces were up and running. That would happen in 2014. If the new healthcare law had happened sooner, this uninsured woman could have bought an insurance policy without an insurer digging into her medical records looking for a preexisting condition.

Before the Affordable Care Act established consumer protections, insurers could deny an individual's application for a single health insurance policy if the applicant had an illness. The insurers did not want to pay claims they did not have to. The ACA outlawed the practice in 2014. No longer could insurers deny a person health insurance coverage based on her health history.

The ACA created high risk pool insurance to help the ill and uninsured get health insurance until the online marketplace policies started in 2014. I spoke to this woman a few weeks before she died in 2011. The ACA passed in 2010. Was the subject ill before healthcare reform passed? Was she caught in the transition from no possibility of getting an individual policy and waiting for the ACA's high risk insurance to start in 2010? Did she even know about the Affordable Care Act?

Another option for older Americans like this subject is Medicare. But the subject was one year away from qualifying for Medicare, a federal health insurance program for people 65 and over.

She and her friend came up with a plan. They would marry. The insurers could not prevent her from becoming a dependent (as a spouse) on her new husband's group insurance policy from his job. The friend's employer agreed to the scheme as well.

The subject, her friend turned spouse, and the employer did not lie. The marriage vows were legal but false at heart. And for that, my friend was afraid to have her identity known. She was afraid the insurance company would deny her claims

What torment and fear must this subject have felt as an uninsured person with a cancer diagnosis. How much tossing and turning? How much did the stress stymie her chances for recovery? How much time did she lose trying to figure out a way to get health insurance and treatment? How much crying in her pillow did she do?

Word got to me that my friend died. I had only just spoken to her weeks before. I was shocked. A person I knew had evaporated, poof!, gone. She was no longer on the earth. I couldn't believe it. I visited my friend in February 2011. She died in March.

By the fall 2011, this story and many others had been raging through my blood. On November 14, 2011 the US Supreme Court agreed to hear arguments in a case that could end the Affordable Care Act. I was livid. I smacked a kitchen towel I was holding against the table and yelled at the TV. "I am taking these portrait stories to Washington DC and standing at the Supreme Court for the justices to see just who needs the Affordable Care Act." And I did.

Artist Note (3/2012)

The subject died in her home before I had the chance to do a full-length interview. She gave me permission to do this portrait. She wished to remain anonymous. She did see this portrait. We had agreed that I would sit with her at a later time to get her full story. I never had the chance.

The question is, "Would a sham but legal marriage constitute grounds for rescinding coverage?" I will never know if she feared that happening, or if she just did not want her family and friends to know that she had conspired with a friend to get health insurance.

Artist Note (2011)

The subject requested anonymity until her full story can be told without impunity.


(from a 2011 interview)

American Citizen, Occupation Undisclosed, Uninsured then Insured, Age 64

The uninsured subject, married her good friend to get health insurance coverage through her friend’s employer-based group plan.

As his spouse, she could be added as a dependent on his plan. Her pre-existing condition could not disqualify her.

The subject needed to find a way to get healthcare benefits to cover cancer treatments.


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