(Interview 1/2019, oil on canvas, 40 ins. x 30 ins.)
Artist Note (2019)
Jeff is not extraordinary because he damned healthcare reform (Affordable Care Act aka Obamacare) before he got sick, and then grasped onto the law to save his own life. Jeff's story isn't remarkable because he wanted to live and took the insurance afforded him by the new law when he was uninsured and facing death. None of that.
Jeff is a hero because he had the courage to be fiercely honest with himself. If all of us were as honest about what it’s like to need healthcare, and then go even further by baring our souls for the greater good, we'd see the consensus for healthcare and health insurance reform rattle legislators into making real change that benefits people. We should all be like Jeff Jeans. Jeff Jeans is a hero.
Jeff Jeans got very sick. He was uninsured and needed health insurance to get treatment to live. Jeff was uninsured through no fault of his own. During The Great Recession he folded his real estate company and moved to a new state to take a job that did not provide health benefits. He always had health insurance even when he was self-employed. Being uninsured was new.
In 2012 before the new healthcare law was fully implemented, and millions were existing in that hopeless ditch of the uninsured with no way out, The Affordable Care Act paved a way for very sick people like Jeff to get treatment. He survived. But his Libertarian worldview did not.
The irony and tragedy were not lost on Jeff. He railed against healthcare reform with his Libertarian zeal when the Affordable Care Act became law in 2010. But when a cancer diagnosis shattered his callous beliefs, he turned to the provisions in the new law that saved his life. Without healthcare reform, Jeff knows he would be dead.
Self-reckoning was the force that brought Jeff face-to-face with his arrogance and his past. Who has the courage to look in the mirror so deeply that he does not recognize himself, a self-examination so dogged and thorough that he lay blubbering in a hospital bed without pretense, without excuses, without ego to whitewash the truth?
"I was self-centered and uncompassionate. No empathy for other people. I was an opinionated Libertarian. I used to read only right-leaning news. I have a background in economics and finance. If I've been wrong about healthcare, what else was I wrong about? Obamacare saved my life."
Jeff is on a hero’s journey. The formidable foe in Jeff's hero journey was throat cancer ready to claim his life in spring 2012.
The miraculous for me in Jeff's story (besides getting treatment in the nick of time) is the human capacity to change.
The blessings from Jeff's courage are first, the honesty Jeff models, (which he doesn't even know he's doing), by going public with his story.
Jeff confesses his missteps. I'm awestruck because it feels like I'm eavesdropping on something so personal, I should look away. Self-chastisement for the greater good. His public honesty implores us to examine our own thinking and actions. We rarely – no never! -- see adults own up to this extent. Can we be this honest with ourselves?
Secondly, he is using his own life, no matter the consequences, to challenge us to think about this dysfunctional health insurance system in the US that kills (more so before healthcare reform) some people or deflates lives to the point of hopelessness if they do not have very good health insurance.
But Jeff Jeans took self-transformation a step further. He smothered his crisis with self-honesty to the point of demanding accountability from himself. What does that look like? He holds up his life, his actions and his rebirth to public scrutiny simply by speaking up about what happened to him.
Jeff confronted the granddaddy of all crises – D E A T H. He drew upon uncharted human inner strength to survive. He was no longer afraid of changing and being changed when death was the alternative. The old Jeff dissolved to make room for a new self that needed fresh ideas to stay alive. He gladly leapt into the unknown and took the spiritual road less traveled to save his own life no matter the fallout.
We are in awe of self-transformative power because we know intuitively that, as human beings, we all have it. Yet, we are afraid of ourselves. We have power. We have the capacity to question and know everything about our world and ourselves in it. We can get good answers to our own brooding and messes. But this kind of probing usually upends our tidy little lives. So, we shelve the elemental force that is us, so we can avoid changing.
Jeff, on the other hand, did not try to squeeze his right-wing ideology into his need to use the Affordable Care Act to save his own life. He didn’t make excuses when his actions didn’t jive with his doctrine. He changed. HE changed rather than lie to himself.
Jeff has endured taunts mostly from the Left. "Oh, so now you support Obamacare, now that it saved your life" is pretty typical. To carry on when tomatoes are hurled at your head takes courage. A lot of courage.
In 2017 Jeff confronted Paul Ryan then Speaker of the US House of Representatives at a town hall. Jeff spoke eloquently of being radically Right and against the Affordable Care Act. He told his wife, “We would close our business before I complied with this law.” Then, at 49, Jeff got cancer and was given six weeks to live. WEEKS. That’s not a typo.
Jeff’s testimonial in front of Speaker Ryan was riveting. I was watching an emancipated man. He was ideologue no longer. He was declaring his humanness and connection to every other person wanting to stay alive in this country and needing healthcare and health insurance to do it. Jeff’s message cut through the politispeak. Jeff spoke as a human being. Anybody who saw the video knew it.
Mr. Jeans joins the Art As Social Inquiry family with this portrait story. The fear and suffering do not set him apart from others in this project or the millions in this country who cope with unpaid medical bills, out-of-pocket costs, and untreated illnesses that thrust them into lives of quiet desperation. Jeff's story is remarkable for the sweeping inner turf Jeff had to navigate to go from “self-centered and uncompassionate” (his words) to empathy and grace.
Jeff’s story is living proof that health insurance IS very important. It saves lives. Very good universal health insurance is a human right, or should be, in a first-world country like the United States that says it values human life.
Jeff reflects. “It’s not only wrong and immoral to judge others but to judge and then try to justify rationing healthcare according to wealth is morally wrong and reprehensible.”
If what happened to Jeff Jeans happened to us, or somebody we know – better yet, somebody we love -- would we have a true universal healthcare/health insurance system that serves ALL people in the United States? I think so.
We would demand, beg, rebel, persist until we had a system where angst about getting injured or sick didn’t infiltrate every blessed thing we do because we’re afraid medical bills will sink us.
The country thanks you, and I thank you, for sharing your story, Jeff Jeans.
Here is Jeff’s story.
Online Retailer, Age 56, Insured
Jeff was uninsured and unemployed when he found out he was facing death.
The 2008 Great Recession subsumed Jeff's business, gorging itself on just about every mom-and-pop enterprise in the country especially real estate. Jeff and his wife shuttered their real estate businesses in Arkansas and Missouri then moved to Arizona hoping for better prospects.
Jeff was uninsured for the first time in his working life.
As a business owner and president of his company, Jeff was unable to purchase health insurance through COBRA. COBRA is a federal law that requires employers with 20 or more employees to offer continuing coverage to individuals who would otherwise lose their health benefits. COBRA is reserved for employees. Jeff was an officer of his company and therefore ineligible.
Jeff tried to buy insurance on his own, directly from the insurance companies. He was turned down four times. Before the actual throat cancer diagnosis, the insurance companies refused to sell Jeff health insurance because he had lost his voice.
Before the Affordable Care Act, insurance companies could deny people insurance coverage if those individuals had pre-existing health conditions. The Kaiser Family Foundation explains, “Before private insurance market rules in the Affordable Care Act (ACA) took effect in 2014, health insurance sold in the individual market in most states was medically underwritten. That means insurers evaluated the health status, health history, and other risk factors of applicants to determine whether and under what terms to issue coverage.”
The year was 2012. With no employment and no insurance, Jeff and his wife moved to Arizona to start over. Then Jeff fell into the uninsured persons’ abyss.
In fall 2011 Jeff lost his voice. He thought allergies might be the cause since his mom had an allergic reaction to a tree native to Arizona.
By mid-March 2012, a biopsy confirmed that Jeff had throat cancer. A biopsy in a hospital setting in Arizona would have cost about $10,000. Jeff’s wife, an indefatigable researcher and advocate, found it was cheaper to travel to California for a $1200 endoscopic biopsy.
Jeff was still uninsured at this point and paying all his medical bill out of his own pocket. “After the doctor saw it was cancer, and realized our predicament, he only charged for the lab tests out of the goodness of his heart. He didn’t charge us the $1200 for the biopsy. He said, ‘I know what you are up against without insurance.’”
Relying on the kindness of strangers is still a common theme in American healthcare. In a 2019 Kaiser Health News article, the crowdfunding site GoFundMe characterized its campaigns this way. “Back in 2010, when the crowdfunding website began, it suggested fundraisers for ‘ideas and dreams,’ ‘wedding donations and honeymoon registry’ or ‘special occasions.’ A spokeswoman said the bulk of collection efforts from the first year were ‘related to charities and foundations.’ A category for medical needs existed, but it was farther down the list. In the nine years since, campaigns to pay for health care have reaped the most cash. Of the $5 billion the company says it has raised, about a third has been for medical expenses from more than 250,000 medical campaigns conducted annually.”
The doctors told Jeff he had 6 weeks to live. Jeff offered $90,000 cash—three times the cost -- to the hospital and doctors in Arizona to treat his cancer. They said no. They wanted health insurance. If the doctors discovered that the cancer metastasized, or if Jeff went into cardiac arrest during chemotherapy and needed open-heart surgery, 90K would not be enough to cover the cost.
Meanwhile, Jeff’s wife had consulted an insurance advisor before they left for California for the biopsy. She learned that the Affordable Care Act made provisions for people like Jeff who had preexisting conditions, were uninsured, in acute need of healthcare, and unable to buy insurance because the insurance companies would not sell them a policy.
The Affordable Care Act had not been fully implemented in 2012 when Jeff was facing his medical crisis. People could not yet go online and buy insurance on the ACA online marketplaces. The online exchanges didn’t exist yet.
But there was a way for Jeff to get health insurance in 2012 through the Affordable Care Act. The provision was called the Pre-Existing Insurance Program (PCIP). The Affordable Care Act put aside money for states to set up high risk pools to insure sick people who were uninsurable, and not getting insurance through a job or the government (Medicaid, Medicare, etc). The program was temporary. The thinking went that in 2014 those with pre-existing conditions would be eligible to go on the ACA online marketplaces and buy insurance policies. Discriminating against people with pre-existing conditions would be illegal starting in 2014. People like Jeff would no longer need temporary health insurance in high risk pools.
The Affordable Care Act’s Pre-existing Condition Insurance Program required applicants to have their applications postmarked on 15th of the month for insurance to start on the 1st of the following month.
Jeff’s wife was unrelenting. On March 15, 2012 after Jeff’s cancer diagnosis, she lobbied her insurance advisor to help her fill out Jeff’s application THAT DAY. She faxed the application to the PCIP federal offices THAT DAY to make the March 15 deadline for insurance to start April 1. She also had the insurance advisor fax the application THAT DAY. And she mailed a copy of the application with a request for a signature-upon-delivery which she got, so she knew the PCIP office had received Jeff’s application.
“If my wife had submitted it on the 16th, I would have died because I would have had to wait another month for the insurance. The cancer would have killed me. I was truly blessed at that time. If my wife would have started the process a day later, I would have died.”
When Jeff and his wife were driving back from California after the biopsy, their car broke down. A regular ol’ tow dolly wouldn’t do. They needed a flatbed truck to get their car back to Sedona. Sitting in a greasy spoon diner waiting for a tow, Jeff’s wife contacted the PCIP office once again to confirm receipt of Jeff’s application. This time she called. They had, indeed, received Jeff’s application by the March 15 deadline for insurance to start on April 1, 2012. Faxed twice, mailed with return receipt and called -- the first part of the insurance slog was over. Big sigh of relief.
Now all that Jeff needed to be insured was for the Pre-existing Insurance Program administrators to approve his application. His wife called. Every. Single. Day. Including weekends. On March 21, 2012 the Pre-existing Insurance Program approved Jeff Jeans’ application. Jeff’s health insurance, through the Affordable Care Act’s PCIP provision, would be effective April 1, 2012.
By the end of March Jeff had been admitted to the hospital. His condition put him in the ICU. He needed a temporary tracheotomy and a feeding tube to survive. None of this was covered by Jeff’s newly acquired health insurance which would not start until April 1. This was March. The chemotherapy and radiation needed to save his life could not begin until Jeff’s health insurance coverage started. Jeff, his wife, and the hospital staff waited.
Once Jeff got the word that his application was approved for health insurance coverage effective April 1, his wife chased Jeff’s doctor down the hospital corridor to tell him that Jeff had insurance. The doctor immediately scheduled chemotherapy and radiation for 6AM on April 1.
“I had the highest doses of chemo allowable. It kicked my a**.” Jeff was 49 at the time. He finished chemo but to be completely done with cancer, Jeff needed a Neulasta shot to fight off infection. The insurance company would not pay for it. Jeff paid the $5000 cost himself. Once enrolled in the Pre-existing Insurance Program, Jeff got a letter about every 3 months that Congress met and cut the budget for his program. His deductible and out-of-pocket expenses were increasing. “They increased four-fold in one year.”
The demand for temporary insurance in the high-risk pool was high. The program was underfunded. Jeff noted, “In 2013 PCIP stopped taking people. Anybody in my shoes in 2013 is dead and cremated or buried by now. That’s when I consulted with Paul Ryan and his team. They were high on high risk pools.”
Jeff quotes the then US House of Representatives Speaker, Paul Ryan “Well, they work when they are funded.”
Jeff shared his story with Paul Ryan’s staff to try to rebut the Speaker’s statement. If the GOP was in favor of high risk pools, why was the Republican Congress cutting funding for them? “If they would have worked to fund the high risk pools, there would not have been a problem.” Jeff said.
Jeff’s voice is raspy from the scar tissue on his vocal chords, but he feels good. His story ends well but not without personal cost. Jeff was too sick to work. Jeff’s wife couldn’t work for two years while tending to Jeff. The medical bills for the two uninsured weeks in the hospital at the end of March 2012, before PCIP insurance coverage started, came to $1 million, a mind-blowing sum for a middle-class family. Jeff and his wife joined the unfortunate statistic of those forced to declare medical bankruptcy.
Jeff admits that drinking alcohol caused his cancer. Internet trolls shamed him for it. Jeff correctly observes that when people are judged, “Others will not want to speak up.”
Nevertheless, Jeff remains vocal about how the Affordable Care Act saved his life. He started a Facebook page called Obamacare Saved My Life to give people a place to share their stories. “This page is devoted to the millions of Americans who have been positively impacted by the Affordable Care Act. The ACA is love & compassion personified!”
In a CNN Don Lemon interview, Jeff talked about the Affordable Care Act, “I don’t think I really understood it. And, you know, until you’re really sick and ready to die…it changed me. I’m a completely different person today than I was then. Unless you have been through something like that you don’t understand. I talk to other people and they have different viewpoints than me. You know I can relate to that. I was that person. At one time I was that guy. I was Paul Ryan talking about repealing it before I got sick. I was Paul Ryan but not anymore.”