Insurance Imbroglio After Multiple Sclerosis Diagnosis


(Interview 7/2010, oil on canvas, 40 ins. x 30 ins.)



How the painting started.



Update 2021

I love this painting. I loved painting the hand in the portrait. I also remember laughing at how it turned out. It was hot the day I interviewed this subject. He must have spent the summer outside. He had a rich layered kind of tan built up over many weeks in the sun. When I showed up to interview him, he was just finishing mowing his lawn.


I often wondered if this guy really wanted to tell his story. His wife made all the arrangements. She was knowledgeable about exactly what was happening with the insurance. The family was insured through her health plan at her corporate job. She was able to clearly explain what their insurance options were under COBRA when she lost her job. She knew about the Recovery Act's stimulus package that would help them pay for COBRA.

So much support for my standing in DC. The portraits make the healthcare nightmares real.

During World War II wages were frozen. Businesses amped up benefit offerings to compete for workers. And the IRS declared the employers' cost for those benefits tax-deductible. And so it began.


This country unwittingly committed itself to the the employer-sponsored system. What started out as a logical way to attract talent has mutated into a chokehold that hurts people like my subject. Having insurance tethered to a job feels abusive today.


I have no update for this subject. In 2010, his wife told me that she could find a policy on the individual market for him-- a single policy not part of the group plan. But the plan reflected the discrimination he faced having multiple sclerosis, a preexisting condition. The policy he could get covered only $2500 of his $60,000/year prescription bill, drugs he need to treat his MS.


The Affordable Care Act passed in March 2010 but was not implemented until 2014 when individuals could buy single policies. This subject had no healthcare exchanges where he could buy a policy just for himself and possibly qualify for financial help paying the premium.

The subject’s multiple sclerosis medications cost $5,000/month without insurance. He knows his preexisting condition makes him uninsurable. When his wife’s COBRA benefit expired, the family needed to find some kind of insurance.
 

A study. Oil on canvas, 24 ins. x 20 ins.

(from a 2010 interview)

Jeweler to the Trade (does piece work like resizing rings, etc. for retailers) Age 45, COBRA Insured


The subject has been diagnosed with multiple sclerosis.


A paperwork snafu delayed his diagnosis and treatment 3 months. His check for the insurance premium went unprocessed because it was "lying on somebody's desk" at the insurance company, the subject said. The insurance company cancelled his policy.


The check was to pay the premium for the policy his wife had through her former employer. COBRA law gives a former employee the option to pay for insurance coverage through the former employer’s group insurance plan for a limited amount of time.


The insurer eventually reinstated the subject's policy after much distress and time spent on the phone. He was able to resume his treatment for MS after a 3 month delay.


The subject’s wife sold annuity packages for a securities brokerage firm. Her firm laid her off -- fallout from the economic Crash of 2008 .


The couple paid 65% of the $932/mo. insurance premium for the first 15 months of COBRA. ($932 is about $1,130 in 2021 dollars.) The financial help they received came from the American Recovery and Reinvestment Act of 2009 (stimulus). President Obama signed the Recovery Act into law in February 2009 as part of a response to The Great Recession. Investopia described the 2008 crash as the most significant downturn in the American economy since The Great Depression.


The couple paid the premium in full for the three remaining months until the COBRA provision ended


Without the Recovery Act the couple’s savings would have been wiped out.


The subject’s multiple sclerosis medications cost $5,000/month without insurance. He knows his preexisting condition makes him uninsurable. When his wife’s COBRA benefit expired, the family needed to find some kind of insurance.


The subject found a policy on the individual market to cover necessary care but it only covers $2,500/year for prescriptions. The subject’s prescriptions cost $60,000/year. The subject and his wife are searching for a prescription assistance program.


The subject's wife gave birth to twin boys while the family was paying for insurance under COBRA. With COBRA expiring, one child qualifies for health insurance through the Children's Health Insurance Program (CHIP). The other child was born with a club foot. His disability qualifies him for medical assistance through the state's Medicaid program.


The subject's wife found a $174/mo. HMO policy with a $2500 deductible for herself. She has no health concerns. Her experience and expertise as an administrative assistant got them through the hours of phone calls making COBRA work, and searching for other insurance coverage as COBRA expires.