Peg and Paul

Peg has been a patient at the clinic for several years. She comes in once a month to get her medications for high blood pressure. She usually sees the provider once a year or if something unusual comes up. We have been talking to her about insurance for a while, but she was reticent for various reasons. Her husband Paul has healthcare – he is 65 and qualifies for Medicare.

Finally, we convinced her to apply for the Healthy Michigan Plan. She was denied. They made too much money.

Let me explain their situation. It is just the two of them in the household. Between the two of them, they work three jobs. Paul has worked for a local business for over 20 years; he makes $9.50 per hour and typically works 25 hours or less a week. Not because he wants to, but because that is how this particular business operates. He also works a second job. Peg works 24 hours per week, and just got a raise. She will now be making $10.50 an hour.

The two of them, along with their adult daughter, came in to apply for health insurance through the Marketplace. They qualify for Premium Tax Credits, which are applied to the premiums for her healthcare insurance. That brings the premium down to $120 a month. Her raise will almost cover the cost of her healthcare insurance.

For those of us NOT living on the edge of poverty, $120 a month for healthcare seems like a deal. But, when you are just barely getting by and have huge hospital bills from years ago that are still being paid on, well, it is not that easy to make the decision to use your raise to pay for healthcare.

They did make the decision – for peace of mind. They are in their 60s and know that life can change in an instant.

The decision will impact their life. There will be no extra income now – it is all committed to her healthcare insurance.

Why do we make it so hard for people? This is not a problem with healthcare; it is a problem with our society.