Guest Blog by Jonathan Miller
Can you afford to spend half your income on healthcare?
If the State passes their current budget proposal, that’s what I’ll have to do.
After years of working, I’m now disabled with a chronic condition I’ve had my whole life, called Cystic Fibrosis. With access to all the care I need, and afforded the many hours it takes to do all that my health demands, I can find a small amount of stability when it comes to my health, and piece together something that resembles a meaningful, impactful life. But, without my healthcare, I would die – possibly within weeks.
As all qualifying disabled people are legally bound to, I get my health insurance through the federal Medicare program. Overall, Medicare is a well-designed, well-run system that allows beneficiaries some ability to customize their care. They can choose to rely just on basic coverage if that’s all they need, or get more comprehensive coverage if they choose to pay for it. It’s a good system, but the one group of people that Medicare is simply not designed to serve are low-income, chronically disabled individuals.
Basic Medicare does not cover prescriptions, nor does it have a cap on how much you can be charged. You have to purchase additional coverage to get these. So, someone like me, with potentially hundreds of thousands of dollars of medical expenses in a given year, has no choice…you need the additional coverage. The problem for myself, who lives on very modest Social Security payments and a small disability check from a previous employer, is all of this supplemental coverage quickly adds up to substantial costs – costs I can’t afford.
When I first transitioned to Medicare, I was terrified, because it didn’t take long for me to realize, “This is going to cost me THOUSANDS more dollars every year.” My income is too high to qualify for Medicaid or the federal prescription subsidy program. And, because I am on Medicare, I am no longer allowed to purchase a private health plan from the marketplace, which I used for a couple years and was excellent. As I did further research, I came to the conclusion that if you add up all of the premiums, healthcare expenses, and additional costs related to my treatment that are not covered by insurance, being on Medicare would likely cost me half of my income each year. That’s half of my income, gone…every year…just to stay alive.
I didn’t know what I was going to do, until I discovered the Qualified Medicare Beneficiary (QMB) Medicare Savings Plan (MSP).
It was a life saver.
This program allowed me to afford all of the additional coverage I needed. Suddenly, instead of spending half my income on my healthcare, I would only have to spend around 15%. While it’s true that my Medicare Savings Plan helps me buy my healthcare, what it truly buys me is freedom.
Now, the State wants to take that away from me.
They are threatening to change the income eligibility for Medicare Savings Plans so that I, and thousands of others like me, will no longer be eligible. Obviously, this is devastating news. I look to a future without my QMB plan, and I genuinely do not know how I will pay for my care.
I’m not naive. I understand the political landscape we have found ourselves in, and the difficult choices that have to be made as we put together the best possible budget we can manage. I hope our legislators can find the money elsewhere, and allow me to keep my Medicare Savings Plan. But, if this cut is unavoidable, it’s essential that we find additional coverage options for disabled people like me. Without this plan, I will have literally zero other options.
Could we let disabled people on Medicare also buy into Medicaid? How about providing subsidies for supplemental Medicare coverage? Is there a way to at least provide some of the MSP benefits to those whose income is slightly higher than the requirement? I don’t know what our state has the capacity to provide, but, I do know this:
We should never force anyone to spend half their income on healthcare.
CALL TO ACTION:
Legislators are caucusing now and next week on the state budget.
CALL YOUR LEGISLATOR — Find their contact information here.
For more information, read “Defending health care — at the state level.”