On being queer in the age of endangered healthcare.
Over the last couple of months I’ve felt several emotions — primarily grief, rage and fear. But this past October I also underwent an abdominal myomectomy to remove eleven fibroids, so I’ve also been feeling physical pain. My recovery has been slow and difficult, and I consider myself incredibly fortunate to have had health insurance that covered my surgery minus a $150 co-pay. I am also fortunate to have a partner whose salary was enough to support us both financially while I took four weeks unpaid leave from a relatively new job, and who was able to work from home during my first week of recovery.
Still, every time I found myself saying how lucky I was to have these things, I got angry. Extremely angry. Because I shouldn’t have to consider myself lucky. Because these are not things I should have had to worry about while undergoing a painful and stressful health event. Because I believe healthcare is a human right. But because this is America, I found myself thanking my lucky stars.
When I underwent surgery in October, I was on my partner’s healthcare plan, which had no deductible for hospital visits and procedures. We paid the low copay of $150 instead of the roughly $13,000 it would have cost out-of-pocket. In December, we found out that her employer was changing the plan for 2017—and not for the better—due to rising Obamacare premiums. We did the math: if we had this new plan at the time of my surgery, we would have had to pay a $5,000 deductible plus 30 percent of co-insurance for an in-patient procedure. This would have translated to nearly $9,000 in out-of-pocket costs. Thankfully for us the surgery was well-timed, and afterwards we had the option to transition our health insurance to my new employer’s plan, which features lower co-pays for doctor’s visits and a lower deductible. (Had we been on my employer’s plan at the time of surgery we still would have been responsible for paying at least a few thousand in out-of pocket-costs.)
When this insurance change came up last month and I began looking into switching to my company’s plan, I was asked to clarify my relationship to my partner, because my company does not allow domestic partners to be on the plan. I use the word partner because my partner prefers it to wife, but we are legally married. So, great, we are eligible for insurance. But imagine if our marriage wasn’t legal; if this was 2011 instead of 2016, and there was no option to be married. Or imagine our lives under the Trump administration — we live in New York and feel pretty confident that our state will protect our right to marry, but what if we lived in a more conservative state? The confirmation of a conservative Supreme Court justice could very well alter the decision to uphold gay marriage throughout the U.S., should the issue reach the court again, and LGBT couples across the country would be at risk of losing their rights to joint healthcare.
At my previous job I was able to put my partner on my plan as a domestic partner (we were not yet legally married) but only because we had been residing together for 18 months. That was the requirement — cohabitation for 18 months or more. We were lucky again, because we’d been living together for the required time period, but again, what if we hadn’t been? Why were we subject to penalization for not residing together for a specific amount of time, when a marriage would have rendered that point null and void? (A marriage that was not legal, at the time, in most of the United States?)
At this point my partner did not even have the option to elect for healthcare at her job, so she would have HAD to get Obamacare, or have nothing at all. Additionally, in all of these scenarios we would have faced huge out-of-pocket costs for medical events that took place for both of us over the course of the last few years, had we not had the option to be on each other’s plans at any given moment. But at least we knew there was Obamacare if we really needed it, which gave us great peace of mind. In an economy where job security is scarce, we knew that in an emergency situation we could fall back on Obamacare, which would have been exponentially more affordable than any Cobra plan, and far better than no insurance at all.
Since the Republicans took control of our House and Senate and Trump has been elected, it seems incredibly likely that Obamacare will be repealed, or greatly modified in some way that does not serve its beneficiaries. We all know Obamacare is far from perfect, and the rising premiums render healthcare all-but-unaffordable to many middle-class individuals and small businesses, many of whom presumably voted for Trump for this reason exactly. I don’t believe that the Obamacare we have is the plan that Obama intended for our country. I think we have a long way to go towards achieving the real goal of single payer healthcare, but I am terrified by the prospect of there not being even a relatively affordable option on the market at all for uninsured or low-income individuals. Insurance, even the mediocre kind, still saves lives and the financial livelihoods of many.
When I stop and think about the healthcare situation in this country I get very angry (I may have mentioned this already) and I’ve had a lot of time to think over the last two months. Since the election, this anger has become increasingly tied to my queerness and femaleness, and I fear for what might happen to my community and my peers under a Trump administration—from not only a human rights perspective, but from a healthcare perspective as well. I know I am one of the lucky ones, to have access to decent health insurance through my employer. But I also know all too well the trapped feeling of needing insurance so much that dreams and ambitions are cast aside in exchange for an unfulfilling and stressful work environment. (A work environment which may have its own negative physical effects on the body, and who knows, maybe even cause fibroids.)
What I really want to know is this: is there a way to mobilize in our fight for accessible, affordable healthcare? I want to help fix this conundrum. I want people to have freedom in their lives to choose their profession and create art if they want to, and not be hindered by pre-existing conditions or the gender of their partner or the corrupt privatized healthcare industry we have now. Healthcare affects each and every one of us—without it, and our health, we can’t fight the good fight. Right now, we need to be able to fight as hard as we can, as hard as we ever have.
Francesca Hoffman is a Bed-Stuy resident, a real estate agent turned property manager, and an event planner and musician.