The ACA and Worked For My Family – And We Needed it to Work

My name is Tim Suttle. I’m married with two children under the age of ten, and I’m a pastor of a small church in the Kansas City area.

Last summer my family received a letter telling us that our insurance provider was cancelling our policy because it would not meet the minimum standards set forth by the ACA when it goes into effect in 2014. At first we were surprised and a little bit alarmed. It only took us about two minutes to remember that our insurance was terrible. It had no co-pay. We pay everything up to $3k for each individual member of our family – essentially a hefty monthly charge for the privilege of having the insurance company (who shall remain nameless), negotiate lower fees.

I know that some people are pretty upset about losing their insurance plan. But our policy was being cancelled because it was not fair insurance. It was a mercy killing. Or at least we thought so at first.

Then we started shopping for new plans. (My wife took the lead on this whole process, so I give her all the credit for this entire story).

We found several good private options and began to apply. Every time we went through underwriting we were denied because of pre-existing health conditions. My wife even went through the appeals process at one carrier, getting special letters from doctors to help our case. Again, we were denied due to pre-existing conditions. After a few months of trying several providers, we realized that we couldn’t get insurance.

Before the ACA, our only option would be to split our family into insurable, and un-insurable groups, buy a policy for the insurable group, and then go into the Kansas high-risk health insurance pool – policies that are much like what we are currently a part of: expensive and not very good. Instead we realized that we are perfect candidates to go on the local exchange that should have been created by our state as part of the ACA… only our state didn’t create an exchange. Our state has been attempting to thwart the implementation of the ACA from day one.

Nevertheless we waited for to go live and began the process. At first we had little luck with the site. We could get further in the process than some people, but this website was pretty hopelessly broken. My wife made a few phone calls, always found answers to her questions, or got calls back with answers later on. It should be noted that Sandy Praeger’s Office (Kansas Insurance Commissioner), has been very organized and helpful.

So we waited a little while. My wife kept gathering information, reading updates, making sure she compiled all of the right information. Then a few days before Thanksgiving, she sat down to apply again. She made it through the entire process in the course of a couple of hours. We were signed up. Within a few days we had our conformation in hand.

When the documentation came, we still had a few questions. The toll free numbers worked, the representatives were helpful. Sometimes they ran our questions straight up to a supervisor. If they had to call us back with an answer they did so promptly. Our case was far from simple. We have kind of an odd situation, as do many of those who need this coverage. But everyone we dealt with was pleasant, patient, hard working, and in the end, quite efficient.

End result? We have health coverage that is significantly cheaper than we had before, and much better quality.

I know the ACA isn’t perfect. Many people are opposed to it because they think it is a bad idea. I also know that many are opposed to it it simply because it’s an Obama idea, and it’s a political thing. I know that for years our representatives will have to work out the kinks, and we still have a long way to go. But my family really needed this to work. We were in a bind. I wrote this to in order tell our story, and to say that the ACA worked for us, and we really needed it to work. I’m feeling thankful today for the ACA, and for all of those who are working so hard to make it happen. What you are doing is important. Keep up the good work.

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  • BosqueNorse

    I was very pleased to see how helpful the ACA was for you and your family.
    I am sure there are also many others who have had your good and positive experience.

  • Msironen

    Website that didn’t work now works? Preposterous! What next; we have a common ancestor with monkeys and the climate is changing?!

  • B.J.D

    I have the exact same policy now that I did before the ACA (I am self insured) but now I pay 30% more for it. Yahhh Obamacare!

  • What about the government’s mandate regarding ‘reproductive care’ that is in the ACA? What about the lawsuits brought by Hobby Lobby, the Mennonite cabinet makers, and Catholic hospitals?

    For those who do not know, the point at issue is whether or not a religious business person can be forced to pay for treatments that violate his religious convictions. HHS has offered some ‘exceptions’ to the regs, yet they are so strict that one bright observer said that not even Jesus and the apostles would qualify.

    The ACA also threatens the stability of traditional families. It’s been called the ‘Marriage Penalty,’ and the ACA penalizes married couples by making it harder for them to receive subsidies than unmarried couples.

    It is also true that under the ACA, a spouse is not a dependent, only children are. This creates a weird American version of Sophie’s Choice – who gets the kid? Which one stays on my plan and which one goes on yours?

    I am glad that Pastor Suttle got a better deal on his family’s health plan. It costs more than he thinks.