Bad Stevens, 54, from Lakeport, Calif., used to think vitamins and exercise would keep him healthy. After a battle with thyroid cancer, Stevens doesn’t consider himself invincible anymore (Photo by Heidi de Marco/KHN).
This post has been updated to reflect the subjects 2014 insurance coverage. Click here to read.
Have you heard of the young invincibles? Thats the name given to to them — healthy people whose enrollment in Obamacare insurance is key to offsetting the costs of older, less healthy buyers.
Brad Stevens is a 54-year-old, not-so-young invincible recently reformed.
He has been uninsured for most of his adult life. Ever since about 24 when I finished college. Basically, Ive always tried to take care of myself and be healthy and exercise and eat right and take vitamins and that type of thing, he says.
During the three decades Stevens has spent without health coverage, there have been numerous attempts to curb the growing ranks of the uninsured in the U.S. by revamping the nations insurance market, including the Affordable Care Act. Stevens is not alone in his uninsured status. Twenty percent of Californias population is uninsured, some 5 million people who could gain coverage under the health law.
The on the eve of the opening of health care exchanges that were created by the ACA. Stevens participated in the survey, which aims to follow the same group of individuals over the next two years. (Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.)
Stevens wasnt interested in the debate over how best to provide health care to the uninsured. He didnt view it as an issue for him. Im the epitome of health, and so I didnt have much concern. My health care was working out every day, eating right and taking care of myself, he said.
But that began to change. One day while cycling on the country roads in Lakeport, Calif., where he lives, Stevens took a spill and separated his shoulder. By then, he had worked in a number of jobs, usually working with his hands. Hed been a building contractor, manager of a fruit warehouse, and a massage therapist. In pain for six months and with only $2,000 to his name, Stevens got medical help from the county. Now he bikes in a gym where he sees his clients.
That wasnt the end of his troubles. One day, he says, Boom! I ended up with cancer, thyroid cancer.
Because of the health care law, Stevens will qualify for Medicaid, the federal program for low income families and individual. Before the health law, being covered by Medicaid was available only to children, pregnant women and the disabled. Now all low income people in states that are expanding Medicaid will qualify. Stevens earns less than $15,000 a year in his struggling massage business.
Stevens says he is relieved that he wont have to worry about being denied coverage for pre-existing conditions, another change made by the health care law. Besides his battle with thyroid cancer, which is being controlled with medications, and a separated shoulder, his mother and aunt have multiple sclerosis. Hes avoided getting tested for the disease out of fear that the results would make it impossible to qualify for insurance.
Stevens says he worries about people like his massage patients. People are hurting, and they need help, and I dont think Congress has a clue. Fifty-five-year-old people are falling apart. They cant swing a hammer till theyre 70 or 80, like some congressman who sits at a desk and jaws.
Once he occasionally went to the county fairgrounds when a volunteer group offered free medical check ups. Now he is anxious to sign up for Medicaid, although he hopes he wont have any additional medical issues. I hope I dont need to use it, he says. Im thinking Im going to get a peace of mind from it.
This story was produced in collaboration with NPR.
2014 Update
LAKEPORT, Calif. , he was living in Lakeport, Calif., a struggling massage therapist in a struggling town on the southern tip of Clear Lake. Brad has been uninsured his entire adult life and believed firmly that clean living and exercise could stave off any need for medical care. After a bike accident which injured his shoulder and a battle with advanced thyroid cancer, Brad was anxious to enroll in some form of insurance any kind of insurance under the Affordable Care Act.
I talked to an insurance guy who is selling Obamcare and found out I dont qualify, Bradsaidlast November. What Im going to get is Medi-Cal,Californias Medicaid program.
The insurance broker had warned Brad about long wait times, but when he called the toll-free line for Covered California, the states insurance marketplace, Brad said, I waited four minutes. It was a piece of cake. The operator didnt offer to help him apply for Medi-Cal,butinstead told Brad to call the social services office in Lake County. It wasnt a one-stop shop.
When Brad finally called the county social services office on January6, he was worriedhis two aging cars andthe modest home he had bought long ago from his mother would count against him a common concern. Sure enough, the forms that arrived in the mail asked for details about Brads bank account and any cars he owned.“So I called them back up and said,‘You dont need half of this stuff that youre requesting.’They said,‘Yes, youre right. Thats an old form. We havent switched over.'”
OnJanuary 23, Brad collectedhisrecordsand made the half hour drive down to the county office. They were really efficient at the office, Brad said, sounding surprised. Of the county worker, She was like, Boom! Boom! Boom! Shes been doing this ten years. I was just signing stuff. The county worker told him to expect the Medi-Cal enrollment to take 45 days.
Whenwe next talked on February 7, he was anxious to get his insurance card. He needed to refill his thyroid medicationBrad has no thyroid and relies on medication to keep his body functioning. His pharmacist told him that thecompany that makes his pillshad raised the price from $12.99 to $68. Im down to 24 pills right now, so Im counting them daily. If I havent gotten my [Medi-Cal] number before Im out of pills, Im going to call Walmart to find out what their price is.
There were other concerns if his Medi-Cal didnt kick in soon:To monitor his condition, Brad has to get his blood drawn every year. In the years following his thyroid cancer, he could get the blood work done for $50 to $60he always had to pay cashbut now that same service was costing him $200. Its gone astronomical.
With only a few thyroid pills leftand no Medi-Cal confirmationBrad went to Walmart and was able to get his prescription filled for $10 in cash. Its a different brand than hes used to, and he says it makes him more irritable and restless at night. The medication I get at Walmart isnt as good as the medication I get here at the pharmacy in Lakeport. The brand stocked at his local pharmacy, while now much more expensive, keeps me really level. Where I find the stuff from the pharmacy at Walmart, I do more fluctuations, moods and more night sweat nights. More heart palpitations.
At the beginning of March, a Lake County case worker called Brad to tell him his Medi-Cal was active. Basically it took two months from start to finish, Brad said. Now that Im covered, I want a physical, and a regular check up that normal people having insurance get, and I want to get a colonscopy, Brad said, laughing at his own enthusiasm fortheinvasive and unpleasant procedure.
Its been a few years since Brad has seen a specialist about his thyroid. The last specialist, at the University of California, San Francisco, charged him $2,500 for an hour-long visit. It was super expensive, Brad said. And I ran out of money. Now that hes enrolled in Medi-Cal, Brad is planning to call his primary care doctor soon to make an appointment and search for a specialist in his rural region.
Even though the card still hasnt arrived,he saysbeing accepted into Medi-Cal is an extraordinary relief: Its an incredible piece of mind. Im going, Yee-haw!
