Thursday, March 22, 2012


This week marks the two year anniversary of the Affordable Care Act. I am not turning political on here and don't really care for a political discussion about this issue (that's what Facebook is for). I do want to talk about some of the provisions of the bill that a lot of people don't realize and one that directly relates to our family.

Most people aren't aware that the healthcare bill did many things other than the hot-button insurance requirement. It also made it illegal for insurance companies to deny coverage to people with pre-existing conditions, allowed parents to keep their children under their insurance plans until the age of 26 and a myriad of other changes to Medicare, etc. It also, most significantly to me and my family, got rid of lifetime and annual insurance caps.

If you have never gone through a  family member having a critical illness, you may not understand the significance of this. But I can tell you, for my family this has meant the difference between bankruptcy and a semblance of normalcy. If this part of the law had not gone into effect in Sept 2010, we would not only have lost Naya, we would have also lost everything.

Prior to Sept 2010, most insurance plans (even the good ones) had annual insurance caps and lifetime provisions. Most annual caps ranged from @$25k- $500k. Lifetime caps were @ $1-2 million. As of Sept 2010, lifetime caps were prohibited and annual caps were set to a minimum of $750k and needed to be completely phased out by 2014, although a lot of the major insurance companies decided to do away with any sort of cap at that time. Our insurance company was luckily one of them.

I'm not sure if the general public is aware but a longterm hospital stay, especially in the ICU is incredibly, unbelievably, ridiculously expensive. Naya was in a neonatal intensive care unit for approximately 7 weeks. For those 7 weeks, she underwent surgery, received 1-1 nursing, multiple daily X-rays, multiple echocardiographs, ultrasounds, genetic testing, blood/plasma transfusions, was on a ventilator, received a plethora of drugs and saw just about ever specialist known to man (and probably a host of other treatments/tests that I am forgetting). The final bill was close to $3 million dollars. For 7 weeks. Imagine what that would be for 7 months and realize that a lot of typical NICU stays are truly that long.

Now imagine that Naya was born a year earlier and our insurance policy had contained those typical caps. I'll give the best case scenario and say that our annual cap was the same as the lifetime cap of $1 million. That would mean that not only would we have lost our daughter, but we would be stuck with at least $1 million in medical bills out of pocket. And we couldn't have paid that (really, who could?!) so we would have had to claim bankruptcy. Icing on the cake to not only lose your child but also the rest of your life possessions. Instead, we only had to pay our maximum yearly out-of-pocket expenses (still a nice chunk of change but much more manageable than $1 million) and we were able to keep our home and much of the rest of our life in tact. Say what you will about the politics, but we are living proof of how The Affordable Healthcare Act was meant to help families, especially those in crisis. And for that, I am grateful.


  1. I live in canada where we don't have to pay for healthcare. I am so grateful fur this as my daughter has had 3 surgeries, numerous tests, ultrasounds, a stay in the NICU, genetic testing and much more. I know a lot of people were unhappy with the changes in the US but your family is the proof that it works. My little girl is also a July 2011 baby I have read your blog from the start and have thought about you often. I hope you continue to heal. You are a Fierce mamma

  2. Thank you for sharing that. I think many people have no idea what a critical hospital stay can cost. If you can make just one person understand, then you have done something great because knowledge is power.
    Still thinking of you and your little girl, stay strong Jamie.


  3. Thank you for sharing this. I'm glad that you were able to stay out of bankruptcy because of the law. I hope that other families are able to benefit from it in the future as well. I'm so sorry for your loss of your baby girl.