LOS ANGELES—Natalie Jill Hamingson’s life-saving emergency surgery three months ago to remove her inflamed gall bladder could have set her back by at least $49,000 had she not taken advantage of a provision in the health care reform law — so-called Obamacare.
She is one of millions of young adults, according to recent research, who otherwise would have lacked healthcare coverage or faced dauntingly expensive private health plans.
Hamingson’s surgery was a culmination of more than two years of pain, most of the time “excruciating,” she said. There were four emergency room visits, some misdiagnoses by primary care physicians and specialists and a slew of blood workups and scans, all of which would have buried her family in debt.
Except that under the 2009 Affordable Care Act (ACA), Hamingson was able to continue being on her father’s health insurance plan.
“These months of pain and hospital visits have been an ordeal, but having health insurance made it easier for me,” Hamingson, 24, said. She added, “For [Mitt] Romney to say that the health care law is not important and that the ER is an option for those without insurance is a joke.”
Hamingson shares her story with whoever wants to listen. She admits that before her illness she was somewhat ignorant of the health care act President Obama signed into law in March 2010, but now she is an ardent advocate for it.
Peace of mind for parents
The provision in the ACA that allows people like Hamingson to join or stay on their parents’ health plans until they turn 26 has provided “care for millions of young adults, and financial security and peace of mind for the parents,” observed Anthony Wright, executive director of Health Access.
Previously, parents could only cover their children until they turned age 19, unless they were disabled, or up to their 24th birthday if they were enrolled in college full time. Under ACA, young adults up to age 26 can remain on their parents’ plan even if they are out of school, married or living on their own, if they cannot get health insurance through an employer.
A survey by the Commonwealth Fund, a leading source of healthcare research, showed in June that 13.7 million young adults between 19 and 25 stayed on or joined their parents’ health plans in the 12 months ending November 2011. This included 6.6 million who likely would not have been able to do so prior to the passage of the ACA.
In California alone, 350,000 young adults have benefited from the expanded care provision, Wright said.
At the time Hamingson got on her father’s health insurance plan in January 2010, she had been “unknowingly uninsured” for nearly six months after she graduated from the University of California, Los Angeles, because of a miscommunication with the human resources department at her father’s company. Luckily, she was healthy for much of that period.
But around Christmas 2009, Hamingson experienced a “sharp pain” on the upper right side of her abdomen. The pain, she said, went away within a few hours. Her primary care physician told her the pain was likely a side effect of the medications she had been taking for a sinus infection.
“I went several months without pain after that,” said Hamingson, who lives with her divorced mother in Sherman Oaks, a Los Angeles suburb.
She resumed her job search, but almost always came up empty. The part-time jobs she snagged didn’t pay well, and none offered health insurance.
Then in September 2011, after a severe attack of abdominal pain, the young woman saw a gastroenterologist in New York, where she had landed a part-time job as a restaurant hostess. A medical imaging and endoscopy revealed that she had billiary dyskinesia (abnormal movements of the gall bladder). The gastroenterologist told her she should have her gall bladder removed.
Because of the kind of insurance she had, “I would have had to pay out-of-network charges” in the New York hospital, Hamingson said.
That, plus the need to be closer to her family, brought her back to Los Angeles, where the gastroenterologist she consulted with told her the surgery might not work. Initially, Hamingson tried acupuncture, which was covered by her health plan.
“It seemed to work for a while,” she said.
That led the gastroenterologist to urge her to stay on the acupuncture regimen even after the abdominal pain returned last May.
“Looking back, it was completely faulty advice,” Hamingson said.
Rushed to the emergency room
On July 27, Hamingson crumpled over with pain and was rushed to an emergency room from her job at an Italian restaurant. She ended up going to the ER three times over the next 24 hours. The first two times, the ER staff discharged her with pain medication.
“ER folks are only trained to triage and get your pain under control, not to diagnose,” Hamingson said.
It was only after the third attack of prolonged pain that a surgeon she went to decided to take her gall bladder out with minimally-invasive laproscopic surgery. When it came out, the surgeon showed her how badly damaged and scarred it was.
Now fully recovered and back on her feet, Hamingson has resumed her job search, but she worries about her mother. After her parents divorced six years ago, Hamingson’s mom was dropped from her father’s plan. Under ACA, her mom will become eligible for federally subsidized health insurance coverage starting in January 2014.
Neither of the two part-time jobs Hamingson has provides health insurance, and she’s making a little too much to be eligible for Medicaid, the federal-state health care plan for low-income people called Medi-Cal in California.
“It’s scary when people don’t have health insurance,” Hamingson said. “I hope I can find a job that provides health insurance before I turn 26 in December next year.”
This article was made possible by a grant from The California Endowment and was produced as part of New America Media’s series on the Affordable Care Act.
