Would Giordano be better off if reform provisions were cemented in place right now? Maybe, maybe not. Washington and Lee law professor Timothy Jost says beginning in 2014 out-of-pocket expenses will be limited and will be the same as they are for high-deductible health savings accounts (HSA) for individual and small group policies—currently $6050 for individual policies and $12,100 for small group coverage, an amount that would be hard to pay for someone who has lost a job. Giordano would qualify for subsidies to help her buy new insurance, but chances are she would still have a tough time paying her bills. To afford coverage, people in her fix may be forced to choose one of the low-cost policies designed to cover only sixty or seventy percent of their medical bills.
To put medical debt in the larger context of a family’s finances, Washburn also explores what happens to patients’ credit records when they can’t pay their medical bills—an important addition to the narrative. It’s not pretty. Even a small unpaid bill can contribute to a poor credit score, and if patient and provider dispute a bill, the hospital can send the bill to a collection agency. “Once it goes to collections, even if paid promptly, it’s a stain on their credit report,” Boston consumer advocate Mark Rukavina told Washburn.
After Jon Stewart’s interview with Health and Human Services Secretary Kathleen Sebelius last week, in which he tackled an ignored piece of the health reform story, Washburn noted that her piece about Frances Giordano also illustrated another underreported story. I say amen.