Laurel to the Missoulian

For telling the human story of health reform

Last Sunday, the Missoulian in Missoula, Montana did what Campaign Desk has been urging papers to do—it showed how its readers how might fare under health reform. Missoulian state bureau reporter Mike Dennison interviewed five families to see what reform would mean for them under the proposal crafted by their very own senator, Max Baucus. The Baucus plan which emerged from the Senate Finance Committee is considered the template for a final bill, so using the Baucus proposal made perfect reportorial sense.

Fifty-nine year old Beth Ferris has chronic fatigue syndrome and a policy from Montana’s high risk pool with a premium of $5,600 and a $7,500 deductible. Last year the policy did not cover most of the $15,000 in medical expenses she accumulated. A lot of her treatments are experimental, and the pool doesn’t cover them. Ferris, who works as a self-employed writer and filmmaker, gets by on some investment income and help from others, and has resorted to renting out half of her house to bring in money.

Under the Baucus bill, if she bought an $8,000 policy, she would be eligible for a $5,000 subsidy and would have to pay $3,000 herself. That could be an improvement if her doctor is covered. Still, she has to wait four years for things to improve, since the bill doesn’t take effect until 2013. In the meantime, her enthusiasm for health reform has faded. “I have to wait to see what actually happens to people who do fall through the cracks,” she says.

Dennison interviewed twenty-eight-year old Andrea Martin of Helena, a childhood cancer survivor. She’s fine now, and has returned to school to study nursing. That meant she lost health insurance from her job as a waitress. No insurance means she doesn’t get the periodic electro-cardiograms she needs. No money, she says.

It’s hard to say how reform will affect her. She may have a job with insurance by 2013, or she might not—so it’s not easy to say how she would qualify for Medicaid or subsidies to buy insurance if she is not employed. For her, reform means she needs help now, and there’s nothing forthcoming. “I never really know what the truth is any more,” she told the Missoulian. “Everybody says they’re going to make health care better, but what does that mean? For who? For the people? For insurers? For employers?”

In a companion column, Dennison asked how health reform would affect his own family. Not much, he concluded, because his family has good coverage from his wife’s employer. As the president has said, if he likes his coverage, he can keep it. Then Dennison raises a little-discussed thread in the whole debate—what if you have coverage from an employer and don’t like it?

“What Obama and Baucus don’t say is that if you don’t like the health insurance you have, you still have to keep it,” Dennison reported. The column noted that the legislation would have no effect on one of his sons who is a college student in British Columbia—“coverage,” he says, “that appears better than my own, at very low cost.” His son, he explained, has a health card that works like a credit card:

You go to a clinic or hospital, they swipe it, you see someone for your medical problem. No bills. No questions about insurance, how you’ll pay, etc. No questions about which doctor is in “the network,” because they all are. You’re covered.

Dennison interviews showed that there are lots of people who need help now, and the solution proposed by Montana’s senior senator—another high risk pool like the one to which Beth Ferris belongs—may not be useful. There aren’t many details of how the plan would work, what it would cost, or what it would cover. Senate staffers told Dennison that it’s supposed to offer good, affordable coverage, and one noted that the legislation would be a “cornerstone to build upon for generations.” Translation: there’s not much help coming any time soon for ordinary Montanans like Martin and Ferris.

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Trudy Lieberman is a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR's healthcare desk, which is part of our United States Project on the coverage of politics and policy. She also blogs for Health News Review. Follow her on Twitter @Trudy_Lieberman.