Obamacare may not be much help because a Treasury Department ruling on this matter means that his wife and kids cannot shop in the exchanges because their eligibility would be based on what Devor paid for his own coverage. I asked Washington and Lee law professor Timothy Jost about the status of that rule. Jost said the rule that came out in May “left undecided the question of what happens if individual coverage [from an employer] is affordable, but family coverage is not”—the case for the Devor family. Jost said he didn’t expect the dilemma would be resolved until after the election. So Devor and his family are in a bureaucratic no-man’s land.

In the meantime, his wife Bambi and their children had been eligible for Illinois All Kids, a state subsidized program that has been costing him only $40 a month—until the rules changed. In June, the state sent the Devors a letter saying it had run out of money and needed to tighten eligibility. Bambi became uninsured once again.

His children are covered for now under All Kids, Devor says. But All Kids does not seem to be a good solution: “Almost no doctors accept All Kids, and there is usually a one-month wait for any kind of doctor appointments,” Devor said. Meanwhile, two of the children have bad skin infections, which have been diagnosed as MRSA, a drug-resistant staph infection.The one doctor who would treat the kids prescribed a cream, but the rash hasn’t gone away. “Honestly I don’t think the quality of care is very good,” Devor told me. “But he’s the only doctor we can see in Salem. I want to find a dermatologist, but I have to find one who will take us.” That’s not easy in southern Illinois. “We don’t even go to get check-ups anymore,” he said.

Miranda, Devor’s 18-year old, who wants to be an architect, is attending a community college with the help of Pell grants and her dad’s checks for textbooks. She also works part-time at a nursing home. Miranda may also become uninsured at the end of the year, when she will no longer be eligible for All Kids.

Devor had heard that under the Affordable Care Act, children could stay on their parents’ insurance until age 26. The catch: that works only if there is family coverage, and, as we’ve seen, Devor currently can’t afford that. “If she can’t afford a policy in the individual market—and pay for it herself—I don’t see many options for her now,” said Jost. In 2014, Miranda might be eligible for subsidized coverage under the ACA, but only as long as she is not part of her father’s household; that is, as long as he doesn’t claim her as a dependent for tax purposes.

Devor and I talked about her-not-so great options, and the family’s as well. He believes the president let him down. “Obama made all these compromises to the Republicans to vote for his healthcare plan. None of them made compromises. People really want universal healthcare, not what we got—a pretend system that props up the insurance system. I know plenty of people who work hard everyday, come home tired and dirty, love their kids, and are stuck,” he said.

Devor said he had read about Romney’s plan, and doesn’t like it at all. “From what I understand, he wants to give more tax breaks and give many people high-deductible insurance. That’s a terrible idea,” he said. “I make more money than people I know in my own circle of friends. How are they going to afford those deductibles? They can’t.”

So is he voting for Obama? “No,” he said. In Devor’s eyes, “Obama is clearly the better choice of the two.” But: “I can’t say I’m voting for the lesser of two evils. I will vote for a third-party candidate.”

Related stories:

The Man in the Middle


Revisiting the Man in the Middle

 

Trudy Lieberman is a fellow at the Center for Advancing Health and 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. Follow her on Twitter @Trudy_Lieberman.