Love in the Time of Unsubsidised Health Insurance: An ACA Prequel

At the end of 2006, a little over a decade ago, my future husband and I decided we were going to get marred.

Good for you, you say, But, we don’t want to here another cute story of hetero high school sweet hearts getting hitched.

Lucky for you, that’s not the story I want to tell, either.

It wasn’t the best time for us to get married. I was trying to finish my Master’s thesis, my husband was in the last semester of his Bachelor’s degree while having a full-time Assistant Manager position in retail. I was working part time, applying to PhD programs, and in therapy for severe OCD.

I’d started having panic attacks for the first time in the fall of 2005, coinciding with my first real job, beginning graduate school, and living together without roommates for the first time. Occasional panic attacks increased in frequency, days laced together in ebbs and flows of absolute terror. Less than a year later, violent intrusive thoughts joined my illness. Getting to class and going to work, were the largest victories of my days. On my days off, I’d curl up on our couch and stare at the walls. Functionality was nonexistent.

I scheduled a session with one of the school’s counselors, who suggested I might be schizophrenic, which runs in my family. During my first session with a licensed psychologist, I was asked if I thought the devil was sending me evil thoughts. I’m an atheist. Thankfully, both that therapist and I realized it wasn’t working after our first meeting and she suggested I try another individual in her practice. The first diagnosis suggested was psychosis, which was about as comforting as schizophrenia had been. She scheduled an appointment with a psychiatrist for me. I lived with that diagnosis for a week, trying to define the shape of the rest of my life. During my next appointment, she gave me an OCD questionnaire under the suspicion that I was too lucid for psychosis. Eventually I was diagnosed with a variant of OCD, heavy obsessions with compulsions that manifested internally, churning thoughts and circles of logic.

I wasn’t sure I was going to survive. Standing in my parents’ gazebo one cool day, I asked my father to promise that if something happened to me, they’d help my boyfriend finish his degree. I had a small money market account with funds remaining from my undergraduate degree. I changed my boyfriend to my primary beneficiary on my bank accounts. One of the few things that kept me through those hard days was wanting to care for the one I loved.

It took months to find the correct dosage of anti-anxiety medication that allowed me to function, but a bit of my spirit had been broken. I had always been the sane one of my friends, the responsible one, the brash one. Anxiety and doubt had bruised my mind, warped my sense of self, left me questioning what my level of ability would be for the rest of my life. I asked my boyfriend if he wanted to leave me, knowing this isn’t what he signed up for when we started dating in 1999. I gave him permission and my blessing if he wanted to find someone sane. He didn’t.

As I said, it wasn’t a good time to get married. We should have been focusing on school, work, and my mental health. Together, we were earning less than $30,000 a year. Money was tight and my mind wasn’t right. A high dosage of Paxil allowed me to function, but smoothed my higher reasoning to mush. I wasn’t as afraid of my thoughts as I had been, but I wasn’t afraid of much else, either. It would have been nice to wait.

However, there was a deadline looming: I was going to turn 24 in September 2007 and get booted off my parents’ health insurance. The weekly sessions with the psychologist, monthly sessions with the psychiatrist, and medication were critical to my survival at that time. Aside from that, going without health insurance is a game of Russian roulette. One accident can ruin your life. There was one easy answer, one good solution: Get married.

As I said, my logic wasn’t quite solid at the time. We should have gotten married before my birthday, at the end of September, but two factors changed that decision. A dear friend of ours was returning from the Peace Corps in late October after having been gone for two years and we wanted him to be able to attend our wedding. Also, getting married close to Halloween seemed cool, so we set a date for the first weekend in November 2007.

Young, inexperienced, naive, I assumed I could afford one whole month plus six days in September, three days in November worth of health insurance. We were busy with wedding planning, so I waited longer than I should have to look at prices. Two weeks before my birthday, I started calling insurance companies. Those with name recognition whose plans covered mental healthcare were so far out of our budget, it was comical. Over twelve hundred dollars, more than our wedding’s budget. I hung up after receiving the quote. There were other companies I found online, sketchy plans with names I never heard of before. I wasn’t sure if they were scams or actual insurance options. None of them covered mental health, either. We considered getting a credit card to handle the premium, but had just gotten our first one months earlier to purchase invitations from that newfangled Amazon website.

Again, we made a young person’s decision: Survive forty days without health insurance for me. I loaded up on my Paxil prescription and birth control, scheduled only one appointment with my therapist until after the wedding, and decided to hold our breath.

As I noted before, we were low on funds in those days. We held separate checking accounts in the same bank and split expenses between them: my account for food and household goods, his for rent and bills. Buying wedding rings, shoes, ties, and a seventy dollar dress for me made our budget tighter than usual, but we knew what checks we wrote, when our bills came out of the account, and when our paychecks were deposited.

The bank called us on a Monday morning right after my birthday to inform us that my boyfriend’s account over-drafted three charges over the weekend. It made no sense, but I scrawled out a check from my account and deposited it into his that evening. By the dome light of our car, we scanned down the receipt tape account summary, trying to figure out what expense we’d missed. To our surprise, there was still money in his account. We hadn’t missed anything.

Our rent and two debit charges had been withdrawn from our account before his paycheck was processed. Over a hundred dollars had been claimed in overdraft charges despite the fact that the money was there. They’d simply processed the withdrawals before the deposit. I was sure it was a simple misunderstanding. We’d be able to rectify it after work the next day.

My parents had been farmers, which is basically running a small business. In addition to personal banking, we went to our local branch multiple times a week during my childhood. They had free chocolate milk in the summer, lollipops all year round. The tellers all knew my name. I still remember confessing dissatisfaction with my appearance to one of the workers, sitting behind a desk. I was complaining that my eyes weren’t blue, my hair straight and brown instead of curly and blonde. It was the late eighties. I’d wanted to look like Barbie or the Maier’s bread girl who doubled as my imaginary friend. She’d laughed at me and told me I was lucky because “straight hair is in right now.” I had no idea what she meant, using terms to describe fashion that my mother never employed. It hadn’t occurred to me that banks wouldn’t be on your side. They’d seemed to eager to help throughout my childhood, so friendly, so community-centered. They were providing a service; we were the customer.

I’d ordered a pair of red flats with gold beads to wear with my wedding dress, which arrived the Monday we’d gotten the call from the bank. I decided to wear them to work the next day to make sure they fit. A fan of boots with clunky heels, the slippers were a significant change. After work, I picked up my husband at his job, across the parking lot from our bank, stepped over the unusually steep curb leading to the sidewalk, and marched through the front doors half an hour before they closed.

We explained our situation to a teller, then another teller. Both said they could do nothing about our situation. They always take out debits first, put deposits in second. The quieter, meeker person I’d become since my OCD diagnosis shrunk out of the way of my real personality. I demanded to see a manager and we were whisked away to an office in the back. Everything that I’d experienced growing up, a middle-class white girl, told me that if I explained the situation, justice would be served.

The manager told me there was nothing he could do, either. It was just policy.

Rage tickled my veins, feeling angry and alive all at the same time. I told them we were closing our accounts, taking our money elsewhere, when my boyfriend stopped me, saying that he’d have to switch his direct debit withdrawals to a new account first. Regardless, I wasn’t leaving without satisfaction, demanding that, at the very least, they close my account.

It was long past closing time. Weary looking tellers counted out my three hundred dollars, gave me a handful of coins, and showed us out. I was giddy as they locked the doors behind us, righteousness pumping through my veins. They’d lost a customer. Though we’d gained nothing material, I felt more alive than I had in months. I was explaining this all to my husband when I encountered the unusually high curb in my new flats, misjudged the height, and stepped down. My ankle crunched beneath me and I fell.

I knew something had gone horribly wrong before the pain hit. I rolled over onto my back, gasping. My boyfriend tried to help me up, but my body was already registering what had happened. I started to cry as sharp hot pain radiated up my leg. I’m not sure how long I laid there before the bank’s employees noticed us outside, him hovering over me while I sobbed in their parking lot.

Aided by my boyfriend and a teller, I hobbled inside and was told I needed to fill out an accident report. Between the tears and the pain, I didn’t know what to say. I asked for ice; they had none. I asked to put my foot up; no one helped. I sat in the locked bank, waiting as I heard the employees arguing over finding the correct form, photocopying it, getting me to fill it out with a shaking hand. Over the twenty minutes we waited, my ankle grew purple and swelled like a grapefruit.

My boyfriend eased me into the driver’s seat and I drove home. I called off from work the next day because I couldn’t walk. I called off the next day, too. I used a dining room chair to get myself to and from my car, keeping my knee on the seat and walking it beside my good leg. When I was at home, I kept it elevated and iced. When ever it tried to rotate my ankle, it crunched. Without health insurance, there was no way we could afford a doctor’s visit, even if it was broken.

On the second evening, my husband bought me an ankle-brace from the pharmacy. We agreed I couldn’t afford not to go to work. The next day, I parked close to the building, used the brick wall to pull myself to the front door, to the elevator, and up to the third floor where I worked as a secretary. This went on for two weeks, hobbling around like a 24-year-old with a peg-leg until the pain abated enough that I could put weight on it as long as I was wearing the brace. My psychologist think I should go see a doctor. I tell her I can’t afford it. The brace stays on for five weeks. At one point, the bank’s insurance company leaves a message on my answering machine. I ignore them.

A few days before our wedding, I take the brace off to go to work. My ankle aches, cracks, but supports my weight. My hobbling is minimal during our wedding. Only the people who know I hurt myself notice. The brace goes back on the following day. I wear it for eight weeks.

My husband and I start to call it my crunchy ankle because I couldn’t rotate it without grinding noises for nine months. It sounds like a hand crank burr grinder being slowly turned. It doesn’t stop hurting. In the spring, I step off the sidewalk while on campus, my foot landing in a small divot in the grass. It turns again. I limp to the professor’s office and the brace goes back on for a week.

It takes two years for my ankle to stop crunching. A half decade later, it still aches after bouncing on it at a punk concert. Nine years later, it’s still my weaker ankle, stiffer after long days, easily strained while exercising.

I survived forty days without health insurance, but I shouldn’t have made that choice. What’s more, my husband and I shouldn’t have had to start our married life because our flawed health system mandated that I either get married or don’t receive insurance. Our relationship as a couple has worked out well, but I know friends who forced relationships too fast, too early to receive benefits. Had the market place been available to me, I’d have been able to purchase my own insurance plan, mandated mental healthcare benefits included, and would have waited to get married on our own terms.

My husband graduated a few weeks after our wedding, though his grades sagged as a result of trying to juggle our wedding, my mental and physical health, and a full-time job. I had put my Master’s thesis on hold to plan our wedding. When I returned in the spring to talk to my adviser, I found out that he’d taken the semester off. Life got more complicated after that. My husband’s student loans came due after graduation. What had been enough money to live on before his graduation wasn’t enough anymore. I took a temp-to-hire job and was told I would receive a full time position that never materialized. My husband was offered a job at a bookstore that never opened. I eventually found full time work on a dairy farm, moving far from the campus where I’d been studying. I never finished my thesis, but have the student loans to show for it.

The economic climate of the mid-aughts was unkind to us, as it was to so many. We made some poor choices trying to survive those years, survive my mental health, survive the transition into independent adulthood. I don’t regret what has passed because I’m writing this, sitting across from my husband of nine years, working with cows whom I love, and living a stable life. Still, I think those years sucked away some of our potential. Our life, like my ankle, is weaker than it would have been had we the ability to make other choices.

When I look at policy agenda the new administration is facing, I think of how we were harmed by greedy banks and an inadequate healthcare system. I think of the teenage employees with whom I work and hope they don’t face the same challenges we did.

Post Script: As part of a class action law suit, we received about seven bucks back from our bank a handful of years later.

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