Amy Houston of Mulvane is a small-business owner and mother of four who is in the coverage gap. She loves living in Kansas, but fears she might have to move out of state because of her need for health insurance.
Amy was diagnosed with Hodgkin’s Lymphoma in 2009 and began her treatments the following year. At that time, Amy was a manager at a corporate restaurant in Wichita, so she had health insurance but was required to work 50-hour weeks. To make time for chemotherapy treatments, Amy worked 10 10-hour days in a row, took four days off for chemo and went back to work for another 10 days of 10-hour shifts. She kept that schedule up for six months to maintain her insurance and job.
Radiation was different. It took place every day. Amy hadn’t worked at the restaurant for long enough to qualify for medical leave under the Family and Medical Leave Act (FMLA). Once Amy had to start taking time off every day for radiation, her employer fired her and she lost her insurance.
This put Amy in the insurance coverage gap. She wasn’t eligible for Medicaid but didn’t earn enough income to qualify for federal tax subsidies to purchase insurance on the marketplace. At that time for a family of her size, the coverage gap included individuals with annual incomes between around $5,000 and $36,000.
Without insurance, every expense thereafter was entirely out-of-pocket. Fortunately, her cancer was in remission at the end of 2010. She continued to see an oncologist to monitor the status of her cancer. At her last appointment, Amy’s doctor found evidence of cancer cells.
Amy decided she needed to “stop the bleeding” financially and started skipping her oncology appointments. She racked up $80,000 in medical debt and needed to pay it off. Amy tried to file for bankruptcy, but did not qualify.
The last thing she heard from her doctor was that her “cancer was probably back.” He said it could stay put for 2 to 20 years – it could be nothing or it could be something.
Amy said, “I had to make a decision about if I was going to provide for my family or if I was going to continue to go to the doctor. I needed to provide for my family. I needed to keep a roof over my children’s head.”
These days, Amy has become a strong advocate for KanCare expansion. She still does not have health insurance.