Healthcare Wealth Safety Nets Are Designed To Exclude Disabled Wealth
Before the Affordable Care Act was passed, I could not get private health insurance because of my medical history. I literally called up my insurance provider and asked them “How much would it cost me per month to take the current healthcare plan provided by my employer and pay the premiums myself?” and I was told, in no uncertain terms, that there was absolutely no way I could get health coverage by the very people who were currently providing me healthcare. Not that I couldn’t afford it, but that they simply would not let me have it at any cost. The only way I could maintain my coverage was to stay with my current employer. If I became unemployed, my current coverage and any possibility of future coverage with my insurance provider would end.
Employer‐sponsored healthcare plans were the only way I could guarantee coverage. Now, with the Affordable Care Act, employer‐sponsored plans are are the only way I can guarantee affordable healthcare coverage. So, I did what any good red‐blooded American is supposed to do: I worked my way up the corporate ladder to where I had access to a substantial and complete benefits package including dental, vision, and medical insurance. Problem solved.
A few years go by and I get married and buy a house. Now, the concern is life insurance: I don’t want to leave my spouse at risk if something were to happen to me (and by “me” I mean “my ability to generate income due to my untimely death or dismemberment”). My job did offer a basic life insurance plan (equivalent to 1 year’s salary), but in order to get anything more substantial, I would need to sign up for a separate plan and take a health screening.
I did this and got denied. Which, for those of you who might not know, is really bad. Being denied for life insurance from one company actually makes it harder for you to get life insurance from another. Luckily, my financial advisor was able to make some phone calls and find someone who was willing to offer me coverage at a reasonable price. I’d finally been granted the ability to protect the wealth and assets I’d worked so hard for all those years.
Fast forward a decade.
I’m older now. Greying around the edges and a little squishier and creakier in the middle. I’m starting to think about long‐term care: how I’m going to make sure that my possible need for an assisted living or nursing facility won’t leave my spouse and I bankrupt or stuck on medicaid. Assisted living and nursing facilities are prohibitively expensive and costs can run into the tens of thousands of dollars a month.
To offset these costs, a lot of people pay for long‐term care insurance which is basically a healthcare plan that only covers costs related to an assisted living or nursing facility. I won’t go into the history of why, but these plans are prohibitively expensive and premiums can easily double or triple with little notice. They’re also designed to exclude the people who are most likely to need them.
If you were to examine an application form for a long‐term care insurance plan, you’ll find at the very bottom a question that essentially asks “Do you currently use any kind of mobility aid?” And if the answer is “yes”, it kindly instructs you to throw the application in the garbage. So, I cannot use long‐term care insurance to protect my wealth as I age.
But all is not lost: I could use a long‐term care rider that’s common in a lot of life‐insurance plans. It basically says that you can draw down your life insurance plan in order to pay for your long term care. This would be a great option for me, if my life insurance plan had one. It does not. And in order to get one added, I would have to go back through underwriting, which I can no longer do.
Because if I did, the company who currently manages my life insurance policy (the one that would barely cover me in the first place) would no longer cover me. Apparently, in the decade since I’ve held the policy, the rules for underwriting has changed and there is no way that I could qualify for coverage. Keep in mind that my diagnosis and medical history have not changed. Instead, the insurance company decided to change the rules for underwriting and the only reason I am currently insured is because they’re not able to cancel my policy.
This brings me to my last option: my spouse’s life insurance policy. They can get through underwriting and get a long‐term care rider added to their plan. We could then use that rider to cover my long‐term care if the need should arise. But if we were to both need care, the money would run out very quickly and the best we could hope for is a medicare waver (assuming we find a facility that accepts said waivers). So, we’ll be left in the position of choosing who gets the care they need.
All these years I was told that, in exchange for doing my part to amass capital, these systems would be there to help me protect it. The truth is, in American society, my life, my existence, and the capital it creates are not worth investing in. My body is a commodity no one is buying. By my very nature, I’m a bad investment.
So let put this as plainly as I can: when people say things like “If you want healthcare so badly, get a better job!” Or “If you want life insurance, all you have to do is pay the premiums!” they’re fucking liars. These “safety nets” everyone tell you about are explicitly designed to exclude disabled people and, by extension, disabled wealth. They refuse to take our money. We literally cannot pay them to protect us and no amount of wealth we could ever hope to generate in our lifetimes will change that. Disabled people simply aren’t allowed to protect the wealth they’ve been told they have to earn in order to receive healthcare or even have the possibility of protecting those they love in the event the unthinkable happens.