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I am soon to become a first-time grandmother! My daughter is about to give birth to twin boys. I remember how excited I was when she first told me the news about twins. But I also had an immediate reaction of worry. Not worry about her health or that of my future grandchildren. I worried about how my daughter and son-in-law were going to manage financially. I didn't share my worries with my daughter because I didn't want her to be anxious. Why was I worried? My foremost concern was health insurance. Both my daughter and son-in-law work in the culinary field in Asheville. It is not customary for small restaurants to provide health insurance. My son-in-law is the pastry chef at one of the better restaurants. His employer does not provide health insurance. My daughter works for the largest caterer in the area. She, with her lower salary, was lucky to have employer-sponsored health insurance. At present my son-in-law pays about $100 per month for health insurance. He has a discount for healthy lifestyle. My daughter pays only $30 per month. I became worried last month when she said she could no longer cook because she couldn't reach shelves and got too tired standing on her feet. What about health insurance? Fortunately, her employer is most generous and offered to provide health insurance until the birth of the twin boys, even knowing that my daughter will not be returning to work there. Her decision not to return to work is another part of the story. With twins, rather than one child, and a salary of $12 an hour, she and her husband weighed the likely stress of working against the financial benefits. More than half of her gross salary would go toward child care. In the culinary business, it is difficult to regularly take time off for medical appointments and illness of children, something likely to occur with infant twins. But on the other hand, not returning to that job means that my daughter will no longer have access to an employer-sponsored health care plan. She looked into whether her children would be eligible for N.C. Health Choice for Children. No. Her husband earns about $3,000 above the limit, which is now set at 200 percent of the federal poverty level. The quoted cost for a family health insurance plan is more than $500 per month. That will amount to 13.5 percent of their gross family income. And, of course, that does not include the $500 deductible and the $25 co-pay for general medical visits. Keep in mind that if they were eligible for N.C. Health Choice for Children, the federal law states that the medical expenses could not exceed 5 percent of the family's income. I knew that there was recent legislation authorizing an increase in the income limit for the N.C. Health Choice program. I didn't know the details and I contacted Verla Insko, one of our legislators. She noted that the approved increase of the income limit eligibility to 300 percent of the federal poverty level will take some months to implement. With Congress unable to override the SCHIP veto, the state will need to seek a Medicaid waiver for the buy-in program up to the 300 percent of federal poverty level. Apparently, such waivers can take nine to 12 months. So here I am, a soon to be grandmother, with a college-educated daughter and son-in-law who both work hard. They have an income level close to the average income of $45,000 in Buncombe County. Yet, without private-sector employer-sponsored health insurance they will have to pay a large sum for health care. They will pay much more for health insurance than I ever did in my previous job with the federal government where I had a higher salary than theirs combined. Fortunately, they have no pre-existing conditions which would make health insurance prohibitively costly. In some ways I wish more of us had to face family anxieties about health care insurance. It might make more of us have empathy for those who are not so fortunate. We might not be in the present situation where many working families above the 200 percent federal poverty level do not have access to health care at a reasonable cost relative to income. How many other working families in the state and in Orange County don't have access to reasonably priced health care insurance through their employer and are not in poverty? Expanding subsidized coverage for children in families with incomes up to 300 percent of the federal poverty level will be a step in the right direction. My grandchildren will be qualified for N.C. Health Choice, hopefully sometime next year. Bernadette Pelissier is a retired social scientist who lives in Orange County and serves on several community boards. Readers can contact her at bpelissier@juno.com or c/o The Chapel Hill Herald, 106 Mallette St., Chapel Hill, NC 27516. Author: BERNADETTE PELISSIER Columnist Copyright, 2007, The Durham Herald Company |
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