A year ago, Jane Neldon thought she was doing well enough as a massage therapist to start working on her own. Then she saw her health insurance premium spike from $280 a month to more than $700.
“My health insurance costs more than the rent for my office,” she says. “In a year that I thought I’d finally be making strides, I was knocked back down.”
Emily Bardeen retired two years ago at 62 years old and in budgeting, she anticipated the $500 a month she was paying for health insurance could double. Instead, she’s paying more than $2,000 a month for coverage with Optima, the only carrier available for individual coverage in Charlottesville. Its rates here for 2018 jumped 300 percent, the highest in the country.
“It’s crushing as a retired person,” she says. “I pay $2,336 for the right to have a $4,600 deductible on my silver plan.”
When she spoke with C-VILLE, Bardeen had just gotten home from the hospital. “I knew going to the hospital was going to cost me $4,600,” she says. “I nearly didn’t go, but I really needed to.”
Neldon and Bardeen are two of the many locals who were gobsmacked by the rates Optima offered here. And they’ve joined Charlottesville for Reasonable Health Insurance, an 810-member group that doesn’t believe Optima’s rates are justified.
Sara Stovall, one of the group’s organizers, raised an outcry last year when she found out insurance for her family of four would cost nearly $3,000 a month. The group filed a complaint May 30 with the State Corporation Commission about the Bureau of Insurance, which okayed Optima’s 300 percent premium increase.
“We have extremely compelling information that the Bureau of Insurance acted irresponsibly,” says Stovall. Optima’s preliminary rates for 2019 are 30 percent lower than 2018, further proof, she says, that the current rates are “unjustifiable.”
The SCC responded that the group’s letter wasn’t enough and it needed an attorney and actuary to file a formal complaint, says Stovall. “They’re sort of circling the wagons,” she says. The group is determined to push the issue and already has an attorney—and Stovall has talked to an actuary.
For Neldon, 31, skyrocketing premiums have been “a huge heavy weight on me,” she says. “It’s a factor in every decision I make. Do I go to the doctor or wait it out? That used to be an easy decision for me.”
She adds, “It’s a new stress about something I haven’t had before.”
“It affects our life in every way,” echoes Bardeen. She and her husband were about $200 above the Affordable Care Act’s cutoff for subsidies. “There’s no sliding scale. You either get help or you don’t.”
Bardeen’s husband is eligible for Medicare, but for her health insurance, they’re paying $30,000 a year—twice as much as their mortgage. “It’s unthinkable,” she says. The couple is considering a move to Waynesboro, and while insurance isn’t the main reason, “it is a factor,” she says.
Bardeen stresses that during her visit to Sentara Martha Jefferson’s ER, her caregivers “were very conscious” about her health insurance concerns. Sentara also owns Optima.
On July 1, a Senator Creigh Deeds bill goes into effect that allows self-employed people like Neldon to get the coverage available for small businesses. And Deeds and Delegate David Toscano are working on other bills, such as one that would require more transparency in hospital pricing, says Stovall.
For Neldon, the new law means “some light” at the end of the health insurance tunnel.