In May 2000, we adopted a healthy baby. Just a typical middle-class couple, small-business owners who had to pay for health insurance out of our profits as we grew the business. Or so we believed. As it turned out, 'healthy' was one of the terms needing further exploration, along with 'middle-class' and 'insured'.
Many of our plans didn't work out as we expected. BY October 2001, we had our backs to the wall. Our baby couldn't hear or speak, our formerly healthy business had $0 in gross receipts for the month and nothing expected within the quarter, and our for-profit health insurance was due to have a premium adjustment in 5 months.
SCHIP saved my child's healthy development, as well as our family business. This program should be wearing a cape and tights. Anyone who thinks that middle-class entrepreneurs' kids don't need help to access health care, follow me past the jump to find out how confused you are.
We had the kind of crappy high-deductible, high-premium, low-lifetime-maximum, fight-for-every-claim, no-one-you'd-let-treat-your-dog-that-bites-in-the-provider-network so-called 'health insurance' that you can buy if you're running a business with a handful of employees. We paid for it, at the cost of about 15% of our gross income every month, because that's the responsible thing to do when you have a baby.
In August 2001, we became concerned. Our little girl wasn't speaking. While she appeared to respond to sounds, and could follow four-step instructions in sign, she didn't say a word yet. As we had been warned that we needed to be patient about language development due to pre-adoption history, we weren't panicked. We were worried, because she seemed frustrated. We scheduled an evaluation from early intervention, the public program that serves all children 0-3 by identifying and addressing common developmental challenges.
That evaluation was scheduled for Sept. 11th. They cancelled and had us come back on October 5th. By that time the bottom had fallen out of our small business. On Sept. 11th we had five clients, by the end of the month we had three and two of those were behind on their bills.
We knew that we were in trouble, despite having the year of living expenses that financial advisors recommend in the bank. Although we had done everything right, something unpredictable had gone wrong and we had no way to project when we would begin to make money again.
Bad luck got worse. After the evaluation, we got a report that indicated the need for more testing. It said, basically, Your instincts were correct. There is something seriously wrong with your baby, and we have no idea what it is. Go get these tests done.
The testing uncovered significant hearing loss, which explained the gaps in her development and predicted enormous challenges for her in school and at work. There was also good news: the problem was correctable, with a couple of operations, time and effort. That was when we panicked.
We were about $150,000 of surgery, recovery and therapy services away from our child's sensory perception being improved to get her within the range of normal. Without immediate surgery and months of followup treatment, it was unlikely that she would be prepared to benefit from preschool the following year.
Our child was getting further behind, in terms of her cognitive development, every day; the window between birth and age three was closing, and her language development was stuck at 6 months, with no prospect for improvement until at least one surgical intervention was completed.
Our family needed a lot of expensive health care, and our business was on the verge of failure. If we missed a premium, we'd lose coverage. If we submitted the claims that we expected to make, in 5 months we'd be re-rated and unable to keep paying, under any realistic predictions for our future income. So our child's future was suddenly in jeopardy because neither of us had a job with group benefits and something had gone wrong.
I felt like the most irresponsible parent ever. We couldn't pay for our own child's medical needs. We were going to lose our business no matter what we did, I reasoned, so it would make sense to get started in our new lives as employees. To meet our debts, we would both have to get jobs, although this would rule out having a parent dedicated to meeting our child's special needs. I began looking for any job with benefits, only to learn that the jobs offering benefits would require a waiting period before we would be eligible. I was distraught and hopeless.
My wife, who is not as self-indulgent as I am, didn't flinch. She dug into the data. She found that, under the rules of our state, only the previous year's income was used to determine eligibility for SCHIP. So the facts that we owned our house, our car, our business, wouldn't affect our child's ability to get insurance. SCHIP is a group plan, so it has coverage that we couldn't buy in the for-profit market at any price for our small business. While there are significant limitations on the coverage regarding which providers accept it, we didn't care which doctors and speech therapists helped our baby nearly as much as we cared that she get help.
My wife put the baby to bed and we began to read. We looked at the benefits, the income guidelines, and our daughter. Finally, we looked at each other.
On one hand, we had never even discussed whether we would take welfare. Welfare, Medicaid, those are for needy families. We're middle class people who finished our degrees, running a business that should be able to support a bunch of families, we even had a license from the state to adopt this kid. How could we possibly be eligible for a government program? And even if we were technically eligible, how could we take a benefit that was meant for poor children?
And on the other? We couldn't turn down health care for our child, care that we couldn't possibly afford to buy in the free market, because we were too good to take a means-tested benefit.
We spent a long night arguing about it, knowing that our baby couldn't hear what we were saying. Eventually, I was convinced that the best choice was to swallow my pride and take the help.
I went to the welfare office the next morning, carrying the files holding our previous year's taxes. We registered for SCHIP. I was stunned to learn that we were eligible for other forms of assistance, based on our previous weeks' income, but of course we weren't having a bad enough year to take food stamps. I left that building realizing how lucky my kid was. To live in a society that provides a minimum of support for children, and to have a mom who wouldn't let her go without.
Our baby got the operations that gave her 90% of normal hearing, and she got the treatment required to benefit from that surgery. Today my daughter is a typical, normal second-grader. In fact, we had to explain to this year's teacher that her mild hearing deficit can be addressed with free, simple techniques like seating in the front row.
My kid is on the way to being a productive taxpayer, contributing to our society, because her health care was taken care of by a government program.
As for her parents: We dedicated our creativity to saving our business, knowing that our child's health care was going to be covered, and we did it. We closed a couple of large deals in the summer of 2002. Today our business supports five families, in addition to our own.
Please help pressure Congress to save SCHIP, so it can save families like mine.