BRATTLEBORO — How does a woman like Kathie McClure, an Atlanta attorney and mother of two, become a health care reform activist?
When her two children - a son and daughter who are chronically ill with Type 1 diabetes and epilepsy, respectively - became uninsurable in Georgia's individual insurance market because of their pre-existing conditions.
McClure said it had cost more than $40,000 a year for health insurance for herself, her husband and her two children. But once her son Chris and her daughter Caitlin finished college, and lost their coverage on the family policy, they found that no health insurance company would cover them.
That's why she started up the nonprofit organization VoteHealthcare.org in 2007 and has been driving a purple-painted old school bus around the nation for the past five years - to educate and inspire people, and get them involved in changing the way the health care system works in the United States.
McClure was in Vermont earlier this month as part of a tour of the Northeast this fall that is focusing on countering what she says is a massive misinformation campaign by conservatives regarding the federal Affordable Care Act (ACA) and proposed changes to Medicare.
“I knew I was heading to 'New England Blue,' but I didn't realize how far down the road you were,” she said.
McClure came to Vermont at the urging of her friend, Richard Davis of Guilford, who is executive director of Vermont Citizens Campaign for Health, a Brattleboro-based nonprofit advocacy group.
“I've learned a lot from Richard about how Vermont is focusing its efforts on chronic care, which makes a lot of sense when you figure that the 20 percent who have chronic illnesses consume 80 percent of what we spend on health care,” she said.
She said that Vermonters were fortunate to have a system where insurers could not pick and choose who they wanted to insure. Vermont is one of only five state in the county that require insurers to cover every one who applies and is able to pay the premiums, regardless of age, gender, or health.
“I live in a state where there are no consumer protections to speak of,” said McLure. “Few health insurance companies want to sell a policy to those who are chronically ill, not when it will cut into their profits. And if you can get insurance, it is completely unaffordable.”
The Affordable Care Act, passed by Congress last year and upheld by the U.S. Supreme Court in June, remains a hot political issue, and McClure said she can't understand why that is so.
Profits or sound policy?
“The way I see it, profits have become a substitute for sound policy,” she said. “The notion that the free market can solve the ills of our health care system is deranged. That's why we have to look to government to ensure fairness and create a system for shared risk between insurance companies and clients.”
McClure said the politicization of health care issues is symptomatic of a bigger problem in our nation.
“Driving the national agenda along is difficult, because people feel powerless,” she said. “Unlike Vermont, where there still seems to be a strong sense of community and people feel that one person can make a difference, it's hard to find that in the rest of the country. I think we need to worry less about the size of government, and focus on its effectiveness. Health care is one of those things where we need government to step in.”
That is why she has a purple bus. McClure said she chose the color because health care should be seen not as a “red” or “blue” state issue, but an issue that transcends ideology because every American should have access to quality, affordable health care.
McClure said not enough Americans are aware that the ACA also known as “Obamacare,” has already made a difference. For example, insurers are now required to provide free preventative care to their policyholders and can they can no longer cap the amount of benefits received over a lifetime.
By 2014, insurers will be barred from refusing to sell policies to people with pre-existing conditions, and while most people will be required to have insurance, many will be eligible for premium subsidies and tax credits to pick up the cost.
Vermont is prepared to use the ACA to help the state create its own health care system, Green Mountain Care. But not every state has embraced it. McClure sees the expansion of Medicaid eligibility, and the efforts of states led by Republican governors to refuse to implement the ACA, to be the next big battle.
“Insurance providers are going to put pressure on their governors to take the federal money and expand Medicaid,” she said. “The result will be more and more working people will have a shot at getting decent health care. By 2014, when the state insurance exchanges are supposed kick in, people will really see the benefits of the law.”
The price of private health insurance has been going up much faster than the rate of inflation for years. But McClure believes that because more voters have health insurance, it was never a big issue until the current recession, which has greatly increased the ranks of the uninsured.
“Many know someone who is struggling to keep their coverage, or have lost it themselves,” she said.
However, McClure said she is hopeful that after five years of campaigning, there has been progress in health care reform.
“Cost control, and dealing with the chronically ill, is still the big gorilla in the room, but I feel so much better now than I did five years ago,” she said. “2014 offers so much promise.”