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Nathan Wilkes

My Healthcare Story

“You should get a divorce,” our son’s social worker told us during a meeting in late 2007.

My wife and I exchanged worried glances, hoping for a punchline that would not come. The social worker was serious.

We were meeting with her to discuss how to maintain health coverage for our 4-year-old son, who was about to cap out of his second insurance plan in less than two years. At the time, there were very few protections or options for insurance for people with chronic illnesses, and our son had one of the most expensive – hemophilia.

“You have got to be kidding,” I replied. But we knew she wasn’t. We had spent the last two years under lifetime caps forced onto us by insurance companies. Our son’s life now had a price tag, and my employer had a million-dollar reason to fire me. The anxiety I felt when we first learned of our new cap never subsided. It was compounded by a lack of insurance options and a path forward that would allow our son to maintain access to his life-saving medication. The social worker explained that other families in our situation often got “paper divorces” so that their children with chronic illnesses could get guaranteed coverage through Medicaid.

The strength of our relationship held us together in the face of adversity and helped us be strong advocates for our son, but now we were faced with the irony of sacrificing the marriage we valued in order to protect our family.

My wife and I struggled with this decision. Being forced to game a system by getting divorced was not representative of the family values we both grew up with. We wanted to live in a society that supported egalitarian, universal health care for all – one that supported families and let them get the health care they needed without such unreasonable sacrifice.

To preserve our marriage AND our family, we made the difficult decision not to divorce. I did have to quit my job, which could no longer cover us, and take the difficult road of starting my own business. Colorado was one of only a handful of states pre-Affordable Care Act (ACA) that had community rating for small groups, which meant that insurers could not price us out of coverage as a small business. Had we lived in most other states, divorce would have been our only viable option.

We took what we had learned through our experience and shared it with others, including testifying to Congress during the development of the ACA. The ACA provided guaranteed coverage and officially ended lifetime caps, but other market provisions meant that I couldn’t realistically ever work for a company with more than 100 employees.

Because the ACA wasn’t perfect, because insurance companies still tried to avoid paying our medical claims, and because the gains we made now face repeal, our family continues to advocate for health reform solutions that cover everyone – solutions that support families no matter what medical challenges they may face.

City/Town: Englewood, Colorado
Organization: Health Care for All Colorado
Email: nathan [at] nathanwilkes.com

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