Underinsured Michiganders face such grim realities that Garret Levis moved 400 miles just to afford the care to keep him alive.
MARQUETTE, MI — Michigan man Garrett Levis moved hundreds of miles to find a place with a lower rate of coronavirus cases. Living with a compromised immune system, he made the decision in August to move from metro Detroit to the Upper Peninsula, just to be able to manage the risk of working and affording his medical expenses.
“I moved 400 miles north to go to a safer area COVID-wise last month so I could work,” Levis told The ‘Gander. “Once I get the back pay from unemployment I’ll be totally fine. Unfortunately not even [Michigan’s Unemployment Insurance Agency] knows when I’ll be getting that, so I’m just taking it one day at a time.”
Levis couldn’t get a job closer to home in Westland because he’s immunocompromised. Exposure to the pandemic coronavirus could be fatal for him.
As The ‘Gander previously reported, Levis received a life-changing diagnosis just a few short weeks before the coronavirus was discovered in Michigan. He tested positive for HIV. That made the months that followed exceptionally dangerous for him.
Levis explained that T-cells are the “army of the immune system”, and that normal T-cell counts range from 1,000 to 1,500. His T-cell count was only 222, just above the 200-count threshold of AIDS. He told The ‘Gander in July that his doctor said he could die if he returned to work during the height of the pandemic.
Although he has health insurance coverage through his parents’ health plan, the medical bills have still piled up due to his unemployment. This puts him in a category with a quarter of adult Americans: the underinsured.
What Levis Needs to Survive
Levis’ medical expenses have only continued to rise throughout the coronavirus pandemic. HIV is an expensive disease to have at any time. But because he couldn’t safely return to work, Levis has not had any income during the summer months to cover any expenses his insurance plan doesn’t cover
What can’t be covered through the government’s Ryan White HIV/AIDS Program has to come from the very little savings Levis has on hand.
“The hardest part is not being able to pay medical bills,” Levis told The ‘Gander. “They are small bills but because I have had to have so many visits in such a small amount of time, the $40 bills have been adding up.”
Though Levis isn’t excited about either presidential candidate, he has no question who he’ll be voting for in November, and health care is central to his decision. He says h’s voting for Biden because of President Donald Trump’s failures on public health. And, in particular, how delays to the postal service have impacted people who rely on life-saving prescriptions.
“I am still getting the meds from the nonprofit but I’m worried about the postal service taking longer,” Levis said. “The pandemic really showed how ‘well’ [Trump] can handle an actual situation with his country.”
Uninsured and Underinsured Under President Trump
Prior to the pandemic, 2.3 million people became uninsured under Trump. In Michigan, 44,000 adults lost their insurance. Vox attributes this to the administration’s efforts to undermine the healthcare exchanges, rising premiums and Trump’s encouraging states to put in barriers to accessing Medicaid. And that situation has only worsened during the pandemic, as newly unemployed Michiganders lost employer-sponsored health insurance.
During the global health crisis created by the coronavirus and the resulting swell in unemployment, Trump doubled down on his efforts to dismantle healthcare systems that are available to people without employer-sponsored care, The ‘Gander reported.
“Most of our patients have jobs. They’re working people without insurance,” said Dan Martin, executive director of the free clinic Ferncare in Ferndale.
Ferncare has seen a major uptick in demand since the beginning of the coronavirus pandemic, Martin told The ‘Gander, as a combination of people losing their jobs and getting new ones without insurance and the increased demand for health services caused by the pandemic have sent more people to free clinics like his.
But even among people who have some form of insurance, between being underinsured like Levis or temporarily losing coverage during a particular year the Commonwealth Fund found that most Americans had insurance that didn’t actually cover them consistently.
“Coverage insecurity will leave people with mounting medical debt, as well as significant financial barriers to getting the health care they need to survive the pandemic and lead healthy and productive lives,” according to the report, which is based on a survey of more than 4,000 adults between the ages of 19 and 64.
The report found that a third of Americans had cost-related reasons they didn’t seek health care. That experience was reflected by Flint resident Carol-Anne Blower, who paid $200 for a 3-minute telehealth appointment this July, even with her insurance.
She isn’t sure what she would’ve done if she had to do it over, she said.
That critical flaw in insurance is something Joe Biden wants to address with a government-managed public healthcare option, as well as with strengthening the insurance exchanges that Trump has undermined.
That’s the kind of thing Martin says clinics like his need.
“Anything that expands the accessibility of health insurance to people would be helpful. In an ideal society, we wouldn’t need to be here,” he said. “Secondarily, if [the government] can’t provide insurance, then funding to help support these folks to get through.”
The Cost of Staying Alive
Prescription drugs are an even greater drain on Michiganders. Without help from a nonprofit, Levis’ medication would cost him as much as $4,000 per month. In 2018, the Associated Press reported that for each price cut in prescription drugs President Trump touted, 96 other drugs increased their prices. That trend hasn’t changed.
“A 30-day supply of levemir, which is a long-acting insulin, is $464,” explained Martin. “Somebody who doesn’t have insurance probably can’t afford to pay that.”
In 2019, drug manufacturers raised prices again contradicting Trump’s claims to have reduced prices, and claims last month that Trump reduced drug prices were entirely unfounded, as the program he was claiming was a success hadn’t been implemented yet.
The urgent need for treatments for the coronavirus is gasoline on the fire, as The ‘Gander reported. The Trump administration has said it wants to see coronavirus treatment covered but doesn’t intend to see lingering effects like heart or kidney damage covered. Also, the Trump plan largely relies on private insurers willingly waiving out-of-pocket expenses based on their approach to one of the few promising coronavirus treatments, remdesivir.
By contrast, Biden’s plan calls for “no co-payments, no deductibles, and no surprise medical billing” for coronavirus treatment. He also wants to have the government approve the price of any vaccine to ensure the cost is fair and accessible.
And as Michiganders get older, the costs associated with prescription drugs increase dramatically. Covering that is one of the purposes of Medicare, but that program has also been threatened by Trump, who in August signed an executive memorandum to defer payroll tax obligations that helps fund the critical safety net for older Americans.
“I would not be able to maintain my basic living needs,” Detroiter Beverly Coleman told The ‘Gander. “[I would be] choosing to not pay my rent or car payment or medicine or groceries or copays for doctor services.”
For people like her, Biden would make prescription drugs more affordable by requiring drugmakers to negotiate their prices with Medicare, and presumably his new public option for health care. He also wants to lower the Medicare eligibility age to 60, allowing more Michiganders to gain the much-loved insurance program.
“So here’s the bottom line,” Biden said in a June speech. “My plan lowers healthcare costs, gets us universal coverage quickly, when Americans desperately need it now. Families are reeling right now, enduring illness, forced into risky choices, losing their employer’s plans in droves as their employers go out of business or have to suspend business.
“They need lifelines now, now. That’s what the families here today deserve. That’s what the families all across this nation deserve.”