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Health

Kansas Woman Says Health Reform Law Helped Her Launch Business

ACA_Meg_Ladybird_pie.jpg
Jim McClean
/
Heartland Health Monitor

Consumers across Kansas and Missouri appear to be selecting health plans in the Affordable Care Act marketplace at a brisk pace. Enrollment in both states is ahead of last year’s place.

Heartland Health Monitor’s Jim McLean has the story of one area business owner who says she might not be in business if not for the health reform law. It’s a story that may sound familiar to anyone who’s heard former Health and Human Services Secretary Kathleen Sebelius speak recently.

Kathleen Sebelius is no longer responsible for the Affordable Care Act, but she’s still talking it up on the lecture circuit, giving examples of how the law is helping people.

One of her favorite examples is the story of a Lawrence woman who credits the health reform law with helping her start a business--a diner that serves old-fashioned stick-to-your-ribs food along with fresh-baked pies and donuts.

“The Ladybird diner on Mass Street in Lawrence is a wonderful new operation," Sebelius says. "But the owner there, the first time I was there, said to me, 'You know, Kathleen, this is really your diner.’ Well, that’s cool. Great. Why? She said, ‘Well, I’ve always wanted to open a diner. I’ve had that dream all my life but I have a pre-existing health condition. But the passage of the health law and my ability to get insurance allowed me to then open this diner.’”

Meg Heriford runs the Ladybird. She agreed to take a break from the kitchen for a quick interview before a recent dinner rush on a KU basketball gameday. She said she doesn’t mind Sebelius using her story.

“No, that’s so flattering. I mean, she’s a hero to so many of us and I’m more than happy to be a poster child of, certainly I wouldn’t call it a perfect program. But neither am I. So, I think I’m an apt poster child," Heriford says.

Before the health reform law, Heriford says a pre-existing condition--a lump in one of her breasts and a genetic predisposition for cancer--made coverage either impossible to get or prohibitively expensive.

But the law changed that. Insurance companies can no longer deny coverage. So, Heriford was able to go into the ACA marketplace and get a plan that covers her and her family for little bit more than $200 a month.

ACA_Ladybird_exterior.jpg
Credit Jim McClean / Heartland Health Monitor
/
Heartland Health Monitor
The Ladybird Diner in Lawrence.

Having that security, she says, allowed her to quit her waitress job, start the diner and take what she hopes is a temporary cut in pay.

Heriford knows her premiums are probably going up this year, but she thinks she can find another affordable plan by going back into the marketplace and shopping.

“Yep, we’re back in the marketplace looking again and it may indeed go up a bit. It’s starting to look like it will," she says. "But I think that it is certainly more accessible to me now than it would have been five years ago when again [as] a woman of child-bearing years with a pre-existing condition I didn’t have any hope of finding health care that we could afford.”

Heriford is doing what millions of other newly covered Americans are doing. With insurance companies raising rates, she’s looking for the best deal she can get.

Sheldon Weisgrau, director of the Health Reform Resource Project in Kansas, says it’s good that Heriford and other consumers are price shopping. But he says they should be careful not to sacrifice good coverage to get lower premiums.

“I think that is a concern. People have become a little savvier in looking at other costs, but that’s still the primary consideration is the monthly premium," Weisgrau says. "That can work well if you don’t need to use a lot of health care services throughout the year. If you do, some of those people may be facing higher out-of-pocket costs down the road.”

Heriford says she understands the trade-offs. She wants the best deal she can get on good coverage.

“I’m in my 40s and I have four kids, I have this diner to run, so it’s important that I stay healthy," she says.

Federal officials tracking enrollment say consumers like Heriford are setting records in the marketplace. Nationwide, more than 8.5 million people have selected ACA plans since the Nov. 1. That includes nearly 85,000 in Kansas and more than 250,000 in Missouri.

Open enrollment runs through the end of the month.