Policy-ish

A Cut That Won't Heal Transforms One Woman's View Of Obamacare

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Tammy Boudreaux tries a tendon-stretching drill after surgery. Boudreaux was able to get much of her operation and rehabilitation covered by the insurance plan she bought via the Affordable Care Act.

Tammy Boudreaux tries a tendon-stretching drill after surgery. Boudreaux was able to get much of her operation and rehabilitation covered by the insurance plan she bought via the Affordable Care Act. Carrie Feibel hide caption

itoggle caption Carrie Feibel

When we first met Tammy Boudreaux, a freelance social worker in Houston, last December, she was still weighing her health insurance options.

She told us she was overwhelmed and confused by the choices she was finding on HealthCare.gov. And the high deductibles of the Obamacare plans didn't seem like such a great deal. But when we checked back in with Boudreaux this month, we learned that a chance encounter with a bottle of hot sauce ultimately changed her mind.

Last fall, Boudreaux, 43, was uninsured — and wielding a knife. She was cutting the wax seal off a bottle of hot sauce when it slipped and stabbed deep into her index finger.

Boudreaux went to the emergency room right away and paid out of pocket to get it stitched up. Still, at that point Boudreaux didn't see any urgency; she's relatively healthy and figured a plan with a high deductible would be a financial burden.

The holidays came and went, and she remained undecided about whether to buy insurance.

Meanwhile, her finger wasn't getting better.

"I couldn't grab a shovel when I wanted to garden," she told us in a recent follow-up interview. "I couldn't grab small items, [and] the keyboard — I could not use my finger on the keyboard."

Not only that, but the finger hurt. A minor accident had become a major problem. "I can't get by," she realized. "It's my finger — it's a pretty serious injury. And I'm relatively young. I don't want to live the rest of my life with this impediment if I don't have to."

But getting more treatment could be expensive. So Boudreaux chose a plan with Blue Cross Blue Shield of Texas that cost $336 per month. The plan started Feb. 1, and within a week she was getting surgery to repair her finger.

After the procedure came weeks of rehabilitation at Houston Methodist, where she still sees hand therapist Peggy Boineau. "We're going to look at strength today," Boineau told Boudreau at a recent visit, slowly talking her through the steps. "Turn your hand this way. Straighten that joint."

The two women laughed as Boudreaux had trouble flicking tiny beads into a plastic bucket, an exercise to loosen the finger joint.

Boudreau pays a $50 copay for each therapy session. Beyond that she has to meet a $3,000 annual deductible before the insurance begins to cover her medical care.

But Boudreaux now says it's worth it, and she believes that if other uninsured Texans had just pushed through the difficulties of signing up, they'd be as pleased as she is now.

"I'm really impressed that Obama started this," she says. "I think he's going to be viewed similar to [President Lyndon] Johnson with his focus on social issues, which is good."

Louis Adams, a spokesman for Blue Cross Blue Shield, points out that two-thirds of Texans who enrolled on the federal website chose one of his company's plans.

"We're pleased to know that Tammy and so many others looking for health insurance that best suits their individual needs, chose us, and are giving us the opportunity to be with them when they need that coverage," he says.

In Texas, only about a quarter of people eligible to sign up for a new health plan actually did so. Open enrollment for 2015 begins Nov. 15.


This story is part of a reporting partnership with NPR, Houston Public Media and Kaiser Health News.

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