The end of my preexisting condition

Ingrid Case picture

Ten years ago, my husband and I had a baby.

The baby got started in the time-honored way, and the pregnancy involved only the routine discomforts of weighing more than I'd ever weighed before: swollen ankles, light tides and my own ZIP code.

When it came to getting the kid out into the world, things got a lot less routine.

Our son was 15 days late and might have been later but for an induced labor. The induced labor turned into an emergency cesarean section, and our son was born limp and blue, his cord wound several times around his neck.

I got to enjoy not just the stress of emergency surgery and baby resuscitation but the fun of a ripped uterus, a crushed and resected bladder, and an anesthesia side effect that temporarily paralyzed me from the collarbones down. In the next few weeks, I had five infections, kidney stones and difficulty nursing.

Everyone is fine now, but it took some time and effort to get us there.

If I have another baby -- not something we're planning -- there's an increased chance that my uterus will rupture. At the very least, I'd need another C-section to get any subsequent kids out.

This will always matter to me, because it happened to me and to our baby.

It matters a lot less than it once did, though, because the Supreme Court ruled that the Obama administration's health care reform legislation is constitutional.

Among other things, that means that it's no longer OK for health insurance companies to use my preexisting condition as an excuse to refuse me a policy or to charge me a ridiculous rate for coverage.

You see, that C-section counted as a preexisting condition in the bad old world of health insurance. My difficult labor meant that I would probably need expensive interventions if I had another baby.

As long as I'm within what an insurance company considers my childbearing years, they'd love to not have me as a customer. If they did write me a policy, it would likely cost me an arm and a leg, or it might exclude any costs associated with having future babies.

When insurance companies list what they consider preexisting conditions, they include some pretty common stuff: C-sections, high cholesterol, athletic injuries, depression, asthma, allergies including hay fever, arthritis, even a history of domestic violence.

It doesn't matter whether your problem is severe and life threatening or mild and well managed. You don't get credit for healing or for having dumped that lout years ago.

If it's on your record, it has a better-than-average chance of happening again, and that makes insurance companies run fast in the opposite direction.

This wouldn't have mattered so much if I worked for a large company.

Employees are typically covered under group plans, where insurance companies agree to accept the healthy and less healthy alike, without picking and choosing. But I'm self-employed, and my preexisting condition made it difficult to find or afford coverage for my family.

Until now, my husband has stayed an employee, in part so we can hang onto group health coverage. The new law, however, means that he can also be self-employed if he wants to be, without selling me back into corporate bondage.

He deserves that option. So do I.

I'm much happier and more productive as a freelancer than I ever was as an employee.

You deserve that option, too, and not just for your own benefit.

Difficulty arranging affordable, non-group health care coverage amounts to a corporate subsidy, because it makes it tough for smart, energetic people with good ideas to work on their own.

That shoots the future in its economic foot. Most of the great ideas that move our world forward come from self-employed people.

No coverage means that very few geniuses will take to their garages to invent the Apple or FedEx of 30 years from now. Even geniuses understand when they're putting their families at untenable risk.

When it's easier to find and afford coverage for just one person or just one family, more people will take the risk of starting their own businesses. Plenty of those businesses will fail, for all the usual reasons that businesses go under.

But some will succeed, and from those successes will come the new ideas and technology that will drive job growth and increased quality of life for everybody. I don't think we should do without those advances, whatever they turn out to be.

I'm hoping that you don't, either.

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