A singer’s Obamacare lament

When we last spoke with leukemia patient Carol Kroger, she had resolved to apply for the state-run health reform exchange Covered California, hoping to escape the rising premiums of her private plan.

A musician in our “Health Reform in Hollywood” story, Kroger and other performing artists were excited about Obamacare’s promise of affordable health insurance. After all, only the lucky few who qualified for the brass ring of Screen Actor’s Guild coverage had ever had a glimpse of a health plan that didn’t break the bank.

But as Covered California’s open enrollment deadline came and went on Monday, Kroger held out. Her decision illustrates a reality: health reform’s exchanges do not align with everyone’s insurance needs.

She has opted for an agent-brokered health plan that is not part of Covered California. It offers her coverage with a monthly premium of $792 and a maximum out-of-pocket expense of $950.

It’s not an ideal alternative, said Kroger, who works as a real estate agent and receives modest royalties from her music.

The Covered California plan that she ultimately decided against could have had her paying under $400 a month in premiums. But a maximum out-of-pocket expense of more than $6,000 was the rub.

“The premiums are cut in half [with Covered California] which is great, but I go to the doctor a lot,” said Kroger, who emphasizes that her chronic leukemia is “the disease you die with, not the disease you die from.”

She’s also unsure if Obamacare will cover the costs of her osteoporosis medication Prolia, which averages out to about $225 a month. When she called Covered California reps last week, they were unsure as well.

Kroger’s claim to fame as an artist was her composition of the ballad “The Commitment,” which she sang for us at her Los Angeles home. She couldn’t make one to Obamacare, but who could blame her?

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