|By Amy Stansbury, The Evening Sun, Hanover, Pa.|
|McClatchy-Tribune Information Services|
"For 40 years I paid into the system," Goulden said, "and now I feel like a fool."
Resting on a chair in the back room of his
Goulden spent most of his life as a factory worker insured by the same large insurance company and, happy with its service, he opted to insure his own business with a subsidiary of that same company when he opened up shop in 1990.
But about five years ago, things changed. Goulden was diagnosed with chronic liver disease and as he watched his insurance premiums skyrocket, he said he realized why he had never before had a problem with the company -- he had never been sick.
"They pushed me out," Goulden said. "I faced the possibility of losing everything I had worked for."
Now a member of the local organization, Adams Hanover Health Care 4 All PA, Goulden works to share his story with others and to push
After his diagnosis, Goulden said, he quickly recognized the need for sweeping changes. His insurance premiums rose from
At first, the insurance agents told Goulden that he was ineligible for continued coverage because his
wife didn't make enough money to qualify as a full-time employee of the business, he said. Goulden fought back, countering that because his wife co-owned the business, she did not earn wages like an employee, but instead shared profits with her husband.
"So two days later they came back and said, "We will keep you, but we have raised your premiums to
SEE ALSO: Administrative costs drive up health care spending
Later, he said, the insurance company demanded he submit his federal tax returns to prove that he had a legitimate business.
"The tax returns show how much money I make, so they could use that information to know how much they could charge me in order to push me out," Goulden said. " I called legislators and asked, 'How can they possibly do this?' And I found out that they can. There is no regulation about what they can require you to submit."
So before long Goulden was forced to drop his policy and go without insurance, despite his critical medical condition.
If it were not for the Affordable Care Act, also known as Obamacare, Goulden said he would not have insurance today. After going six months without, he was picked up by one of the first provisions of the law to take effect. Enacted in
Recognizing what it considers to be both the advantages and shortcomings of the Affordable Care Act, Health Care 4 All PA, has launched a statewide educational campaign to inform citizens of what can still be done in health care reform. The group praises the new law for setting regulations on the insurance industry, preventing insurance companies from dropping or excessively raising rates on sick policyholders like Goulden, or refusing to cover people with pre-existing conditions.
On the other hand, say group members, it fails to cover all Americans or institute enough cost-cutting measures to keep individuals and local municipalities out of bankruptcy. A study conducted by the group and a team of independent economists found that a single-payer system would save municipalities throughout