Obamacare Odysseys

Obamacare Odysseys: After Hesitating, She’s Pleased With New Obamacare Plan

A Missouri City woman was finally able to get needed surgery for her injured hand after purchasing an individual plan through the Affordable Care Act.

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Tammy Boudreaux tries a tendon-stretching drill at Houston Methodist Orthopedics and Sports Medicine in Sugar Land. Boudreaux was able to get surgery for her hand after signing up for a plan under the Affordable Care Act.

Last year, Tammy Boudreaux of Missouri City spent weeks debating whether to sign up for an Obamacare plan. She was working as a freelance social worker, but she had no health benefits, and she couldn’t get coverage through her same-sex partner.  It had been a few years since she could get well-woman exams or mammograms. She paid out of pocket for almost everything, including a recent visit to the emergency room for a cut finger.  

Boudreaux wasn’t convinced that the Affordable Care Act was the right answer. The healthcare.gov website was annoying to work with, and she was surprised the monthly premiums on the various marketplace plans weren’t lower.

“Whoa! Shut the computer! Find something else to do,” she said back in December, when NPR first featured her story.

For months, Boudreaux, 43, remained undecided. She missed the first enrollment deadline, on December 24, that would have gotten her started on coverage by January 1. But once the holidays were over, she reconsidered. She shopped the online marketplace and chose a Blue Cross Blue Shield PPO health plan.

“I’m extremely happy,” she said. “It’s been very smooth even when I needed to schedule the surgery.”

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Tammy Boudreaux undergoes a test on her finger to check post-surgical improvement of nerve function.

It was the realization that she couldn’t avoid surgery that finally compelled Boudreaux to sign up. It’s an embarrassing story, she said, but back in November she was cutting the wax seal off a bottle of hot sauce when the knife slipped and stabbed deep into her index finger.

Boudreaux, a self-described “adult klutz,” got the finger stitched up in the emergency room, but it wasn’t getting better.

“It was not healing or straightening, it was crooked,” she recalled. “I looked like I had an arthritic finger.”  

The finger also hurt a lot. Boudreaux was working in hospital emergency rooms, and medical friends told her she had probably damaged the nerve and cut a tendon.

“I couldn’t grab a shovel when I wanted to garden, I couldn’t grab small items,” she said. “I could not use my finger on the keyboard, so it was very discouraging.”

Boudreaux’s new plan cost $336 a month. It kicked in February 1, and within a week she was in the operating room.

After that came weeks of rehabilitation at Houston Methodist Orthopedics & Sports Medicine in Sugar Land.

“Swelling and range of motion are what we look at mostly. And strength too,” explained hand therapist Peggy Boineau.

“We’re going to look at strength today,” she told Boudreaux. “So turn your hand this way. Straighten that joint.”

Boudreaux went through a number of drills, like squeezing stiff putty and identifying small objects by touch. During one exercise, she flicked tiny beads into a plastic bucket.  

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Hand therapist Peggy Boineau, right, helps Boudreaux improve sensation in the nerves of her injured hand.

The new insurance plan didn’t cover everything. First Boudreaux had to meet a $3,000 deductible. Then there were co-pays. For example, each therapy session cost $50.

But Boudreaux said she realized it was an investment in her future self.

“I think that was part of my hesitation of getting the insurance. Because I thought ‘Oh, I really don’t need it, I can make do. I’ll get by,’” she recalled.

But then she realized: “No, I can’t get by. 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.”

In April, Boudreaux accepted a full-time job with hospital chain HCA. She manages a small team that conducts psychiatric evaluations in emergency departments in the Houston area.  

Boudreaux expects she’ll qualify for the employer health plan pretty soon, but she’s not actually sure if she’ll drop her marketplace plan and switch right away.

“I’m loyal, so if I’m treated well I usually stick with that plan,” she said.

“I’ll compare (the plans) but I will probably stay with Blue Cross Blue Shield for this year,” she added, “And then determine whether or not I want to stick with that plan or go with a plan through my employer. But it’s really helped.”

Boudreaux acknowledged that she was frustrated with the Affordable Care Act at first. The website experience didn’t help. But now that she’s on the other side – the insured side – she has a new perspective. She feels relieved and safe.  

“Go healthcare!” she said. “I’m really impressed that Obama started this. I think he’s going to be viewed similar to [Lyndon] Johnson with his focus on social issues, which is good.”

Boudreaux said if other uninsured Texans had just pushed through the difficulties of signing up, they’d be as pleased as she is now.

More than 733,000 Texans signed up for a plan through the healthcare.gov marketplace this year.

But that represents only 23.3 percent of Texans who were actually eligible to sign up, according to research by the Kaiser Family Foundation.  

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Florian Martin

Florian Martin

Business Reporter

Florian Martin is currently the News 88.7 business reporter. Florian’s stories can frequently be heard on other public radio stations throughout Texas and on NPR nationwide. Some of them have earned him awards from Texas AP Broadcasters and the Houston Press Club. Florian is a native of Germany. His studies...

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