Laura and Michael's Story

Laura and Michael’s Story

The hand of nature’s perfect craftsmanship is apparent as Pennsylvania’s northeast mountain region delicately evolves into the pristine and fertile agricultural fields of the Lebanon Valley.  The tranquility of a late July day in Lebanon County is only disturbed when the gentle summer breeze rustles the fields of soybeans, corn stalks and barley.   The subtle voices of loafing cattle transcend the stillness of a region that prides itself in its infamous dairy industry.  Amish buggies and Mennonite farms, a common presence in this region perpetuates the sense of serenity.  These “plain people” represent the Germanic traditions embedded in the work ethic that founded this Pennsylvania Deutch region.  Generations have tilled this fertile soil which today gives rise to the occasional modern subdivision-a constant reminder that the inevitable hands of father time can even touch a region so rooted in tradition. 

Carefully nestled into this pristine farming region, is the historic town of Annville, where the voices of its ancestors can still be heard in the well preserved architecture of the old homes.  Maintaining the integrity of the ancestors is Michael, a carpenter who restores the old houses as well as builds structures for the future.  Alongside his wife, Laura, they have built a carpentry business and are an inspiration for the spirit of “rugged individualism” that has built Lebanon County and the United States. 

The traditional spirit of independent determination has been challenged by the backdrop of our modern health insurance reality.  Michael and Laura’s independent business is easily constrained by premiums that equal $6200 a year with a $2400 deductible.  Laura often refers to their health insurance policy as “homeowners insurance”.  As she explains with a subtle cynicism, “It basically means that if one of us gets really sick, all our policy is good for is making sure we don’t have to sell our house and cash in our retirement in order to pay medical bills.”  As Laura rubs her temperamental knee, she explains a common reality.  It costs their family over $8600 a year just to access the system.  After what Laura refers to as her annual “dues”, they still don’t get total coverage.  Even annual physicals are still only partially covered.  At the Age of 52, Laura should be having annual cancer screenings such as a mammogram and a colonoscopy.  However, even after paying their annual “dues”, these procedures are only partially covered.  The reality of their situation is apparent in the fact that they avoid seeking medical attention for some conditions that may (or may not) be treated.   After all, with a health policy like the one they carry, the only thing guaranteed by a visit to the doctor is a large bill, but not necessarily a cure.  Many times the gamble isn’t worth it. 

Fortunately there is hope in sight for Michael and Laura, individuals who embody the independent American spirit.  When the Patient Protection and Affordable Care Act (PPACA) is implemented, small business owners like Michael and Laura will be eligible to purchase insurance on the smallbusiness exchange (SHOP).  Since they will be pooled together with other small business owners, their costs will decrease.  Their income also qualifies them for a premium credit in order to buy insurance in the exchange which will limit the cost of their premiums to $1280-$2016 a year.  Additionally, as of 2010, they are able to access preventive care without a worrisome debt.  Basic research proven prevention practices such as cancer screenings are now covered under the PPACA.  After years of living with the suffocating constraints of unmanageable premiums and deductibles, Laura and Michael can now breathe easier knowing that there is now a MedicalLoss Ratio.  In other words, 80-85% of these dollars will now be required to be spent on actual care and not administrative costs.  Like all Americans, basic patientprotections and rate review will also apply to them.

With each tap of the hammer Michael maintains the traditions of the ancestors that used to occupy the historic homes of Lebanon County.  Their whispers of gratitude transcend the grind of the saw.  Because of the PPACA, Michael and Laura are able to run a business that preserves their heritage while adapting to the modern world that never ceases to progress into the future.