Do you want my baby? An Affordable Care Act Love Story

By Jessica Priego, NewsTaco

Last I checked, neither my pharmacist nor my insurance company wants my future baby. Barack doesn’t want my fantasy baby either (we are on a first name basis as is clear to see from the emails I get each week that start off with “Jessica, I need you now more than ever” and end with “Barack.”) I don’t want my baby either. This unwanted baby situation is the reason why it was so critical that I get my birth control pills on time and as directed by my doctor this month. I had already fallen off the wagon last month and I needed to try to get back on track again. Bright and early last Saturday morning, a full day before I was supposed to start a new pack of birth control pills, I was in line at my local Jewel-Osco ready to get my prescription.

Last month, I was told that my pills were going to cost $130 after taxes, even with my insurance. Like any normal, assertive, educated, empowered, articulate person, with a brand name insurance card in her wallet, and who was in full support of the Affordable Care Act last year, I asked them to repeat the price one more time and then quietly walked away. Perplexed. I wondered what I had misunderstood, what I had done wrong, how I managed to mess this up. I got home and started to search the web for information about the types of birth control that were covered under my insurance. I was overwhelmed and thoroughly confused in about 5 minutes. I told myself I would get back to the issue later. Then a new month arrived. I missed one full month of birth control pills.

I am one of the rule-following ladies that went out and made sure I got insurance last year when the historic Affordable Care Act came into play. Even though it was expensive for me as a self-employed person, I signed up for a decent plan with Blue Cross and Blue Shield of Illinois.  A $6,000 deductible and what I thought to be a plan that included some key prescriptions felt right. And, in case I had the prescription thing wrong, I would obviously never have to pay for birth control pills since under this new and amazing universal health care law one thing was clear to me: all women in this country would now have access to birth control free of charge. Thank goodness. I was set for success. Lets please not forget: I don’t want a baby. And, I  have been known to be sexually active. So why was I turned away last month? Like so many working women I know, I didn’t actually have time to find the answer.

So, this month, I decided to just shake that “mistake” off and go back to Jewel-Osco and see about getting my pills. By sheer and most random coincidence, this time, I didn’t go alone. I happened to be out that morning with my little sister. My little sister happens to work for a very large, national women’s health advocacy group. My little sister happens to know a thing or two about the Affordable Care Act and a woman’s right to access free birth control pills. When she saw me get turned away again – unless I had the $130 for one month of pills – she intervened and insisted that the pharmacist explain exactly how and why, I couldn’t get my pills. She too doesn’t want my fantasy baby. The very kind female pharmacist shared that my exact type of birth control pills weren’t covered according to my insurance company. Period. She asked why I didn’t try visiting a Planned Parenthood office suggesting they could help me with low cost pills.  I said I had a doctor already. I had a prescription already. I had insurance. All I didn’t have was the $130. I followed all of the rules right? She quietly shared that she sees many customers come in with the same issue and she doesn’t know what to tell them. She said that the insurance and pharmaceutical companies have found ways to “skirt” the law and not actually provide women with the advertised free birth control pills for all.  What? But who publishes this short list of approved drugs? The government she said. There was nothing she could do for me. She told me to call the insurance company or go online to research the issue. But I had done that already. And this baby was going to show up soon if we didn’t get back on these pills soon. My sister said: You need to call Jewel-Osco and Blue Cross immediately. So instead, I tweeted at them.

I asked both the pharmacy and my insurance company why I couldn’t get free pills over Twitter. I also tagged Barack Obama, Planned Parenthood Federation of America, and a handful of news outlets in my tweet. I received replies from both within 24 hours. But the clock was ticking. My pill pack was to start on Sunday. I was going to miss the No Baby Boat again. Both the pharmacy and the insurance company asked if they could call me directly to discuss the matter. And boy did we. It took 5 phone calls, multiple emails, lots of transfers, and all of the patience in the world to begin to sort this situation out. The pharmacy said that they were only going by what the insurance company was telling them. The insurance company said that there is a short list of approved “free” birth control options but that the list, handed down by the government, isn’t widely circulated and is very difficult to find on their site.  They generously offered to email me a link to the site that I could download by logging in to a special website, with a special code to see the list. It was a painful process. Layering on technology hurdles to human and political and business hurdles hurt my brain. I wanted to give up. I should have just found the $130 and paid “them.” Once retrieved, I must say that the list is short. Not every pill has a generic or free substitute just a few do. To complicate matters further, no one but my doctor could switch me from the type of birth control pills I had originally been prescribed to the new ones. Holy mother. I had to contact my doctor’s office about this whole mess,  and was then told that they had to hear this request directly from the pharmacist. I couldn’t request the change myself. Again, what? I eventually got my hands on “the list”, shared it myself with Jewel-Osco headquarters, who then shared it with the pharmacy who didn’t have it anywhere in their files, who then shared it with my doctors office. Make sense? I obviously didn’t get my pills in time to start the month on time. My pills were ready for me on Tuesday.

The Jewel-Osco staff greeted me with such pride as I slowly walked up for my pills on Tuesday. They truly felt like we had accomplished something here. I have been a good customer for years. They know me. They announced loudly: “Mam, please put away your card. These are no cost pills.” Yahoo! “Really” I asked? And as I examined my package of goods, I saw a zero as the total. Success! The little woman wins! There is free birth control for us! So what if I lost a full day of work figuring this out! Then I asked if these pills were exactly the same as my old ones. The answer was no. It turns out there isn’t an exact replacement for the type of pills I had been taking for more than 10 years. These new/free pills are a higher dose but as close as they could match up to “the list.” I asked if I would feel any different or experience any side effect. They couldn’t say. Would these new pills affect my high blood pressure? “We aren’t sure.” was the reply. They referred me to my doctor. He doesn’t want my baby either though. What’s a woman to do?

Jessica Priego is the founder and president of JPriego Communications (JPC), a boutique marketing, PR and advertising firm that specializes in the entertainment, sports and lifestyle arenas. She manages strategy development and implementation for clients including the Chicago White Sox, the United Center (home of the Chicago Bulls and Blackhawks), Fox Deportes, Arenas Entertainment and the National Council of La Raza.

[Photo by Amber McNamara/Flickr]

 

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