Stuck in the middle — Fishing family’s income level leaves them uninsured

Photo by Jenny Neyman, Redoubt Reporter. Jackie Tomrdle, of Kenai, holds baby Katella and almost 3-year-old Isabella in their home off Kalifornsky Beach Road on Friday. Isabella has severe allergies that can flare up at any time, leaving Jackie and her husband, Arvo, in a perpetual state of worry, since they can’t afford health insurance.

By Jenny Neyman

Redoubt Reporter

At first glance, Jackie Tomrdle’s family doesn’t appear to be in a dangerous financial situation. She, her husband, Arvo, and four kids live in a spacious home off Kalifornsky Beach Road with a well-kept yard and a well-fed dog. An SUV is parked out front. Inside, a flat-screen TV faces leather furniture in the living room.

Jackie works at a local gym and Arvo is a commercial gillnet fisherman in the Copper River and Prince William Sound in the summer, and works on the North Slope in the winter. Their income allows them a moderate, middle-class lifestyle, with the perks and comforts that brings — or so it seems, at least.

What their income does not allow is the ability to afford health insurance. Without it, they not only cannot afford to pay the full costs of doctors visits and prescriptions to treat 2-year-old Isabella’s severe allergies, they also can’t protect themselves against the very real possibility that their outwardly middle-class existence could be wiped out at any time by one serious medical situation.

“We just do what we can do,” Jackie Tomrdle said. “The biggest thing is the day-to-day stuff with children who have medical issues. But then there’s also the issue that if one of us gets hurt, we could lose everything. And that weighs heavily.”

The Tomrdles aren’t living in abject poverty, for which Jackie is grateful. But some aspects of life would be easier if they did fall into the guidelines for poverty. At least then she and her kids would qualify for Denali KidCare, the state-assistance medical program for children and mothers with low incomes.

Eligibility guidelines consider monthly income, and with Arvo’s seasonal work, the Tomrdles don’t qualify for state assistance, she said.

“Being a commercial fishing family, it really puts us in a hard position. In order to fish, you need to have time to fish and you need, not just time to actually fish, but time in preparation to get your boat ready and your gear ready and basic maintenance. … On paper, we look like we earn too much money,” Tomrdle said.

But they don’t make enough to be able to pay the premiums private health insurance companies charge for family coverage. Even if they could, Isabella’s allergies are a pre-existing condition, as is an autoimmune disorder Jackie was diagnosed with as a child.

“Even if we had it, they could just take it away,” she said.

Some winters, Arvo hires on with an oilfield company that offers health insurance without a six-month waiting period. But the coverage only lasts for as long as he works — until April.

“That’s just long enough to pay the deductibles,” Tomrdle said.

And there’s still a six-month pre-existing condition clause, so if Tomrdle wants to have her daughter’s allergies covered while they briefly have health insurance, she has to avoid bringing her to a doctor or getting prescriptions for her for the six months prior to the coverage starting.

“Unfortunately, you learn how to work the system pretty quick,” she said.

Tomrdle knew there was something wrong with her daughter’s breathing when Isbabella was 6 months old, but couldn’t get a referral to an allergist until she had an anaphylactic episode at 13 months. She was diagnosed with allergies to peanuts, garlic, eggs and hay, severe enough to restrict her breathing to the point of needing emergency epinephrine shots.

Her first doctor’s visit cost $400 and the prescriptions were more than $1,000, Tomrdle said. Her latest trip to the doctor was a $200 bill and around $800 in medications. Tomrdle said she doesn’t even like to think about what a trip to the emergency room costs — $1,000 to walk in the door, at least.

“I try and not go to the emergency room. That is a last resort. We try and wait until the doctor’s office is open because of cost. Flat out because of the cost,” she said.

Epi pens are supposed to be replaced every year, but Tomrdle keeps old ones around because she can’t afford to buy all new ones. She’s also had to scrimp on medications.

“She’s had allergic reactions and some doctors, they just start piling on the prescriptions, and I have had to say to the pharmacist, ‘I can’t do it.’ I’ll take the stuff I know is the most necessary, and that’s what I have to do. It makes me second-guess myself. It’s very difficult. I do the best I can do,” she said.

The stress of having a child with medical concerns and the bills from doctor visits and prescriptions are hard enough, but there’s also the stigma associated with being uninsured.

“I’ve had people who were so supportive and will just go out of their way to help our family and our situation. But I’ve also had it where the pharmacist won’t make eye contact with you, and is rude,” Tomrdle said. “I’ve had both, honestly. My biggest issue is walking into a doctor’s office and, before they’ve even said ‘Hi,’ they say, ‘You have to pay for this in full.’”

Tomrdle qualified for Denali KidCare for a year in the past, when she had her son, River, now 6.

“When I was calling to make sure everyone had my information, I had one man say to me, ‘Wow, this must be your lucky day,’” she said.

“I don’t think anyone deserves to be treated poorly, under any circumstance. There should be no room for that. And on the flip side, as a parent, I feel almost like a failure for not having (insurance) for my children.”

Health insurance is not a new concern in her family. It was a topic of discussion at the dinner table when she was growing up. Her parents had insurance, but if they didn’t, they’d either have to declare bankruptcy or split up to qualify for state assistance, Tomrdle said.

One of her friends is uninsured, and put off going to a doctor for three years, only to end up with a $20,000 bill and a heart condition that would have been preventable had she been treated sooner. Tomrdle’s mother-in-law works for a nonprofit organization and gets health insurance for herself and her husband — also a commercial fisherman — but it costs more than she makes, so she ends up having to pay, instead of getting paid, at the end of the month. And when Tomrdle was pregnant with her youngest, daughter Katalla, 5 months, “You would be shocked at how many people said, ‘Well, you guys just file for legal separation so you qualify for Denali KidCare.’ Something has to change, and I don’t know the answer to it,” she said.

Tomrdle shifted Katalla, dozing in her lap, to wipe away the tears that well up when she talks about her family’s situation. Across the room, Isabella — “my spicy child,” as Tomrdle calls her — was singing to herself, blonde curls bobbing as she swayed a little with the music. It usually takes reverse psychology to coax some snuggling out of the headstrong toddler — “Don’t come sit on mommy’s lap. Don’t give mommy a kiss.” But this time, ’Bella hopped up on her own and patted the wet spots on her mom’s cheek.

“Are you sad, Mommy?” she asked.

“A little bit. It’s OK, though,” Tomrdle replied.

Tomrdle also fought back tears when she spoke at Sen. Lisa Murkowksi’s town hall meeting on health insurance at the Soldotna Sports Center on Aug. 29. She went to let people know that health insurance isn’t just a problem for people in poverty.

Photo by Jenny Neyman, Redoubt Reporter. Katella Tomrdle peeks over the shoulder of her mom, Jackie Tomrdle, at a town hall meeting on health insurance reform held by Sen. Lisa Murkowski on Aug. 29 at the Soldotna Sports Center. Jackie Tomrdle shared her family’s plight of being uninsured and facing medical bills from her daughter’s allergies.

“My biggest thing is to realize that there are people all around you who are working who are uninsured,” Tomrdle said. “They’re the people cutting your hair, they’re the people you’re working out with, the people you’re passing in the street, but they’re uninsured. They’re working, but they could lose everything with one accident. I know that it’s not just hitting the working middle class. It affects everyone. So something has to change, and I don’t know the answer to it.”

Ideally, Tomrdle said she’d like to have affordable, private health insurance, but a public insurance system may be more feasible.

“I realize that ‘socialized’ medicine is not always the best, but it is something, and I’ve thought to myself that it would be better than what we have now,” she said. “I really wish they (Congress) could just come up with a bipartisan agreement. And I know that’s a fantasy. Unfortunately, because both sides have some views that are really important, but the struggle is leaving us falling through the cracks.”

Tomrdle said she’s not particularly political and votes for whichever candidate she believes is best, regardless of party affiliation. She went to the town hall meeting to listen and hopefully raise awareness in the community that their friends and neighbors are affected by the health insurance crisis, even if they may not outwardly appear to be.

“Everyone knows that something needs to change, but no one’s willing to change the status quo,” she said. “At the meeting, I felt kind of like the people that really needed to be there, weren’t there. It feels like we’ve been spinning our wheels and it’s been going on for so long. I really hope and pray that something changes, and for the good of everyone — not just for us, but for everyone. Every day that there are children in our state and in our country that are uninsured, it’s a tragedy.”

About these ads