As a freelance writer and producer, I tell the stories of patients at Cincinnati Children’s Hospital Medical Center. Now I have my own story to tell.
My family is about to lose our Children’s health insurance because the hospital will not accept Dayton CareSource Ohio health insurance. We have purchased CareSource Marketplace insurance for the past seven years from the Ohio marketplace. Every year, I choose CareSource mainly because we have two young children.
This change, which goes into effect on August 1, does not affect the type of Medicaid insurance. It only applies to those who purchase through Healthcare.gov. With CareSource exiting, there are no plans left to market while Cincinnati Children’s is in the network.
So now, nearly 1,000 families like mine have been turned away from care at Cincinnati Children’s – which, to be clear, is the ONLY place to go for pediatric care in the area.
Do you know how many videos I’ve made where the main message is pediatric patient care? How families and caregivers communicate. It’s almost religious. And it is true. Everyone I have met with Ana has been a great role model. My experiences there with my children have been extraordinary.
In fact, the first thing you see on their homepage is, “We are here for every family, every child, every future.”
But apparently, when money is on the table, “every family” talks, and all the communication in the world about patient care goes out the window.
Is it CareSource’s fault? Is Cincinnati a problem for Ana? Is one group being overly greedy? Is someone being raped? There are ideas in all my favorite places on Facebook. A women’s group in my community is seething with anger. But as a regular drug buyer, I don’t know.
I know that Cincinnati Children’s is ranked #3 among children’s hospitals in the country. I know that, according to their website, their net income for the fiscal year ending June 30, 2021 was about $2.75 billion and their expenses were about $2.5 billion, leaving a net income of about $2.2 billion. I know when I work with other children’s hospitals in the country (I write and publish content for several) many are trying to compete with Cincinnati Children’s, but they can’t match their dollars. Is Cincinnati Children’s Hospital a very expensive hospital, requiring high reimbursements? Or is CareSource a money-grubbing insurance company?
Who knows? None of that is visible. CareSource Marketplace families are only getting interviews, not answers. No one with decisions on the matter seems to care about us. We are expensive and that is just the cost of doing business.
You may be thinking, just get new insurance, lady. Well, when you’re self-employed – as I have been for 20 years – your options are limited. I love what I do and I have a good life because I do it well. But health insurance has always been the star of it all. Healthcare.gov was a godsend for our family. My husband is a stay at home dad and works part time. (The reasons are hard to enumerate here, but trust me when I say it’s the best decision for our family’s health.)
We have used Cincinnati Children Services many times over the past decade. My husband and I took ADHD parenting classes there. One of my children saw the school pediatrician. The same child sees a neurologist to help manage Tourette’s and OCD. One of my children recently had a fracture at their orthopedic clinic.
However, my family is one of the lucky ones. The stories I’ve been reading about other affected families – those with children who have problems that require constant care, or children who interact with therapists – are devastating.
Also, it’s not like there are any real options for where to go in southwest Ohio if your child needs special care. Adult hospitals do not want to touch children’s cases. Doctors refer directly to Ana. The hospital is self-contained. I never looked at it as a problem, because when you have the best behind you, why would you need to go anywhere else?
But now there is a gate around it. I can look inside and tell amazing stories about patients. But if I want to take my kids there, I have to be willing to pay out of pocket. I doubt Ana will send me to tell the story.
Judi Ketteler (@judiketeler) produces health news and is a columnist for Cincinnati Magazine. He is also the author of “Could I Lie to You? The Surprising Power of Being Honest in a World of Lies.”
