Anton Gunn, a former college football lineman, has played both offense and defense when it comes to health care.
Gunn is the recently appointed regional director for the U.S. Department of Health and Human Services, the agency responsible for protecting the health of Americans. He heads a region containing Georgia and seven other Southeastern states.
Last week, he discussed what he sees as the advantages of the much-debated health care reform law at a breakfast forum sponsored by the consumer advocacy group Georgians for a Healthy Future. Considering the office he holds, his stand on the issue is no surprise, but he’s not just going through the motions to support the law. He’s passionate about it.
Gunn shared with the audience a personal, nightmarish encounter with the health care system.
About 10 years ago, he and his wife switched to a new individual insurance policy, after their former plan’s cost rose to more than $1,000 per month. “We couldn’t afford that,’’ he said.
Gunn said he filled out the new application, checking the coverage boxes, and the couple wound up paying $268 a month.
Four years later came exciting news: His wife was pregnant. She went to an ob/gyn, who later sent them a bill of $257 for an office visit. They were unpleasantly surprised, to say the least, having figured on just a small co-pay.
When they phoned the insurance company, Gunn recalled, “they said we [didn’t] have maternity coverage.’’
That came as a shock. Gunn soon learned he had filled out the application incorrectly. “We were out of luck,’’ he said. “There was nothing I could do.’’ The couple made too much money to be eligible for Medicaid, and another private insurance policy wasn’t an option, because the pregnancy would be considered “a pre-existing condition.’’
The doctor gave them a discount on the charges. But Gunn and his wife wound up paying what he estimates was $15,000 out of pocket for the prenatal care, delivery, and after-birth care of their daughter.
“My story is just a small example’’ of consumer pitfalls in current health insurance policies, he said after the forum. Individual health policies have more than their share of gaps, experts say. Health reform will require insurers to provide maternity coverage in the insurance exchanges where individuals will buy policies. The exchanges also are expected to have greater transparency for people to understand what benefits are offered.
Gunn’s region of responsibility, though, is full of Republican-leaning states, where the health care reform law is anathema to many residents. Still, Gunn, who played football in the 1990s for the University of South Carolina, pushes ahead in his support of the Affordable Care Act. Among his arguments is the personal one: “I’m glad it has the consumer protections.’’