Part 1: A hard winter ahead

Winter has been a long time coming for Geoff* and his wife, Elizabeth*. He didn’t think he could actually feel more anxious than he had since March, when he and his family began isolating along with the rest of the country.

(*Geoff and Elizabeth agreed to share their story using pseudonyms to protect their privacy.)

Every day since has been essentially the same. Geoff wakes up early to go for a run around his neighborhood in Montgomery. He gets back in time to get the kids ready for their long day of virtual learning.

But this morning, Geoff felt himself dragging.

“I am a young dude, but I get a new creak or squeak every day,” he says jokingly. Running used to be so much easier when he was in his 20s, he said. He’s now in his mid-30s.

His tone begins to shift, and his voice becomes heavy. “I lay down to go to sleep and everything is fine, until it isn’t,” he says.

Back in May, like millions of other Americans, Geoff started to realize his job was becoming less secure. Finally, in September, he was let go. “That’s when I started experiencing panic attacks,” Geoff said. “And like, who wouldn’t in my situation?”

Geoff lost his income, his daily routine and his health insurance on Oct. 1. He has found it hard to sleep ever since.

Alabama’s coverage losses have soared during the pandemic

The COVID-19 pandemic and resulting economic crash have caused the greatest health insurance losses in American history, according to research published by the nonpartisan research organization Families USA in July.

An estimated 5.4 million workers became uninsured because of job losses they experienced from February to May this year. And 69,000 of those are in Alabama.

“Even before COVID-19, Alabama’s failure to expand Medicaid left more than 220,000 adults uninsured,” Alabama Arise campaign director Jane Adams said. Adams directs Cover Alabama, a coalition of nearly 100 organizations pushing for Medicaid expansion in Alabama. Arise is a founding member of the coalition.

“Further coverage losses during the ongoing economic recession will bring health and financial suffering for even more families across our state. More people will go without needed health care. More hospital bills will go unpaid. And more families will fall into poverty.”

‘All the things I had that I suddenly don’t’

For Geoff, this coverage loss means every choice he makes could bring a new risk.

“I just lay there and my brain reminds me of all the things I had that I suddenly don’t, and it changes the way I interact with the world,” he said.

Geoff and his wife both remain physically active, he said. He used to take comfort in the alone time that running provided. But after he lost insurance, every crack in the pavement or acorn on the sidewalk gives him yet another thing to worry about.

“I have nothing,” he said. “If I fall and twist my ankle, that’s it. I won’t be able to provide for my family.”

Part 2: sacrifice

Geoff and Elizabeth own a small event business in Montgomery. They have relied heavily on working weddings and other public events to pay the bills since losing his salary. Without these gigs, he said, he has no idea how they would make it after losing his salaried job.

Elizabeth also does freelance work that allows their kids to be covered under her private insurance. When Geoff first learned he’d be laid off, he immediately asked his wife if he could join her plan.

“You just take this stuff for granted, right?” Geoff said. “I had great insurance under my parents. Then, I was covered in college, and right after, I was blessed to get a good job,” he said.

But when he saw the monthly premium to get coverage with the rest of his family, he knew it wasn’t an option.

“It was thousands of dollars just to add me!” he said, exasperated. “She doesn’t even make that much altogether!”

Beyond just money, Geoff said he fears most for his children.

A simple hospital visit would cost several thousand dollars thanks to a high deductible, he said. Even a quick trip to the doctor for his children would set them back on groceries for a few weeks.

“I make sacrifices,” he said. “I haven’t bought anything for myself since April, but I still can’t give my kids everything they need, and that is terrifying.”

Geoff and his wife have relied on word of mouth to book business. Their work often means taking jobs that leave the family at higher risk of contracting COVID-19.

“I’m a healthy guy, but every day you see a news story with bodybuilders… guys bigger than me hospitalized and their bodies just ravaged by this virus,” he said.

Parental coverage loss hurts children, too

“COVID-19 is jeopardizing lives and economic security for thousands of Alabama workers just like Geoff,” Adams said.

And now that case numbers are rising exponentially as the United States faces its third wave of COVID-19, many local communities are facing long-term challenges for health care capacity and economic recovery.

But Geoff said he has more to worry about than just the virus. “I’m getting used to the panic attacks because even though I’m undiagnosed, I know it’s a product of the situation I’ve been put in,” he said. “It’s not so easy when I think of my daughter.”

Geoff and Elizabeth’s young daughter was diagnosed with autism spectrum disorder at a young age and was receiving regular care from a specialist. After months of research to find a provider, it would take them even longer to get an appointment.

“And that was with great insurance,” Geoff said.

After losing his job, they could no longer afford the $150 out of pocket per visit. They stopped going to appointments.

“We are left with a child who spends all day at home with two parents who are very clearly not experts for autism. Not even close,” Geoff said.

part 3: the shock of it all

It’s becoming harder and harder for Geoff to relax. What weighs the most, he said, is the shock of it all – even this long into the pandemic.

“I mean, look, I’ve been blessed my whole life,” he said. “I’m a white guy in Alabama. I have a college degree. My parents set me up for success. But things are falling down all around us.”

Geoff said he would vote for Medicaid expansion if it were on the ballot.

“Growing up in Alabama, you always gotta expect the worst but still try to vote for the best,” he said.

For the first time in his 30 years of living in Alabama, Geoff said he feels like state leaders might finally shore up the safety net that keeps so many Alabamians afloat.

“We have got to give up this long legacy of Scotch-Irish stubbornness passed on from our state’s founders hundreds of years ago,” he said. “It’s 2020. You can no longer pretend that you don’t know who you’re hurting by not offering folks help.”

‘I feel like I did everything right’

Recovering from the COVID-19 recession – as families, as a workforce, as a state – is going to require every tool and resource available. Closing the health coverage gap for tens of thousands of hard-working Alabamians like Geoff is the single biggest step our state can take to protect families from delayed health care and medical debt, strengthen our economy and move Alabama forward.

Geoff said if this year has taught him anything, it’s that being nimble is just as important as planning.

“I feel like I did everything right,” he said. “I did everything right, and still I woke up one day and none of that matters. I need help just like everybody else.”

Whit Sides is the story collection coordinator for Alabama Arise, a nonprofit, nonpartisan coalition of congregations, organizations and individuals promoting public policies to improve the lives of Alabamians with low incomes.

Arise is a founding member of the Cover Alabama Coalition, a nonpartisan alliance of nearly 100 advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.

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