Jacklyn Parker: When Knowing How the System Works Doesn't Make It Work for You

39-year-old Jacklyn Parker grew up in Omaha and after training at Nebraska Methodist College she spent five years working as a phlebotomist at Nebraska Medicine, work she loved. After three back surgeries made inpatient phlebotomy too difficult to continue, she left the field. “I took a leap of faith and got into insurance, left phlebotomy, and have been doing insurance now for about four and a half years, specializing in health insurance, specifically with the marketplace,” she said.

Jacklyn lives with her husband and their daughter, Savannah, who is 17 and just started her senior year of high school. Savannah has had high health needs since birth. “She had open heart surgery when she was three weeks old,” Jacklyn said, and Savannah still gets an echocardiogram every other year. She also has multi-level degenerative disc disease, which led to a surgery this past July. “It’s one thing to go through surgery. Like I shared, I have myself, but it’s just another level of mental strength to watch your child be in agony and then there’s nothing you can do,” Jacklyn said. “We are just so thankful for her surgery.”

As a 1099 business owner working in a field she knows inside and out, Jacklyn still finds her own family caught in what she calls a “gray area” of Marketplace income rules. “A big change that happened last year with the marketplace is if you are above the federal poverty line, you can really run into some trouble at tax time,” she said. Because Marketplace premiums are calculated from a household’s adjusted gross income, and business owners’ income shifts with deductions, predicting the right number, months in advance, is difficult. If a household estimates too high or too low, they can owe the difference back at tax time — a rule Jacklyn said is hitting her own family this year. “My husband and I are in trouble because we’re at the top of the line and we have the same rule that we should have been paying this much, but we only paid this much. Now we got to pay it back.”

Through her work, Jacklyn has watched lower-income clients get squeezed. She described helping people near the federal poverty line — in Nebraska, $15,000 a year for a single person — who fall just above the Medicaid cutoff but still cannot afford a Marketplace premium. For clients who misjudge their income for the year, the consequences can be steep. “They will pay back at tax time the difference in what their plan should have been versus what they paid all year,” she said. She has seen the toll this uncertainty takes: “You have a low-income person who’s dabbling on that line. They’re just going to go with no insurance. That’s the solution.”

Jacklyn’s family had to switch insurance carriers this year. “We loved Medica. That was a plan that I just loved. I suggested it because my family used it. And Medica went up over 30% last year,” she said. Under Medica last year, the family paid $222.85 a month for a bronze plan that included $0 copays for primary care visits, mental health visits, and urgent care, plus 20 covered chiropractor visits a year. Staying with Medica this year would have meant a premium of “800 some dollars,” so the family moved to Blue Cross Blue Shield instead, now paying $504 a month for a bronze plan with a $10,000 deductible per person and a $21,000 max out-of-pocket for the family. Blue Cross Blue Shield also does not cover the same prescriptions Medica did. “Affordable is an embarrassing term, to be quite honest with you, when I’m working with clients. I don’t like the word because I know that this is almost a joke that these things are considered affordable,” she said.

Medical bills add another layer of stress for the family. When Savannah had her surgery in July, the family received separate bills from the neurosurgeon, the anesthesiologist, the hospital, and the lab work, each arriving before insurance had finished processing. “The hardest part about the medical debt is that the bills start pouring in before they’ve even filtered through insurance,” Jacklyn said. Setting up payment plans with each provider only added to the load. “You have 10 different people who all want 25 to a hundred dollars a month from you, so you get stressed out and you black it out,” she said. Despite the financial strain, the family does not qualify for financial assistance. “My husband and I are just hardworking people who sit down and do our books at night,” she shared, adding, “And we aren’t living lavishly.”

All things considered, Jacklyn chooses to focus on what has gone right. “I’m really big on being positive. I am so thankful we had something that my family is fortunate enough to afford that $500 a month because I’m only 10,000 in debt. And that’s the scary part for everyone is you don’t need health insurance until you need it,” she said. She is grateful for where they live and the care Savannah received. “Thank God we’re here in Omaha, Nebraska where she was able to be seen in eight weeks and had the relief… there’s so much to be thankful for.”

Still, Jacklyn worries about what she is seeing across the country, not just in her own household. “This past year has just been catastrophic for health care,” she said. “The unnecessary situation that we’re in as not just Nebraska, but as a country with health care is very scary.” Even as someone who understands the system better than most, Jacklyn is left navigating the same gaps in coverage and affordability that she spends her days trying to help others through.