Ashtyn Montali of Boynton Beach, Florida, is your average, every day, nine year-old girl. She likes catching butterflies, riding horses, and drawing pictures. Only, Ashtyn can't do any of those things, because she suffers from severe cerebral palsy. She's also a quadriplegic.
Ashtyn was born a healthy baby girl, but was deprived of oxygen in an incubator at the hospital that delivered her. This lack of oxygen caused her to suffer irreparable brain damage. It took her parents over a year before they were able to trace the cause of their daughter's illness.
Now, nine, and confined to a wheel chair 24/7, Ashtyn needs constant physical therapy, as well as a litany of extremely expensive medications, just to make it through the day. Because she eats through a feeding tube, and suffers from severe reflux, Ashtyn requires a specific type of formula; one which contains no amino acids and costs about $600/month.
Up until recently, all of Ashtyn's medical expenses were covered by Florida's medicaid plan; her therapy, her formula, her surgeries, cases of diapers, etc. However, in July of last year, her coverage expired, due simply to the fact that her father, who had been out work for years, found a job. So, the state of Florida claimed her family wasn't "poor enough" anymore. Translation; they earned over $40k. It's situations like this that make it easy to see why 47% of the population call themselves victims.
When Ashtyn was just 3 years-old, her parents applied for
Med-Waiver, a state-run program which paid for medical expenses not typically covered by Medicaid. Unfortunately, the waiting list for the Med-Waiver program was over 19,000 people long; making Ashtyn 19,001.
Thanks to Florida Governor, Rick Scott, it matters not how many people are in front of Ashtyn now, as one of his first tasks when taking office was to
cut the Med-Waiver program to shreds. Keep in mind, this is the same Rick Scott whose private, for-profit, health care co.,
HCA, admitted to over a dozen
felonies regarding Medicare billing, and, of which, he was CEO. Surprise, Scott was not implicated.
For the past year and a half, Ashtyn's parents, Leslie and Adam Montali, have been trying to get Adam's company,
Reverse Mortgage Solutions, a Texas-based lending co. with offices nationwide, to expand their employee insurance plan to include a better policy for family members. These talks are still on going.
Because they have no choice but to take the "bottom of the barrel" health care plan from dad's company, the Montalis now pay a $1,000/month premium, plus a 20% deductible, and all the other wonderful, additional costs, e.g., higher co-pays, more out-of-pocket expenses, etc.
This is where the merry-go-round spins even faster. According to Ashtyn's mom, Leslie,
United Health Care, the umbrella company that insures
RMS, has informed the Montalis:
"
Even if the formula Ashtyn needs is her soul source of nutrition, they still won't cover a dime."
You don't need a degree in astrophysics to figure out what that means. United blames
RMS for the Montali's lack of coverage. They go on to say that Ashtyn's medication, which costs upwards of $160.00/wk, is also not covered. Because, it's "only for the elderly," and a nine year-old girl "shouldn't need it." Meanwhile, a nine year-old with osteopenia has the bones of a 90 year old, and that particular medication is the only thing keeping them from getting worse. Incidentally, just recently, Ashtyn broke her arm. Her parents have no idea how she did it.
Making matters even more bizarre, is the involvement of the third-party health care co.,
Optum Health Solutions, which is overseeing Ashtyn's physical therapy sessions. Optum recently sent a letter to Ashtyn's school, requiring she be "evaluated every 3 months," as to determine the 'validity' of the therapy. They even went as far as to say, in writing, they believe Ashtyn has reached "Maximum therapeutic benefit" - which is corporate slang for "We don't believe she will ever get better."
This letter, a letter which is basically denying the daily therapy Ashtyn needs to function with any sort of stability, is coming from a company run by doctors, who, without ever meeting or evaluating Ashtyn, have determined - basically from a fax,- she's not worth the expense. Never mind the fact that, without constant therapy, Ashtyn's muscles will atrophy, her lungs could fill up with fluid, her scoliosis will get progressively worse, and her bones will break even easier than they do now. In some cases, therapy is preventative as well as rehabilitative.
The above is just a snippet of one family's struggle - an ongoing struggle to fight for the health care their sick, little girl needs, as well as a struggle to avoid the economic disaster that seems to be lurking in the not-to-distant future, should her father's company decide to keep the same plan.
If, however,
RMS eventually decides to switch their coverage with United, then Ashtyn would be fully covered as early as January, 2013. Thanks, of course, to Obama passing the law which declares pre-exisiting conditions must be covered for children under 18. That's best case scenario.
Worst case is, Romney wins the election and follows through with his plan to
"
Let the states take care of their own poor."
Forget for a moment, the condescending attitude that leads one to believe, if you can't afford tens of thousands of dollars in medical bills every year, you're 'poor.' Instead, think about the fact that putting health care into the hands of governors like Rick Scott, is the equivalent of putting the butcher in charge of protecting the cows.
Again, the solution to the health care crisis is very simple: take away congress's benefits and force them to swim in the sewage with the rest of us. I guarantee we'd have government-sponsored, universal coverage, in place by next Tuesday.
Anyone wishing to donate to Ashtyn Montali's charity,
Butterfly Dreams, can click the link below.
ashysbutterflydreams.com
