Something We Can All Cheer About: Gold Medal Coverage

Many American Olympic athletes, despite being in incredible physical shape, face a tough time navigating the health care system and acquiring comprehensive coverage, just like us mere mortals.

Some Olympic athletes get their health care coverage through a Blue Cross Blue Shield program called the Elite Athletes Health Insurance (EAHI) plan. This plan covers the basics like preventive care and doctor’s visits, but of all things vital to elite athletes, it doesn’t cover sports injuries.

Given their high risk of injury and the EAHI’s high deductible, nearly all Olympic athletes have to buy a secondary plan that covers catastrophic injuries.  Not only do these athletes have to make sense of the different options and benefits, but out-of-pocket costs are based on their sport and level of competition. Athletes with less experience often face higher deductibles.

The EAHI doesn’t even cover all athletes. Each sport gets an allotted number of slots so those who don’t make the cut have to find coverage elsewhere. Athletes who don’t make the Olympic team usually won’t have access to EAHI and aren’t likely to have employer-based coverage.

American swimmer Dana Vollmer is exactly the type of athlete who could fall between the cracks in this broken system. At age 15, Vollmer was diagnosed with a potentially fatal heart problem known as Long QT syndrome. In order for her to keep competing, Dana’s mother had to bring an external defibrillator to Dana’s meets in case her heart stopped beating.

After making the Olympic team in 2004 at age 16, Vollmer failed to make the team again in 2008. With serious health problems and an inconsistent career, Dana worried about securing health care coverage:

“If she couldn't make the Olympics when her days as a student-athlete at Cal were finished, how would she pay the bills? Where would she get health insurance?”  

While many elite athletes do not have serious health problems, they’re all at risk for sports-related injuries, which can be considered a pre-existing condition and make it difficult to obtain affordable coverage in the individual health insurance market.

Luckily, changes to our health care system under the new health care law make it easier to get the coverage you need. Health care reform gives us all something to cheer about-- whether you’re an Olympic athlete or someone with a chronic illness.

For example, young Olympians like Dana Vollmer now have the option to stay on their parents’ insurance until age 26. Over six million young adults have already benefited from this provision.

In 2014, the Affordable Care Act will dramatically change the insurance market, making it easier to obtain comprehensive health insurance. For example:

• Insurance companies will no longer be allowed to deny coverage to people with pre-existing conditions;
• Insurers will not be able to charge you more because of your health status. Premiums can only vary by age, tobacco use, where you live, and your family size;
• New health insurance marketplaces, called exchanges, will make comparing and purchasing health plans easier.

Last week, Dana Vollmer won a gold medal, breaking the world record in the 100-meter butterfly and becoming the first woman to ever break the 56-second mark in the event.

Luckily for Dana, she no longer shows signs of her heart condition. Her story reminds us that while she proved invincible in the pool, none of us are invincible when it comes to our health.

As we celebrate stories of American triumph during the Olympics, let’s also celebrate another American victory— the Affordable Care Act.