Michele Gonzalez: When Getting a Job Made Health Care Less Affordable

Michele Gonzalez, a 45-year-old from Bethlehem, Pennsylvania, has navigated multiple physical and mental health challenges while managing the rising costs of health care. In 2021, she was diagnosed with chronic obstructive pulmonary disease (COPD), and needs required daily inhalers, which cost nearly $100 per month even with her co-pay. At that time, she also discovered a nodule in her lung. She had scheduled MRIs and CAT scans to monitor the lung nodule, but the $250 co-pay for each test made them impossible. “With the cost of living, I have to pick and choose what I’m going to do,” she said. Reflecting on her lung health, Michele shared, “I am scared. Both my parents passed away from lung disease, so it is definitely a worry of mine.”

Michele was also diagnosed with a mental illness a few years ago and relied on medications, therapy, and regular visits to a psychiatrist. At the time, she was covered by Medicaid, which helped keep the cost of her treatment manageable. But when she started a full-time job and transitioned to employer-sponsored coverage, she found that she could no longer afford the care she had been receiving. “I couldn’t afford the medication anymore. I couldn’t afford a psychiatrist. I couldn’t afford a therapist. So I have to decide to stop that,” Michele explained.

Foregoing therapy and psychiatric care has affected her life, though her previous seven years of treatment provide some foundation. “I do definitely have anxiety and certain things that come out every now and then, racing thoughts and stuff that the medication was helping me with. I’ve just learned to pretty much deal with it because what am I going to do?” she said.

Michele prioritizes essential medications but sometimes goes weeks without them due to cost. “I pretty much weigh what I can go without and what I can’t. Like, there are months where I don’t get my inhaler on time. I go weeks without it, so I even have to compromise with that,” she shared.

Reflecting on the broader issue, Michele urged, “I know bringing down the cost is probably hard to impossible, but definitely provide or try to provide some kind of assistance for people who are actually trying to survive and trying to do better and live.”

Michele’s story highlights the difficult trade-offs many Americans face when trying to manage chronic conditions and mental health care, even with insurance, and how moving from Medicaid to employer-sponsored coverage can sometimes make care less affordable.