Karla Rodriguez didn’t know what was wrong, but something was definitely wrong. Her entire lower body was swollen, she was in pain, and she had a cough.
Rodriguez, who lives in St. Anthony, went to a local urgent care clinic on a Friday in late August. There, she was diagnosed with an ear infection.
Rodriguez — a full-time mother of two young children — got worse over the next few weeks. She returned to the clinic, where the same doctor examined her a second time.
“(He) checked me, checked my eyes, and he’s like, ‘Uh …’” Rodriguez recalls. “He asked the nurse, ‘Are you seeing what I’m seeing?’”
The whites of her eyes were yellow, a sign of liver damage.
She soon learned she had a life-threatening disease. Without treatment, Rodriguez would die — and she had no health insurance.
Rodriguez is a “Dreamer” — an adult who was brought into the U.S. illegally as a child and received legal protection from deportation under the Deferred Action for Childhood Arrivals (DACA) program.
She was 6 years old when her family brought her to the U.S. from Mexico.
Because she is a DACA recipient instead of a U.S. citizen, Rodriguez isn’t eligible for Medicaid in Idaho and does not qualify for premium subsidies on Idaho’s health insurance exchange.
An estimated 2,760 people in Idaho were active DACA recipients as of March 2020, according to a report from U.S. Citizenship and Immigration Services. That included about 1,180 people in the Boise area.
About 39% of DACA recipients nationwide had no health insurance coverage in 2017, according to a report last year from the National Center for Children in Poverty. The vast majority of the DACA recipients who did have coverage got their insurance through job benefits — their own or a family member’s.
Only California, Massachusetts, Minnesota, New York, Washington and the District of Columbia offered state-funded health insurance coverage to some or all DACA recipients as of 2021.
Medical treatment just out of reach
By the time Rodriguez went back to the urgent care clinic, she could hardly walk, she said.
After her exam, the doctor sent her to Bingham Memorial Hospital in Blackfoot. She arrived around 9:30 p.m. and received pain medicine and a CT scan. About five hours later, a doctor told her she had cancer — and sent her to a larger hospital for more tests.
At just 26 years old, Rodriguez was diagnosed with multiple myeloma, a cancer that most often attacks people decades older than Rodriguez.
“The doctor was really surprised, because (multiple myeloma) happens to older people,” Rodriguez said in a January interview. “My bones have holes in them, and I have some other lesions in my heart, in my head and then in my lungs.”
Her liver also is three times the normal size and has lesions, she said.
With recent advances in cancer treatment, Rodriguez had options. She could receive radiation, chemotherapy, immunotherapy and/or a bone marrow transplant to potentially save her life.
Hospitals are not required to provide free medical care to people who don’t have an immediate medical emergency. And bone marrow transplants are among the most expensive medical procedures out there. So, much of the health care Rodriguez needed was out of reach until she could get insured.
Her best option was to buy private health insurance — but her plan wouldn’t kick in until Jan. 1, four months into her diagnosis.
Her sister created a GoFundMe fundraiser to help Rodriguez buy health insurance and pay the out-of-pocket bills already accumulating.
In four months, the GoFundMe has raised $1,135 of a $30,000 goal.
‘I’ve been getting bills and bills and bills’
Rodriguez had visits to urgent care and two hospitals, numerous blood tests, a bone marrow biopsy from her spine, X-rays, scans and an echocardiogram, she told the Idaho Capital Sun. And that was just the medical care she received on the road to a diagnosis — before she could even start treatment.
“I’ve been getting bills and bills and bills,” Rodriguez said.
How much?
“I don’t even know,” she said.
She regularly calls around to health care providers and pays “a little bit, just so it doesn’t go to collections,” she said. She also paid thousands of dollars to health care providers as “down payments” on treatments.
Rodriguez has now undergone multiple rounds of radiation and chemotherapy. Those treatments and the disease itself have ravaged her body. She had dental surgery to remove teeth, because of bone loss in her jaw. Her gums didn’t heal, so she underwent hyperbaric oxygen therapy. Her ears began to bleed from the hyperbaric pressure, so she needed tubes inserted in her eardrums by an ear-nose-and-throat specialist.
Rodriguez also has an 80-mile round-trip drive to the cancer center in Idaho Falls for chemotherapy. By mid-January, she’d made that drive at least 36 times.
Rodriguez’s mother helps Rodriguez and her partner take care of their children.
The light at the end of the tunnel: a bone marrow transplant
For the bone marrow transplant that could save her life, Rodriguez will go to Salt Lake City.
Her doctors told her to expect two transplants — often what it takes to put multiple myeloma into remission, according to the Mayo Clinic.
Each transplant isn’t a one-day procedure, though. It is a process that involves harvesting stem cells from a patient, giving the patient heavy duty chemotherapy to kill their diseased bone marrow, then replacing it with stem cells.
The process leaves a patient vulnerable to infection. With new bone marrow, their immune system is like that of a newborn baby.
The health insurance plan she bought has a $6,000 annual out-of-pocket maximum for medical care, a $1,500 out-of-pocket maximum for prescription drugs, and a monthly premium of about $500 per month, she said.
That is expensive, but it could have been worse. Before the Affordable Care Act, she likely would have been turned down for health insurance if she applied after her first trips to the hospital in August. The cancer would have been a pre-existing condition.
“I was glad that it was able to take me when I was already diagnosed,” she said.
On Thursday, Rodriguez was discharged from Intermountain Healthcare’s LDS Hospital in Salt Lake City. She spent about two weeks hospitalized for intensive chemotherapy and monitoring. It was the first big step toward her transplant — getting her body ready for the stem cell harvest, she said.
“It was hard at the beginning, but now we’re almost seeing the end of the tunnel, with starting the process of the bone marrow transplants,” she said.
